健康孕妇和子痫前期孕妇黄斑中心凹下不同脉络膜分层厚度变化的对比分析

摘要

目的 观察正常女性、健康孕妇和子痫前期孕妇的黄斑中心凹下不同脉络膜分层厚度的变化和差异.方法 经我院妇产科检查确诊的子痫前期患者22例22眼(子痫前期孕妇组)、孕20周以上的健康孕妇22例22眼(健康孕妇组)以及正常女性22例22眼(正常女性组)纳入研究.所有患者均进行最佳矫正视力(best corrected visual acuity,BCVA)、眼压、裂隙灯检查及光学相干断层扫描(optical coherence tomography,OCT)检查.采用OCT测量受检者黄斑中心凹下脉络膜厚度(subfoveal choroidal thickness,SFCT)、脉络膜大血管层厚度(large choroidal vessel thickness,LCVT)、脉络膜毛细血管层/中血管层厚度(medium choroidal vessel thickness,MCVT),并比较三组之间的差异.结果 三组间年龄、等效球镜度数比较差异均无统计学意义(均为P＞0.05);健康孕妇组与子痫前期孕妇组的孕周比较差异亦无统计学意义(P＞0.05).正常女性组、健康孕妇组、子痫前期孕妇组的SFCT分别为(263.45±69.66) μm、(310.55±55.63) μm、(350.41±54.32) μm;LCVT分别为(188.25±60.88) μm、(213.27±65.31) μm、(264.77±56.21)μm;MCVT分别为(75.20±33.65)μm、(97.27±22.14)μm、(85.64±20.93) μm.三组受检眼SFCT、LCVT、MCVT比较差异均有统计学意义(均为P＜0.05).健康孕妇组SFCT、MCVT较正常女性组厚,差异均统计学意义(均为P ＜0.05),而两组LCVT比较,差异无统计学意义(P=0.199).子痫前期孕妇组SFCT、LCVT较健康孕妇组厚,差异均有统计学意义(均为P ＜0.05),而两组MCVT比较,差异无统计学意义(P=0.070).结论 子痫前期孕妇较健康孕妇SF-CT、LCVT厚度增加,MCVT无明显差异.%Objective To compare different layers of subfoveal choroidal thickness (SFCT) in normal subjects,healthy pregnant women and patients with pre-eclampsia (PE) using optical coherence tomography (OCT).Methods Twenty-two normal subjects,22 healthy pregnant women and 22 PE patients were included.All patients underwent the examinations including the best corrected visual acuity (BCVA),intraocular pressure,slit lamp,and OCT.The OCT examination was performed to measure SFCT,large choroidal vessel thickness (LCVT),and choroidal capillaries/medium choroidal vessel thickness (MCVT),and the differences between the three groups were compared.Results The differences in age and spherical equivalent among normal subjects,healthy pregnant women and patients with pre-eclampsia were not significant (all P ＞ 0.05).The differences in the gestational weeks between healthy pregnant women and PE patients was not significant (P ＞ 0.05).The mean SFCT of the normal group,healthy pregnant group and PE patient group was (263.45 ± 69.66) μm,(310.55 ±55.63) μm,and (350.41 ± 54.32) μm,accordingly,the mean LCVT of the normal group,healthy pregnant group and PE patient group was (188.25 ± 60.88) μm,(213.27 ±65.31) lμm,and (264.77 ± 56.21) μm,respectively;the mean MCVT of the normal group,healthy pregnant goup and PE patient group was (75.20 ± 33.65) μm,(97.27 ±22.14) μm,(85.64 ± 20.93) μm,respectively,with statistically significance in pairwise comparison (all P ＜ 0.05).The mean SFCT and MCVT of healthy pregnant women was significantly increased than that of the normal subjects (both P ＜ 0.05),but not for LCVT (P ＞ 0.05);whereas SFCT and LCVT of PE patients were significantly increased than those of healthy pregnant women (both P ＜ 0.05),but not for MCVT (P ＞ 0.05).Conclusion The SFCT and LCVT in PE patients are both higher than those in healthy pregnant women,and there is no significant difference in MCVT.