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目的:探讨慢性肾衰竭患者血液透析前后眼内压与房角结构变化及机制分析。方法:选取因慢性肾衰竭长期在海南省人民医院进行血液透析治疗患者58例(116眼)分别在血透前及血透后应用Goldmann眼压计测量眼压及用眼前段OCT检测房角开放距离。根据血透前房角镜检查分为窄角组、宽角组及虹膜新生血管组。测量血透前后上述患者尿素氮、肌酐、白蛋白。采并用配对t检验进行分析比较。结果:窄角组及虹膜新生血管组透析后眼压较透析前升高,其中虹膜新生血管组升高显著;宽角组透析后眼压则无明显升高。血透后房角开放距离较血透前变小。患者血尿素氮、肌酐在血透后较血透前显著降低,而白蛋白血透后增高。结论:血液透析可致窄房角及有虹膜新生血管的患者眼压不同程度升高,可能与房水流出通路阻力增加及血透后患者血浆渗透压的改变有关。故对需进行血透治疗的慢性肾衰竭患者进行血透前眼部情况的评估,减少血透对患者视功能的损伤。
Objective: To investigate the changes of intraocular pressure and angle structure before and after hemodialysis in patients with chronic renal failure and the mechanism analysis. Methods: Fifty-eight patients (116 eyes) with long-term chronic renal failure who underwent hemodialysis in Hainan Provincial People’s Hospital were enrolled in the study. The intraocular pressure was measured before and after hemodialysis using the Goldmann tonometer. distance. According to hemodialysis Gonioscopy is divided into narrow-angle group, wide angle group and iris neovascularization group. Before and after the measurement of hemodialysis patients with urea nitrogen, creatinine, albumin. Mining and paired t-test analysis and comparison. Results: The IOP of the narrow angle group and the iris neovascularization group was significantly higher than that before dialysis, especially in the iris neovascularization group. However, the IOP in the wide angle group did not increase significantly after dialysis. Hemodialysis angle after the opening angle becomes smaller than before hemodialysis. Blood urea nitrogen, creatinine in hemodialysis after hemodialysis was significantly lower, while albumin hemodialysis increased. Conclusion: Hemodialysis can cause narrow angle and iris neovascularization in patients with intraocular pressure increased to varying degrees, may be related to increased resistance to aqueous outflow pathway and plasma osmolality in patients with hemodialysis. Therefore, the need for hemodialysis treatment of patients with chronic renal failure before hemodialysis assessment of the situation of the eye to reduce the risk of hemodialysis patients with visual impairment.