• 【一般实践中的眼压计-其在原发性开角型青光眼的早期检测中的应用。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:König HL
    BACKGROUND & AIMS: The intra-ocular pressure of 1078 general practice patients aged over 45 years was measured with the Schiötz tonometer. Primary open-angle glaucoma was found in 29 patients (2.7%) and ocular hypertension in 40 (3.7%). The technique of using the tonometer is described and a plea is made for general practitioners to make more use of it in screening their patients for glaucoma.

    背景与目标: 用schi ö tz眼压计测量了1078名年龄在45岁以上的全科患者的眼内压。原发性开角型青光眼29例 (2.7%),高眼压40例 (3.7%)。描述了使用眼压计的技术,并呼吁全科医生更多地利用它来筛查青光眼患者。
  • 【儿童的正常眼压: Perkins压平眼压计和气动眼压计的比较研究。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Jaafar MS,Kazi GA
    BACKGROUND & AIMS: We measured the intraocular pressure (IOP) of 50 normal, cooperative, awake children below 5 years of age and 12 normal, volunteer adults with the Perkins hand-held applanation tonometer (Perkins) and the Digilab pneumatonographer-tonometer (Pneuma). Neither sedation, general anesthesia, nor lid specula were used. We confirmed others' findings that the normal IOP, measured in the supine position with the Perkins, is lower in infants and young children (mean = 5.89 mm Hg) than in adults (mean = 13.21 mm Hg; P < .0001). On the other hand, with the Pneuma, the supine pediatric IOP (mean = 14.76 mm Hg) was not significantly different from the adult sitting IOP (mean = 14.42 mm Hg; P = .497). Regression analysis suggests that children and adult Perkins IOP may become equal at around age 12 years.

    背景与目标: 我们使用Perkins手持式压平眼压计 (Perkins) 和Digilab气动眼压计 (Pneuma) 测量了50名5岁以下正常,合作,清醒的儿童和12名正常的志愿者成年人的眼压 (IOP)。既不使用镇静,全身麻醉也不使用盖子。我们证实了其他人的发现,即在Perkins仰卧位测量的正常IOP在婴儿和幼儿 (平均 = 5.89毫米Hg) 中比成人 (平均 = 13.21毫米Hg; P < .0001) 低。另一方面,对于肺炎,仰卧小儿IOP (平均 = 14.76毫米Hg) 与成人坐位IOP (平均 = 14.42毫米Hg; P = .497) 没有显着差异。回归分析表明,儿童和成年Perkins IOP可能在12岁左右变得平等。
  • 【比较从血压计,欧姆龙HEM-9000AI和颈动脉压平眼压计获得的中心压力估计值。】 复制标题 收藏 收藏
    DOI:10.1097/HJH.0b013e328346a3bc 复制DOI
    作者列表:Kips JG,Schutte AE,Vermeersch SJ,Huisman HW,Van Rooyen JM,Glyn MC,Fourie CM,Malan L,Schutte R,Van Bortel LM,Segers P
    BACKGROUND & AIMS: BACKGROUND:The Omron HEM-9000AI is the first automated tonometer to provide an estimate of central SBP (cSBP), which is considered to be more predictive of cardiovascular events than brachial pressure. However, considerable differences between the cSBP estimate of Omron and that of SphygmoCor have been reported, but not explained. This study assesses the sources of differences between both cSBP estimates and provides a handle on which estimate is closest to reality. METHOD:For this purpose, aortic cSBP derived from calibrated carotid SBP was used as device- and algorithm-independent reference. Radial, brachial and carotid applanation tonometry were performed in 143 black South Africans, aged 39-91 years. Each individual was measured with an Omron HEM-9000AI and a SphygmoCor. RESULTS:When using both devices as advocated by their manufacturers, the corresponding cSBP estimates correlated strongly (r = 0.99, P < 0.001), but the Omron estimate was 18.8 (4.3) mmHg higher than the SphygmoCor estimate. Aortic SBP was in between both estimates: 11.7 (5.5) mmHg lower than cSBP-Omron and 7.1 (5.0) mmHg higher than cSBP-SphygmoCor. Alternative calibration of the radial SphygmoCor-curves with radial instead of brachial pressures yielded a cSBP that was 3.0 (4.2) mmHg lower than aortic SBP. The shape of the recorded pressure waves was similar in both devices: less than 5% of the observed cSBP difference was caused by differences in wave shape. CONCLUSION:The results from this study demonstrate that the considerable difference between the central pressure estimates of Omron HEM-9000AI and SphygmoCor is due to algorithm differences, and suggest that the overestimation by Omron HEM-9000AI is larger than the underestimation by SphygmoCor.
    背景与目标:
  • 【颈动脉内膜中层厚度与外周动脉眼压计之间的不一致相关性: 巴西成人健康纵向研究 (ELSA-Brasil)。】 复制标题 收藏 收藏
    DOI:10.1097/MD.0000000000001403 复制DOI
    作者列表:Lemos SP,Passos VMA,Brant LCC,Bensenor IJM,Ribeiro ALP,Barreto SM
    BACKGROUND & AIMS: :To estimate the association between 2 markers for atherosclerosis, measurements of carotid artery intima-media thickness (IMT) and of peripheral arterial tonometry (PAT), and to evaluate the role of traditional cardiovascular risk factors in this association.We applied the 2 diagnostic tests to 588 participants from the ELSA-Brazil longitudinal study cohort. The PAT measurements, obtained with the EndoPAT2000, were the reactive hyperemia index (RHI), the Framingham RHI (F-RHI), and the mean basal pulse amplitude (BPA). We used the mean of the mean scores of carotid IMT of the distal layers of the left and right common carotids obtained by ultrasonography after 3 cardiac cycles. We used linear regression and the Spearman correlation coefficient to test the relationship between the 2 markers, and multiple linear regressions to exam the relationship between the RHI/F-RHI scores and the mean BPA and IMT scores after adjusting for cardiovascular risk factors.In the multivariate analysis, RHI (but not F-RHI) was positively correlated with the mean of the means of the IMT values after adjusting for sex and risk factors connected with both measures (β = 0.05, P = 0.02). Mean BPA did not remain significantly associated with IMT after adjusting for common risk factors.We found that the higher the IMT (or the worse the IMT), the higher the RHI (or the better the endothelial function). F-RHI was not associated with IMT. These 2 results are against the direction that one would expect and may imply that digital endothelial function (RHI and F-RHI) and IMT correspond to distinct and independent stages of the complex atherosclerosis process and represent different pathways in the disease's progression. Therefore, IMT and PAT measures may be considered complementary and not interchangeable.
    背景与目标: : 为了评估动脉粥样硬化的2种标志物,颈动脉内膜中层厚度 (IMT) 的测量和周围动脉眼压计 (PAT) 之间的关联,为了评估传统心血管危险因素在这一关联中的作用,我们对来自ELSA-巴西纵向研究队列的588名参与者进行了2项诊断测试。使用EndoPAT2000获得的PAT测量值是反应性充血指数 (RHI),弗雷明汉RHI (f-rhi) 和平均基础脉冲幅度 (BPA)。我们使用了3个心动周期后通过超声检查获得的左右普通颈动脉远端颈动脉IMT平均得分的平均值。我们使用线性回归和Spearman相关系数来检验2个标志物之间的关系,并使用多元线性回归来检验校正心血管危险因素后RHI/F-RHI评分与平均BPA和IMT评分之间的关系。在多变量分析中,RHI (而非f-rhi) 在调整了与两种措施相关的性别和危险因素后,与IMT值的平均值呈正相关 (β   =   0.05,p   =   0.02)。在调整常见危险因素后,平均BPA与IMT没有显著相关。我们发现IMT越高 (或IMT越差),RHI越高 (或内皮功能越好)。F-rhi与IMT无关。这两个结果违背了人们期望的方向,并可能暗示数字内皮功能 (RHI和f-rhi) 和IMT对应于复杂动脉粥样硬化过程的不同和独立的阶段,并代表了疾病进展的不同途径。因此,IMT和PAT措施可能被认为是互补的,不可互换。
  • 【使用静态,动态和非接触式眼压计进行LASIK术后角膜生物力学和眼内压的变化。】 复制标题 收藏 收藏
    DOI:10.1016/j.ajo.2006.09.036 复制DOI
    作者列表:Pepose JS,Feigenbaum SK,Qazi MA,Sanderson JP,Roberts CJ
    BACKGROUND & AIMS: PURPOSE:To compare the preoperative and postoperative measurement of corneal biomechanical properties and intraocular pressure (IOP) using Goldmann applanation tonometry (GAT), the ocular response analyzer (ORA), and the Pascal dynamic contour tonometer (PDCT) in eyes undergoing myopic laser in situ keratomileusis (LASIK). DESIGN:Prospective, nonrandomized clinical trial. METHODS:IOP was measured in 66 myopic eyes before and after LASIK by GAT, ORA, and PDCT in a randomized sequence. Metrics of corneal biomechanical properties (corneal hysteresis [CH], corneal resistance factor [CRF], and ocular pulse amplitude [OPA]) were recorded. RESULTS:After LASIK, there was a reduction in mean corneal pachymetry of 90.2 mum and in IOP measurements with GAT (Delta = -1.8 +/- 2.8 mm Hg; P < .01), ORA-Goldmann (Delta = -4.6 +/- 2.8 mm Hg, P < .01), and ORA-corneal compensated (Delta - 2.1 +/- 2.6 mm Hg; P < .05). However, there was no statistically significant difference between preoperative and postoperative IOP measurements taken by PDCT (Delta = -0.5 +/- 2.6 mm Hg). Postoperatively, CRF decreased by 28.6% (P < .01), CH by 16.2% (P < .01), and OPA by 1.8% (P = .32). CONCLUSIONS:Measurement of IOP with PDCT appears to be relatively immune to changes in corneal biomechanics and pachymetry after LASIK, in comparison to GAT and ORA measures of IOP. PDCT and ORA both showed statistically lower variation in measurement than GAT. LASIK produced a marked decline in CH and CRF, which may reflect respective changes in the viscous and elastic qualities of the post-LASIK cornea. In contrast, there was no statistical change in OPA.
    背景与目标:
  • 【评估新的原型水凝胶CO( 2) 传感器; 与空气眼压计的比较。】 复制标题 收藏 收藏
    DOI:10.1007/s10877-006-9060-x 复制DOI
    作者列表:ter Steege RW,Herber S,Olthuis W,Bergveld P,van den Berg A,Kolkman JJ
    BACKGROUND & AIMS: OBJECTIVE:Gastrointestinal ischemia is always accompanied by an increased luminal CO(2). Currently, air tonometry is used to measure luminal CO(2). To improve the response time a new sensor was developed, enabling continuous CO(2) measurement. It consists of a pH-sensitive hydrogel which swells and shrinks in response to luminal CO(2), which is measured by the pressure sensor. We evaluated the potential clinical value of the sensor during an in vitro and in vivo study. METHODS:The response time to immediate, and stepwise change in pCO(2) was determined between 5 and 15 kPa, as well as temperature sensitivity between 25 and 40 degrees C at two pCO(2) levels. Three sensors were compared to air tonometry (Tonocap) in healthy volunteers using a stepwise incremental exercise test, followed by a period of hyperventilation and an artificial CO(2)-peak. RESULTS:The in vitro response time to CO(2) increase and decrease was mean 5.9 and 6.6 min. The bias, precision and reproducibility were +5%, 3% and 2%, resp. Increase of 1 degrees C at constant pCO(2) decreased sensor signal by 8%. In vivo tests: The relation with the Tonocap was poor during the exercise test. The response time of the sensor was 3 min during hyperventilation and the CO(2) peak. CONCLUSION:The hydrogel carbon dioxide sensor enabled fast and accurate pCO(2) measurement in a controlled environment but is very temperature dependent. The current prototype hydrogel sensor is still too unstable for clinical use, and should therefore be improved.
    背景与目标:
  • 【胃压计和直接腹内压监测在腹腔室综合征中的作用。】 复制标题 收藏 收藏
    DOI:10.1053/jpsu.2002.30257 复制DOI
    作者列表:Engum SA,Kogon B,Jensen E,Isch J,Balanoff C,Grosfeld JL
    BACKGROUND & AIMS: BACKGROUND/PURPOSE:Abdominal compartment syndrome (ACS) may complicate abdominal closure in patients with abdominal wall defects, abdominal trauma, intraperitoneal bleeding, and infection. Increased intraabdominal pressure (IAP) leads to respiratory compromise, organ hypoperfusion, and a high mortality rate. This study evaluates the efficacy of continuous direct monitoring of IAP and gastric tissue pH in detecting impending ACS.

    METHODS:Ten mongrel puppies weighing 2.8 to 6.4 kg underwent general endotracheal anesthesia, placement of an intraabdominal inflatable balloon to simulate ACS and a Swan-Ganz catheter to measure direct IAP. A gastric tonometer, nasogastric tube, foley catheter, and arterial catheter also were inserted. Half-hourly inflation's of the intraabdominal balloon were used to simulate the development of ACS. Direct intraabdominal (IAP), gastric (GP), bladder (BP), and peak airway pressures (PAP) were measured. Gastric tonometry fluid and arterial blood gas levels were obtained during inflation, and the gastric tissue pH level was calculated. Data were statistically analyzed using Pearson's correlation coefficients.

    RESULTS:Baseline pressures were 2 to 5 cm H(2)O in the stomach and bladder catheters, 1 to 3 mm Hg in the intraabdominal catheter, and correlated with a gastric tissue pH level of 7.4. Significantly high correlation coefficients (cc) were observed between IAP versus BP (cc, 0.77; P <.002). IAP versus GP (cc, 0.79; P <.002) and IAP versus PAP (c, 0.83; P <.0004). A high negative correlation coefficient was noted between gastric pH and IAP (cc, 0.61; P <.026). The pH level dropped to 7.0 with BP and GP of 20 cm H(2)O and IAP of 10 mm Hg, to 6.8 at 30 cm H(2)O and 20 mm Hg, and 6.5 at 40 cm H(2)O and 30 mm Hg, respectively. However, correlation coefficients between gastric tissue pH and BP, GP, or PAP were not significant.

    CONCLUSIONS:These data suggest that continuous direct intraabdominal pressure monitoring is a simple and effective method that correlates well with indirect bladder or gastric pressure measurement. Changes in gastric tissue pH in association with increased intraabdominal pressure may be an early indicator of impending abdominal compartment syndrome. These observations indicate that these techniques may be more sensitive than current methods of indirect measurement, which may be associated with delayed recognition of ACS.

    背景与目标: 背景/目的 : 腹部室室综合征 (ACS) 可能使腹壁缺损,腹部创伤,腹膜内出血和感染的患者的腹部闭合复杂化。腹内压力 (IAP) 升高会导致呼吸系统损害,器官灌注不足和高死亡率。这项研究评估了连续直接监测IAP和胃组织ph值在检测即将发生的ACS中的功效。
    方法 : 十只体重2.8至6.4千克的杂种幼犬接受了全身气管内麻醉,放置腹腔内可充气球囊以模拟ACS,放置Swan-Ganz导管以测量直接IAP。还插入了胃眼压计,鼻胃管,foley导管和动脉导管。腹腔球囊的半小时充气用于模拟ACS的发展。测量直接腹腔内 (IAP),胃 (GP),膀胱 (BP) 和气道峰值压力 (PAP)。在充气过程中获得胃眼压计液和动脉血气水平,并计算胃组织pH水平。使用Pearson相关系数对数据进行统计学分析。
    结果 : 胃和膀胱导管中的基线压力为2至5厘米H(2)O,腹腔导管中的1至3毫米Hg,并且与7.4的胃组织pH水平相关。在IAP与BP之间观察到显着的高相关系数 (cc) (cc,0.77; P <.002)。IAP与GP (cc,0.79; P <.002) 和IAP与PAP (c,0.83; P <.0004)。胃pH与IAP之间存在较高的负相关系数 (cc,0.61; P <.026)。pH水平下降至7.0,BP和GP为20厘米H(2)O,IAP为10毫米Hg,6.8在30厘米H(2)O和20毫米Hg,6.5在40厘米H(2)O和30毫米Hg,分别。但是,胃组织pH与BP,GP或PAP之间的相关系数并不显着。
    结论 : 这些数据表明,连续的直接腹内压监测是一种简单而有效的方法,与间接膀胱或胃压测量密切相关。胃组织ph值的变化与腹内压力升高有关,可能是即将发生腹腔室综合征的早期指标。这些观察结果表明,这些技术可能比当前的间接测量方法更敏感,这可能与ACS的延迟识别有关。
  • 【在控制性低血压中通过动脉眼压计测量血压。】 复制标题 收藏 收藏
    DOI:10.1213/00000539-199107000-00011 复制DOI
    作者列表:Kemmotsu O,Ueda M,Otsuka H,Yamamura T,Okamura A,Ishikawa T,Winter DC,Eckerle JS
    BACKGROUND & AIMS: :A newly developed arterial tonometer enabled us to measure the blood pressure waveforms in addition to determining systolic and diastolic pressures noninvasively and continuously. Twenty-eight adult patients undergoing orthopedic surgery under controlled hypotension were studied. Systolic blood pressure was reduced to two-thirds of baseline values with an infusion of nitroglycerin during nitrous oxide/enflurane anesthesia. Intraarterial blood pressures were simultaneously measured in either the right or the left radial artery with a cannula and a Gould P23XL calibrated transducer; tonometric monitoring was performed on the contralateral radial artery using a Colin CBM-3000 instrument. The outputs of the two blood pressure measurement instruments were recorded for later data analysis. The shape of the tonometric pressure waveform was nearly identical to the waveform recorded intraarterially even during controlled hypotension. Regression analyses of 2039 paired tonometric and intraarterial blood pressure values during the hypotensive period showed good correlations (r = 0.78 for systolic, r = 0.81 for mean, and r = 0.70 for diastolic pressures). The accuracy of systolic, mean, and diastolic readings was from 4 to 7 mm Hg with negligible bias and did not differ significantly among six systolic, four mean, and four diastolic pressure groups. Our results indicate that arterial tonometry can provide accurate, reliable, and real-time monitoring of blood pressure even during controlled hypotension.
    背景与目标: : 新开发的动脉眼压计使我们能够测量血压波形,此外还可以无创,连续地确定收缩压和舒张压。研究了28例在控制性低血压下接受骨科手术的成年患者。在一氧化二氮/恩氟烷麻醉期间输注硝酸甘油使收缩压降低至基线值的3分之2。使用套管和Gould P23XL校准的换能器同时测量右或左radial动脉的动脉内血压; 使用Colin CBM-3000仪器对对侧radial动脉进行眼压监测。记录了两种血压测量仪器的输出,以进行以后的数据分析。即使在控制性低血压期间,眼压波形的形状也几乎与动脉内记录的波形相同。2039年在低血压期间成对的眼压和动脉内血压值进行的回归分析显示出良好的相关性 (收缩压r = 0.78,平均值r = 0.81,舒张压r = 0.70)。收缩压,平均值和舒张压读数的准确性为4至7毫米Hg,偏倚可忽略不计,并且在六个收缩压,四个平均值和四个舒张压组中没有显着差异。我们的结果表明,即使在控制性低血压期间,动脉眼压计也可以提供准确,可靠和实时的血压监测。
  • 【角膜厚度对气压计,Goldmann压平眼压计和Tono-Pen眼压测量的影响。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Bhan A,Browning AC,Shah S,Hamilton R,Dave D,Dua HS
    BACKGROUND & AIMS: PURPOSE:To compare intraocular pressure (IOP) measurements of the Ocular Blood Flow (OBF) pneumotonometer, Goldmann applanation tonometer, and Tono-Pen in eyes with normal corneas of various thicknesses. METHODS:IOP was measured with an OBF pneumotonometer, Tono-Pen and Goldmann applanation tonometer in random order in 181 eyes with normal corneas. Central corneal thickness (CCT) was measured using an ultrasonic pachymeter after all IOP determinations had been made. Right and left eyes were analyzed separately for statistical purposes. RESULTS:With all instruments, IOP varied with CCT, even though the variation in IOP was large. Readings with the OBF pneumotonometer showed a mean increase in IOP with increasing CCT of 0.28 mm Hg/10 microm, an increase of 0.23 mm Hg/10 microm with the Goldmann tonometer, and of 0.10 mm Hg/10 microm with the Tono-Pen. The OBF pneumotonometer consistently recorded comparatively higher IOPs than the other two instruments. CONCLUSIONS:The Tono-Pen is least affected by CCT when used to measure IOP in eyes with normal corneas. The OBF pneumotonometer appears to be more affected by variation in CCT than the Goldmann tonometer. This is contrary to expectations, based on the mechanism of measurement of IOP of the OBF pneumotonometer.
    背景与目标:
  • 【患者主动脉压的无创测量: 比较脉搏波分析和压平眼压计。】 复制标题 收藏 收藏
    DOI:10.4103/0253-7613.93855 复制DOI
    作者列表:Naidu MU,Reddy CP
    BACKGROUND & AIMS: OBJECTIVE:The aim of the present study was to validate and compare novel methods to determine aortic blood pressure non-invasively based on Oscillometric Pulse Wave Velocity (PWV) measurement using four limb-cuff pressure waveforms and two lead Electrocardiogram (ECG) with a validated tonometric pulse wave analysis system in patients. MATERIALS AND METHODS:After receiving the consent, in 49 patients with hypertension, coronary artery disease, diabetes mellitus, PWV, and central blood pressures were recorded in a randomised manner using both the oscillometric and tonometric devices. All recordings were performed 10 minutes after the patient lying comfortably in a noise-free temperature-controlled room. The test was performed between 09 am and 10 am after overnight fast. A minimum of three measurements were performed by the same skilled and trained operator. From the raw data obtained with two devices, software calculated the final vascular parameters. RESULTS:A total of 49 patients (8 women and 41 men), of mean age 40.5 years (range: 19-81 years) participated in the present study. After transforming the brachial pressures into aortic pressures, the correlation coefficient between the Aortic Systolic Pressure (ASP) values obtained with two methods was 0.9796 (P<0.0001). The mean difference between ASP with two methods was 0.3 mm Hg. Similarly, Aortic Diastolic Pressure (ADP) values obtained with two methods also correlated significantly with correlation coefficient of 0.9769 (P<0.0001). The mean difference of ADP was 0.2 mm Hg. In case of Aortic Pulse Pressure (APP), the mean difference was 0.1 mm Hg. All parameters of central aortic pressures obtained with two methods correlated significantly. CONCLUSION:The new method of transforming the Carotid Femoral PWV (cfPWV) and brachial blood pressure values into aortic blood pressure values seems to be reasonably good. The significant correlation between the values obtained by tonometric device and oscillometric PWV method shows that the latter can be used non-invasively in patients to find the aortic pressure.
    背景与目标:
  • 【裂隙灯错误目镜对眼压测量对戈德曼压平眼压计的影响。】 复制标题 收藏 收藏
    DOI:10.1177/112067210801800609 复制DOI
    作者列表:Kubota T,Nagata T,Tawara A,Okada H,Ishibashi S,Yamashita M,Harada Y,Yanase M
    BACKGROUND & AIMS: PURPOSE:This study examined whether intraocular pressure (IOP) measurements through the wrong eyepiece of the slit lamp may be a source of error. METHODS:Seven skilled observers measured the IOP from seven healthy subjects. The observers used a Haag-Streit Goldmann applanation tonometer with two types of slit lamps (Haag-Streit and Rodenstock). In the Haag-Streit slit lamp the prism of the tonometer is aligned with the right part of the slit lamp optics. Conversely, in the Rodenstock slit lamp, the prism is aligned with the left. Each observer measured the IOP of each subject through the right eyepiece, through the left eyepiece, and under binocular vision. RESULTS:The IOP measured with the left eyepiece of the Haag-Streit slit lamp was significantly higher than that measured with the right eyepiece and binocular vision. The IOP measured with the right eyepiece of the Rodenstock slit lamp was significantly higher than that measured with the left eyepiece and binocular vision. CONCLUSIONS:IOP measurement through the wrong eyepiece of the slit lamp may be a source of error.
    背景与目标:
  • 【胃液酸碱度会影响自动空气眼压计测量的眼压PCO2吗?】 复制标题 收藏 收藏
    DOI:10.1164/ajrccm.163.5.2004057 复制DOI
    作者列表:Brinkmann A,Glasbrenner B,Vlatten A,Eberhardt H,Geldner G,Radermacher P,Georgieff M,Wiedeck H
    BACKGROUND & AIMS: :To determine the influence of changes in gastric juice pH due to intravenous administration of pentagastrin and omeprazole on intramucosal regional PCO2 (Pr(CO2)), we investigated 17 healthy human volunteers. Gastric juice pH was obtained from a glass pH electrode for continuous gastric juice pH measurement and Pr(CO2))was measured by using automated air tonometry. After baseline (8:00 A.M.-9:00 A.M.) the subjects received 0.6 microg/kg/h pentagastrin intravenously for 1 h (9:00 A.M.-10:00 A.M., after stimulation 10:00 A.M.-11:00 A.M.) and 40 mg omeprazole intravenously (after omeprazole 11:00 A.M.-3:00 P.M.). Following pentagastrin administration gastric juice pH significantly decreased from 1.2 +/- 0.4 to 0.6 +/- 0.4 (mean +/- SD, p < 0.007, versus baseline), whereas omeprazole transiently increased luminal pH up to 4.4 +/- 1.7 (p < 0.007 versus baseline). These subsequent changes in gastric juice pH were accompanied by a significant increase in Pr(CO2) from 48 +/- 12 to 61 +/- 17 mm Hg (p < 0.007 versus baseline) and a decrease to 44 +/- 5 mm Hg (p < 0.002 versus pentagastrin), respectively. A gastric juice pH > 4 considerably reduces mean gastric Pr(CO2) and interindividual variability. Thus omeprazole may improve the validity of gastric tonometry data.
    背景与目标: : 为了确定静脉注射五肽胃泌素和奥美拉唑引起的胃液ph值变化对粘膜内局部PCO2 (Pr(CO2)) 的影响,我们调查了17位健康的人类志愿者。从用于连续胃液pH测量的玻璃pH电极获得胃液pH,并通过使用自动空气测压法测量Pr(CO2)。基线 (上午8:00上午9:00) 后,受试者静脉注射0.6微克/千克/小时五肽胃菌素1小时 (上午9:00上午10:00,刺激上午10:00上午11:00后) 和静脉注射40毫克奥美拉唑 (奥美拉唑上午11:00下午3:00后)。五肽胃泌素给药后,胃液pH从1.2 +/- 0.4显着降低至0.6 +/- 0.4 (平均 +/- SD,p <0.007,相对于基线),而奥美拉唑瞬时增加管腔pH至4.4 +/- 1.7 (p <0.007相对于基线)。这些随后的胃液pH变化伴随着Pr(CO2) 从48 +/- 12显著增加到61 +/-17毫米Hg (相对于基线p <0.007) 和分别降低到44 +/-5毫米Hg (p <0.002相对于五肽胃泌素)。胃液pH> 4会大大降低平均胃Pr(CO2) 和个体间差异。因此,奥美拉唑可以提高胃眼压计数据的有效性。
  • 【动态轮廓眼压计,未矫正和矫正的Goldmann压平眼压计与青光眼分期之间的相关性。】 复制标题 收藏 收藏
    DOI:10.1001/jamaophthalmol.2017.1012 复制DOI
    作者列表:Wachtl J,Töteberg-Harms M,Frimmel S,Roos M,Kniestedt C
    BACKGROUND & AIMS: Importance:Accurate determination of intraocular pressure (IOP) is crucial for the diagnosis and management of glaucoma. Objective clinical evaluation of the correction equations for Goldmann applanation tonometry (GAT) is lacking. Objectives:To investigate the difference between corrected and conventional GAT and Pascal dynamic contour tonometry (DCT) measurements, as well as the correlation between discordant IOP values and stage of glaucoma. Design, Setting, and Participants:This prospective cross-sectional case series was conducted at the Department of Ophthalmology, University Hospital Zurich, and Talacker Eye Center between July 1, 2011, and May 31, 2016, among 112 white patients with glaucoma. Interventions:Intraocular pressure measurements were performed with GAT and DCT in a randomized order. Goldmann applanation tonometry measurements were modified with 5 correction equations. Main Outcomes and Measures:The primary end point was degree of concordance between corrected or uncorrected GAT and DCT measurements. The secondary end point was association between discordant IOP measurements and the stage of glaucoma, as assessed by the Glaucoma Severity Score. Results:Among the 112 patients (67 women and 45 men; mean [SD] age, 66.3 [13.1] years), 63 of the eyes in the study (56.3%) were left eyes and 85 patients (75.9%) were taking ocular antihypertensive medications. Mean (SD) IOP was 20.3 (4.5) mm Hg (95% CI, 19.4-21.1) as measured by DCT and 17.0 [4.1] mm Hg (95% CI, 16.3-17.8) as measured by GAT. The mean (SD) discordance between DCT and GAT measurements was -3.3 (2.0) mm Hg (95% CI, 2.9-3.6). The 5 corrected GAT values ranged from -2.7 to -5.4 mm Hg compared with DCT. The mean (SD) result of the Dresdner correction formula (17.6 [4.1] mm Hg) was closer to the DCT measurement than the original GAT measurement. The mean (SD) Glaucoma Severity Score was 4.7 (3.4) (95% CI, 4.1-5.4). The uncorrected discordance IOPDCT - IOPGAT showed a positive correlation with the Glaucoma Severity Score (rs = 0.33; P < .001) and a negative correlation with central corneal thickness (rs = -0.22; P = .02). Conclusions and Relevance:In comparison with DCT measurements, these data suggest that GAT values are significantly discordant in eyes with thin corneas and advanced glaucoma. Application of GAT-based correction formulas involves a possible risk of creating an even greater number of unpredictable measurement errors. Hence, we advise with caution, especially pertaining to eyes with thin corneas, to not place reliance on GAT readings, and abandon any correction formula. Trial Registration:clinicaltrials.gov Identifier: NCT01474070.
    背景与目标:
  • 14 Gastric tonometry: where do we stand? 复制标题 收藏 收藏

    【胃眼压计: 我们站在哪里?】 复制标题 收藏 收藏
    DOI:10.1097/00075198-200104000-00011 复制DOI
    作者列表:Hamilton MA,Mythen MG
    BACKGROUND & AIMS: :Gastric tonometry has proved to be a sensitive but not specific predictor of outcome in the critically ill. The data accumulated to date indicate that those patients able to achieve or maintain a normal gastric mucosal pH do better than those who do not. In addition, therapy aimed at improving an abnormal gastric mucosal pH has proved to be less successful. These findings may simply indicate that tonometry identifies those "responders" and "nonresponders," as becomes increasingly apparent in populations of critical care patients receiving interventional therapy. Gastric tonometry has undergone a number of methodologic changes over the last decade, seeing a switch from saline to automated gas tonometry. Along with this switch of methodology has come a deeper scrutiny of the indices used to assess gut perfusion. Most studies (including all the interventional ones) have used gastric mucosal pH. The newer indices of gut luminal PCO2 (PgCO2) referenced to arterial CO2 (PgCO2-PaCO2) or end tidal CO2 (PgCO2-PeCO2), although relatively well validated, remain to be proven as predictors of outcome or guides to interventional therapy. If we take a fresh look at the interventional trials in intensive care patients, there is a very definite trend toward benefit in the protocol groups, although they are generally reported as negative studies. There is much to be accomplished, however, before we accept the gastric tonometer as a routine tool with which to guide therapy based on gastrointestinal perfusion, including a greater understanding of gastrointestinal physiology and, as ever, the call for an adequately powered prospective randomized controlled trial to evaluate the clinical utility of gas tonometry.
    背景与目标: : 胃镜检查已被证明是危重病患者预后的敏感但不是特定的预测指标。迄今为止积累的数据表明,那些能够达到或维持正常胃粘膜ph值的患者比那些没有达到或保持正常胃粘膜ph值的患者做得更好。此外,旨在改善异常胃黏膜ph值的疗法已被证明不太成功。这些发现可能只是表明眼压计可以识别那些 “响应者” 和 “无响应者”,这在接受介入治疗的重症监护患者人群中越来越明显。在过去的十年中,胃眼压计经历了许多方法学上的变化,从盐水转向了自动气体眼压计。随着方法的转变,对用于评估肠道灌注的指标进行了更深入的审查。大多数研究 (包括所有介入性研究) 都使用了胃粘膜pH。与动脉CO2 (PgCO2-PaCO2) 或潮气末CO2 (PgCO2-PeCO2) 相关的肠腔PCO2 (PgCO2) 的较新指标,尽管得到了相对较好的验证,但仍有待证明是预后的预测指标或介入治疗的指南。如果我们重新审视重症监护患者的介入试验,尽管方案组通常被报道为阴性研究,但方案组仍有明显的获益趋势。然而,在我们接受胃眼压计作为指导基于胃肠道灌注的治疗的常规工具之前,还有很多事情要做,包括对胃肠道生理学有更深入的了解,以及一如既往地呼吁进行有足够动力的前瞻性随机对照试验以评估气体眼压计的临床实用性。
  • 15 [New measuring method of non-contact tonometry]. 复制标题 收藏 收藏

    【[非接触式眼压计的新测量方法]。】 复制标题 收藏 收藏
    DOI:10.1055/s-2008-1034746 复制DOI
    作者列表:Plagwitz KU,Lemke K
    BACKGROUND & AIMS: BACKGROUND:The measuring value of intraocular pressure (IOP) in non-contact-tonometry (NCT) depends on IOP and is additionally highly influenced by the biomechanical parameters of the cornea. These parameters (especially corneal thickness) differ among several patients. It is desirable to characterize this influence and to correct the measuring value during the IOP measurement. The new tonometer consists of an air pulse applicator generating an air pulse with a rampshaped rising and a sharp decay after switching off and a Michelson-type laserinterferometer for detecting the corneal movement during the air pulse application and the oscillation after switching off the air pulse.

    METHOD:The method was tested with a mechanical phantom eye. The pressure inside the chamber of the phanton is adjustable. Measuring surfaces, which have to simulate the shape and the elastic properties of the cornea, are made of soft silicon rubber and fabricated with different thicknesses.

    RESULTS:Measurement results show that both the rise of the corneal deformation and the damped oscillation (frequency and damping) depend from material thickness and internal pressure of the phantom eye.

    CONCLUSION:Thus a characterization of the influence of the mechanical properties and a determination of a corrected IOP-value are possible. The task at present is the investigation and formulation of the mathematical dependences.

    背景与目标: 背景 : 非接触式眼压计 (NCT) 中眼内压 (IOP) 的测量值取决于IOP,并且还受到角膜生物力学参数的高度影响。这些参数 (尤其是角膜厚度) 在几个患者中有所不同。希望表征这种影响并在IOP测量期间校正测量值。新的眼压计由一个空气脉冲施加器组成,该空气脉冲施加器在关闭后产生具有斜坡形上升和急剧衰减的空气脉冲,以及一个迈克尔逊型激光干涉仪,用于检测空气脉冲施加过程中的角膜运动和关闭空气脉冲后的振荡。
    方法 : 该方法用机械幻像眼进行了测试。phanton腔室内部的压力是可调的。测量表面必须模拟角膜的形状和弹性,由柔软的硅橡胶制成,并具有不同的厚度。
    结果 : 测量结果表明,角膜变形的上升和阻尼振荡 (频率和阻尼) 均取决于材料厚度和幻影眼的内部压力。
    结论 : 因此,可以表征机械性能的影响并确定校正的IOP值。目前的任务是研究和制定数学依赖性。

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