摘要
目的应用床旁超声测量需行腰椎穿刺(lumbar puncture,LP)的患者和正常体检者视神经鞘直径(optic nerve sheath diameter,ONSD),探讨其与颅内压(intracranial pressure,ICP)升高的相关性、应用价值及潜在影响因素。方法选取ICP升高需行LP的患者100例作为病例组,健康体检者50例作为对照组,应用二维灰阶超声测量所有受试者ONSD,收集相关潜在影响因素,判断ICP升高最佳临界值。结果病例组行LP测得ICP正常的患者(ICP<200 mmHg)与对照组超声测量ONSD差异无统计学意义,病例组行LP测得ICP升高患者(ICP≥200 mmHg)与ICP正常患者差异有统计学意义,经直线回归分析得出ONSD与ICP的相关系数R为0.907,两者呈强相关性,ICP随ONSD变化的回归方程为:Y=-79.222+58.101X。年龄、身高、体重、身体质量指数(body mass index,BMI)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、眼球横径(eyeball transverse diameter,ETD)不是ONSD影响因素,男性ONSD为(4.46±1.23)mm,女性ONSD为(3.90±1.19)mm,男性ONSD结果≥4.575 mm时被诊断为阳性,即异常,灵敏度为93.8%,特异度为100%,女性ONSD结果≥3.925 mm时被诊断为阳性,即异常,灵敏度为87.1%,特异度为100%。结论超声测量ONSD与ICP升高呈正相关,对于不同性别ONSD临界值不同,ONSD测定对临床评价ICP升高具有可靠性,有临床参考价值。
Objective To measure the diameter of the optic nerve sheath(ONSD)in patients with normal physical examination and lumbar puncture(LP)by bedside ultrasound,and to explore its correlation with the increase of intracranial pressure(ICP),its application value and potential influencing factors.Methods 50 healthy people were enrolled as a control group,and 100 patients with surgery were treated as a case group.Two-dimensional gray-scale ultrasound was used to measure all subjects'ONSD.We collected relevant potential influencing factors.Multivariate linear regression equation was used to predict ICP.ROC curve was used to judge the optimal threshold of ICP elevation.Results There was no statistical difference between the normal ICP patients(ICP<200 mmHg)and the control group by ultrasound.The patients with elevated ICP(ICP≥200 mmHg)were statistically different from normal ICP people.Linear regression analysis showed that the correlation coefficient R between ONSD and ICP was 0.907,which showed strong correlation.The regression equation for ICP changes with ONSD was Y=-79.222+58.101X.Age,height,weight,BMI,systolic blood pressure(SBP),diastolic blood pressure(DBP),and transverse diameter of the eye(ETD)were not factors influencing ONSD.The male ONSD was(4.46±1.23)mm,the female ONSD was(3.90±1.19)mm,and the male ONSD result was≥4.575 mm,which was diagnosed as positive,that is abnormal,sensitivity was 93.8%,specificity was 100%.When the female ONSD result was≥3.925,it was diagnosed as positive,that is,abnormal,with a sensitivity of 87.1%and a specificity of 100%.Conclusion Bedside ultrasound measurement of ONSD is positively correlated with ICP elevation.For different gender ONSD thresholds,ONSD measurement has reliability and clinical reference value for clinical evaluation of ICP elevation.
作者
陶莹
孙爱童
TAO Ying;SUN Aitong(Department of Ultrasound,Inner Mongolia Maternal and Child Care Hospital,Hohhot 010060,China;Department of Utrasound,Inner Mongolia People's Hospital,Hohhot 010017,China)
出处
《医学影像学杂志》
2022年第9期1457-1460,共4页
Journal of Medical Imaging
基金
内蒙古自治区自然科学基金项目(编号:2019MS08092)。
关键词
床旁超声检查
视神经鞘直径
颅内压升高
腰椎穿刺
相关性
Bedside ultrasound
Optic nerve sheath diameter
Increased intracranial pressure
lumbar puncture
Correlation
