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ENGLISH ABSTRACT
西藏高海拔地区藏族初中生角膜生物学参数特征分析
旦增仁青
苗恒
次旦央吉
德吉
赵明威
作者及单位信息
·
DOI： 10.3760/cma.j.cn115989-20210219-00119
Measurement and analysis of corneal biological parameters from Tibetan junior middle school students in high altitude area
Danzengrenqing
Miao Heng
Tsedenyangky
De ji
Zhao Mingwei
Authors Info & Affiliations
Danzengrenqing
Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory Diagnosis and Therapy of Retina and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing 100044, China
Miao Heng
Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory Diagnosis and Therapy of Retina and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing 100044, China
Tsedenyangky
Department of Ophthalmology, Tibet Hospital, Tibet Autonomous Region Eye center, Tibet Autonomous Region 850000, China
De ji
Medical Group of People's Hospital of Mozhugongka County, Tibet Autonomous Region 850002, China
Zhao Mingwei
Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory Diagnosis and Therapy of Retina and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing 100044, China
·
DOI： 10.3760/cma.j.cn115989-20210219-00119
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摘要

目的分析长期居住在拉萨市墨竹工卡县的藏族初中学生角膜生物学参数。

方法采用横断面研究方法，于2020年5月采集长期居住在拉萨市墨竹工卡县的1 784名藏族初中生的性别、年龄、年级等基本信息及角膜生物学参数，采用电脑随机数字分配法随机选取每位受检者单眼数据进行统计分析，最终共有690名藏族初中生纳入本研究，其中男366眼，女324眼；12～15岁461眼，16～20岁229眼；左、右眼各345眼。采用SIRIUS天狼星三维角膜地形图及眼前节分析系统测定受检者双眼角膜最薄点厚度(TCT)、中央角膜厚度(CCT)、前房深度(ACD)、虹膜角膜夹角、模拟K1、模拟K2、角膜最薄点位置。采用直方图和Q-Q图法分析除角膜最薄点位置外的其他各角膜生物学连续变量的分布特征，比较不同性别、年龄、眼别间各生物学参数的差异，并通过文献复习与其他民族相关资料进行比较。

结果拉萨市墨竹工卡县的藏族初中学生中右眼ACD为(3.31±0.27)mm，左眼为(3.26±0.26)mm，不同眼别间ACD差异有统计学意义( t＝0.745， P＝0.012)。受检者中右眼TCT、CCT、虹膜角膜夹角、模拟K1、模拟K2分别为(504.99±30.73)μm、(509.10±35.82)μm、(47.45±5.70)°、(43.15±1.89)D、(44.16±2.29)D，左眼分别为(503.34±29.22)μm、(508.36±28.75)μm、(47.86±5.88)°、(43.06±1.40)D、(44.16±1.53)D，不同眼别间上述参数差异均无统计学意义(均 P>0.05)。男性ACD和虹膜角膜夹角值明显高于女性，模拟K1和模拟K2值低于女性，差异均有统计学意义(均 P<0.05)；不同性别间TCT和CCT比较差异均无统计学意义(均 P>0.05)。12～15岁组间与16～20岁组间各角膜参数比较差异均无统计学意义(均 P>0.05)。受检眼中右眼角膜最薄点主要分布于颞下象限内，左眼主要分布于颞上象限内。

结论久居高海拔地区的藏族初中学生的部分角膜生物学参数可能与其他种族人群存在差异。眼科医生在对久居高海拔地区的藏族青少年进行角膜和屈光性疾病诊治时应据此做出适当调整。

高海拔;藏族;角膜;生物学测量
ABSTRACT

ObjectiveTo measure and analyze the corneal biological parameters of Tibetan junior middle school students who have lived in Mozhugongka County of Lhasa city for a long time.

MethodsA cross-sectional study was performed.The basic information including gender, age and grade of 1 784 Tibetan junior high school students who have lived in Mozhugongka County of Lhasa city for a long time was collected, and the corneal biological parameters were measured in May, 2020.The available data of 690 students were obtained in this study.Unilateral eye of each subject was randomly selected for statistical analysis using computer random number method.Three hundred and forty-five right eyes and 345 left eyes from 366 males and 324 females were included.There were 461 eyes from students aged 12 to 15 years, and 229 eyes from students aged 16 to 20 years.Sirius 3D corneal topography and anterior segment analysis system were used to measure the thinnest corneal thickness (TCT), central corneal thickness (CCT), anterior chamber depth (ACD), iridocorneal corneal angle, simulated K1 and simulated K2, thinnest point position.Histogram and Q-Q chart were used to assess the distribution of continuous variables except the thinnest point position of cornea.The differences in biological parameters were compared between males and females, 12-15 years group and 16-20 years group as well as right eyes and left eyes.The literature of corneal biological parameters from other ethnic group was reviewed and compared with the Tibetan subjects.This study complied with the Declaration of Helsinki and was approved by an Ethics Committee of Tibet Hospital (No.QZYY2019-IRBPJ-21).

ResultsThe ACD of the right eye of the students was (3.31±0.27)mm, which was significantly greater than (3.26±0.26)mm of the left eye ( t=0.745, P=0.012). Mean TCT, CCT, iridocorneal angle, simulated K1 and simulated K2 were (504.99±30.73)μm, (509.10±35.82)μm, (47.45±5.70)°, (43.15±1.89)D, and (44.16±2.29)D of the right eye, and thoes of the left eyes were (503.34±29.22)μm, (508.36±28.75)μm, (47.86±5.88)°, (43.06±1.40)D and (44.16±1.53)D, respectively, with no significant differences between the right and left eyes (all at P>0.05). The ACD and iridocorneal angle were significantly greater, and the simulated K1 and simulated K2 were significantly smaller in males compared with females (all at P<0.05). There were no significant differences in TCT and CCT between males and females (both at P>0.05). The corneal biological parameters were not signficantly different between different age groups (all at P>0.05). The thinnest point of cornea distributed mainly at inferior temporal quadrant zone for the right eyes, and superior temporal quadrant zone for the left eyes.

ConclusionsCorneal biological parameters of Tibetan junior high school students in high altitude areas might be different from those of other ethnic students.Ophthalmologists should pay attention to this population in diagnosis and treatment of corneal diseases and refractive error.

High altitude;Tibetan;Corneal;Biological measurement
Zhao Mingwei, Email: mocdef.3ab61iewgnimoahz_rd
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引用本文

旦增仁青,苗恒,次旦央吉,等. 西藏高海拔地区藏族初中生角膜生物学参数特征分析[J]. 中华实验眼科杂志,2021,39(05)：410-415.

DOI:10.3760/cma.j.cn115989-20210219-00119

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角膜生物学参数测量和分析对了解正常角膜的生理功能、提高角膜和屈光性疾病的诊治水平，特别是角膜及眼前段手术的设计具有非常重要的意义 [ 1 , 2 , 3 , 4 ]。已有研究显示，中国不同民族人群中角膜的生物学参数可能存在差异 [ 5 , 6 , 7 ]。国外相关研究还表明，久居不同海拔地区同种族人群的角膜厚度也存在差异 [ 8 ]，但目前关于久居高海拔地区藏族人群角膜生物学特征的研究较少。本研究拟对长期居住在西藏高海拔地区正常初中学生的角膜各生物学参数进行测量和分析，以了解该地区青少年人群的角膜形态特征。
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备注信息
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赵明威，Email： mocdef.3ab61iewgnimoahz_rd
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且增仁青、苗恒、次旦央吉、德吉参与选题、研究设计和实施，参加数据收集和分析，文章撰写和修改。赵明威参与选题，研究设计和指导，文章智力性内容修改和定稿

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