| Objective: Primary glaucoma (Primary glaucoma) is a group serious clinical syndrome which characteristic is damage the optic nerve visual function , endangering patients of visual function and quality of life, and has become the world's second-largest blind eye disease, its blinding , therefore, search out the characteristics of the pathogenesis of Primary glaucoma visual function damage and the research of protection work is of far-reaching significance. For quite some time, in the pathogenesis of primary glaucoma's optic nerve damage have two theories as to the mechanical theory of the main elevation of intraocular pressure and optic nerve blood flow changes in nutrition-based theory of vascular ischemia. Dominated by mechanical pressure theory that IOP is an important reason for optic nerve injury, the role of oppression in the high intraocular pressure, the scleral sieve shift to the rear, slow axoplasmic flow of optic nerve of normal transport, resulting in the gradual shrinking of optic nerve fibers . However, more and more experimental results suggest that increased intraocular pressure caused by glaucoma is not just the only reason for visual function. This experiment was to investigate correlation analysis between the hemorrheology changes and plasma endothelin -1 (ET-1) level of changes in patients of primary glaucoma's optic nerve damage degree in order to infer their visual impairment in primary glaucomathe mechanism and significance.Methods: The patient group included 60 cases primary glaucoma patients who are ready to get more treatment at the Second Affiliated Hospital of Dalian Medical University Hospital from January 2009 to December 2010, their Intraocular pressure under control in drugs than 21 mmHg, exclude other retinal diseases, they were according to result of vision test divided into three groups, Mild vision damage group (A group), Moderate vision damage group(B group) and Severe vision damage group(C group) each group included 20 cases; 20 Cataract patients who are ready to get surgical treatment at the Second Affiliated Hospital of Dalian Medical University Hospital the corresponding period were designed as normal group(D group), Screening criteria for D group: (1) exclusion glaucoma history; (2) the intraocular pressure lower than 21 mmHg; (3) vision examination did not see the other except cataract eye disease outside the exception; (4) depending on the nipple and retinal nerve fiber layer exclude other eye diseases. The 80 patients were excluded long-term smoking, drinking, serious disease of heart head blood-vessel, liver disease, kidney disease, and blood, diabetes and long-term use of anticoagulation drugs and promoting blood circulation to remove blood stasis kind of traditional Chinese medicine.All patients go out of use of the drugs that affect the pupilactivitise before the vision inspection in 24 hours,in order to make patients familiar with vision inspection procedures,all research material use the second above (include the second)vision inspection result. Nurse took 5ml peripheral blood from patients and immediately loaded into the hard plastic tube containing containing Anticoagulants EDTA powder (1mg/ml blood) to collect the sample at 7 o'clock am .The blood sample was transferred to laboratory to detect hemorrheology level.The other blood sample is 2ml,it was collected by the vessel containing 10% sodium 30 ul and aprotinin shake 40ul tubes. In room temperature 3,000 r/min centrifugal 10 min, separate plasma placed - 70℃refrigerated for testing ET - 1 . Determination methods: determine before the sample under room temperature or cold water again 4℃removed harmony, 3000 r/min centrifugal 5 min take supernatant fluid, using radiation enzyme-linked immunosorbent assay(RELISA) spectrometry ET - 1, by the same a skilled operators use GC ria counter - 2010, according to the gamma standard curve direct calculation ET - 1. Application SPSS17.0 statistical software to process data, the data of the same group the same factor in comparison between different samples with independent samples t test. Correlation analysis using Pearson correlation test. P <0.05 was considered statistically significant.Results:(1) the age and weight between ABC three group and D group showed no significant difference, P> 0.05, there was no statistical difference. (2) ET-1 in plasma levels of ABC groups were higher than D group,P<0.05,there was statistically significant difference. (3) ET-1 in plasma levels of A1,B1,C1 groups were higher than A2,B2,C2 group,P<0.05,there was statistically significant difference. (4)hemorheological indexes levels of ABC groups were higher than D group,P<0.05,there was statistically significant difference. (5) ) Whole blood viscosity of A1,B1,C1 groups were higher than A2,B2,C2 group,P<0.05,there was statistically significant difference; between A1,B1,C1 group and A2,B2,C2 group showed no significant difference, P> 0.05, there was no statistical difference. (6) ET-1 in plasma levels and visual field damage(MD value) in ABC groups were correlated, r = 0.74,P<0.05. (7) plasma viscosity and degree of vision impairment (MD value) in ABC groups were correlated, r = 0.62,P<0.05.Conclusion: (1) ET - 1 participation glaucoma vascular disorders process, further cause visual function damage;(2)It is the rule of hemorrheology change affect blood supply to the optic nerve, resulting in primary glaucoma optic neuropathy, cause of visual function damaged. |
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