探讨中国人群眼颅压力梯度参考区间，为建立基于眼颅压力梯度的开角型青光眼诊疗新体系提供理论标准。

横断面研究。对2010年8月至2019年8月首都医科大学附属北京同仁医院神经内科需行腰椎穿刺的受试者共200例。其中，男性97例，女性103例，年龄区间12~79岁，平均(47.0±14.7)岁。对受试者进行眼压、颅压及全身基本参数测量。性别资料采用频数和百分比描述；年龄、身高、体重、眼压、颅内压、平均动脉压、体质指数及眼颅压力梯度等连续定量资料采用±s描述。对于少量缺失数据，采用马尔科夫链蒙特卡洛模拟(MCMC)对缺失数据进行多重插补。采用95%分位数法确定参考值范围，对于连续定量资料的多组间比较采用单因素方差分析，两两比较采用两独立样本t检验。

根据全体受试者测定人群眼压参考区间为9.015 mmHg~20.265 mmHg(1 mmHg＝0.133 kPa)。人群颅压参考区间为6.179 mmHg~14.921 mmHg。人群眼颅压力梯度参考区间为-2.987 mmHg~11.047 mmHg。眼颅压力梯度临床诊疗参考区间为0.423 mmHg~10.508 mmHg。以年龄进行分组，<30岁人群眼颅压力梯度参考区间为-2.968 mmHg~9.028 mmHg；30岁~50岁人群眼颅压力梯度参考区间为-2.466 mmHg~11.606 mmHg；>50岁人群眼颅压力梯度参考区间为-2.466 mmHg~11.606 mmHg。三组间眼颅压力梯度差异无统计学意义(F＝2.041，P>0.05)。以性别进行分组，男性眼颅压力梯度参考区间为-2.769 mmHg~10.089 mmHg；女性眼颅压力梯度参考区间为-3.137 mmHg~11.877 mmHg。两组间眼颅压力梯度的差异无统计学意义(t＝-1.413，P>0.05)。以体质指数(BMI)进行分组，BMI<21 kg/m²的人群眼颅压力梯度参考区间为-1.437 mmHg~11.577 mmHg；21 kg/m²<BMI<23 kg/m²的人群眼颅压力梯度参考区间为-3.046 mmHg~11.026 mmHg；BMI>23 kg/m²的人群眼颅压力梯度参考区间为-3.947 mmHg~10.087 mmHg。不同BMI分组间，眼颅压力梯度差异有统计学意义(F＝6.109，P<0.05)。

眼颅压力梯度临床诊疗参考区间为0.423 mmHg~10.508 mmHg，可作为开角型青光眼临床诊疗的新指标。同时，还为开角型青光眼病因学诊断及个体化治疗的进一步深入研究，提供新的实践基础与研究方向。

To establish the normal reference interval of the intracranial pressure gradient in the Chinese population so as to provide a standard for the establishment of open-angle glaucoma diagnosis and treatment new system based on the Intraocular and Intracranial Pressure Gradient (ONPG).

Cross-sectional study, 200 patients (97 males and 103 females) who underwent lumbar puncture from August 2010 to August 2019 in the Department of Neurology, Beijing Tongren Hospital, Capital Medical University were selected as subjects. Intraocular pressure, intracranial pressure and basic parameters were performed in all patients. The gender was described using frequency distribution and percentage method, and the age, height, weight, intraocular pressure, intracranial pressure, MAP, BMI and ONPG were described using. Markov Chain Monte Carlo Simulation (MCMC) was used to perform multiple interpolation on the missing value. The range of reference values was determined using the 95% quantile method. One-way ANOVA was used for comparison between multiple groups of continuous quantitative data, and two independent samples were used for pairwise comparison.

According to the parameters, the normal reference interval of intraocular pressure, intracranial pressure and the ONPG is 9.015 mmHg to 20.265 mmHg, 6.179 mmHg to 14.921 mmHg and -2.987 mmHg to 11.047 mmHg. The reference interval for clinical diagnosis and treatment of ONPG is 0.423 mmHg to10.508 mmHg. Grouped according to age, Age < 30 was the youth group, 30 ≤ Age ≤ 50 was the middle age group, Age>50 was the elderly group.The reference interval of ONPG in the youth group is -2.968 mmHg to 9.028 mmHg, in the middle age group is -2.466 mmHg to 11.606 mmHg, in the elderly group is -2.466 mmHg to 11.606 mmHg.There was no significant difference in ONPG between the three groups (F=2.041, P>0.05). Grouped according to gender, male reference interval of ONPG is -2.769 mmHg to 10.089 mmHg, female reference interval of ONPG is -3.137 mmHg to 11.877 mmHg.There was no significant difference in ONPG between the two groups(t=-1.413, P>0.05). Grouped according to BMI, BMI<21 kg/m² was the low weight group, BMI 21 kg/m²<BMI<23 kg/m² was the normal weight group, BMI ≥ 23 kg/m² was the overweight group. The reference interval of ONPG in low weight group is -1.437 mmHg to 11.577 mmHg, in normal weight group is -3.646 mmHg to11.026 mmHg, in overweight group is -3.947 mmHg to 10.087 mmHg.There was a statistically significant difference in ONPG between different BMI groups (F=6.109, P<0.05).

The reference interval for clinical diagnosis and treatment of ONPG is (0.423 mmHg to 10.508 mmHg), which can be used as a new indicator for clinical diagnosis and treatment of open-angle glaucoma. Provide a new practice and research direction for further study of the etiology and individualized treatment of open-angle glaucoma.