马来酸噻吗洛尔与布林佐胺联合曲伏前列素治疗开角型青光眼和高眼压症临床研究

Clinical comparative study of timolol maleate and brinzolamide in treatment of open-angle glaucoma and ocular hypertension combined with travoprost

目的对比评价马来酸噻吗洛尔与布林佐胺联合曲伏前列素治疗开角型青光眼和高眼压症的临床疗效。方法将我院使用曲伏前列素单药治疗效果不佳的开角型青光眼与高眼压的76例患者分为S组和B组,S组38例(38眼)患者在曲伏前列素基础上合用马来酸噻吗洛尔治疗,B组38例(38眼)患者则合用布林佐胺治疗,于2周和1、3、6个月随访。对比观察两组治疗前后的平均眼压、昼夜眼压差、心率、血压和不良反应发生情况。结果两组患者在联合用药后2周和1、3、6个月平均眼压下降,与治疗前比较差异均有统计学意义(P<0.05),两组间差异无统计学意义(P>0.05);S组联合用药后6个月昼夜眼压差较B组大,两组差异有统计学意义(P<0.05);两组患者在联合用药前后血压均无明显变化(P>0.05);B组患者心率在联合用药前后无明显变化(P>0.05),S组患者心率则在随访6个月时出现明显心脏抑制(P<0.05);两组均未出现严重不良反应。结论马来酸噻吗洛尔与布林佐胺联合曲伏前列素治疗开角型青光眼和高眼压疗效显著,布林佐胺联合曲伏前列素用药相对更稳定、更安全。

Objective To evaluate the clinical efficacy of timolol maleate and brinzolamide in treatment of openangle glaucoma and ocular hypertension combined with travoprost. Methods 76 patients were divided into group S and group B in our hospital,who were suffering from open-angle glaucoma or ocular hypertension,and the clinical efficacy was poor when they were treated with travoprost monotherapy. 38 patients（ 38 eyes） in group S were treated with timolol maleate,and 38 patients（ 38 eyes） in group B were treated with brinzolamide,combined with travoprost. Follow-up was scheduled after 2 weeks,1,3 and 6 months of combination therapy. The mean IOP（ meanIntraocular pressure）,diurnal IOP difference,heart rate,blood pressure and the incidence of adverse reactions were compared before and after combination therapy. Results The mean IOP decreased after two weeks and 1,3,6 month of combination therapy in 2 groups had significant difference compared with before combination therapy（ P〈0. 05）,and it was no significant difference between the two groups（ P 〉0. 05）. The difference of diurnal IOP was significant between the two groups after 6 months of combination therapy（ P〈0. 05）,and the group S was higher than group B. The blood pressure did not change significantly before and after combination therapy in 2 groups（ P 〉0. 05）. The heart rate did not change significantly,and the patients of group S showed significant cardiac depression after 6 months follow-up（ P〈0. 05）. No serious adverse events occurred in both groups. Conclusion The clinical efficacy would significant when it is treated for open-angle glaucoma and ocular hypertension,either timolol maleate or brinzolamide combined travopros,and the clinical efficacy would be stable and safe when brinzolamide is applied than timolol maleate.