复方樟柳碱对老年前部缺血性视神经病变患者血流动力学和视功能恢复的影响

Effect of compound anisodine on the senile hemodynamics and central eyesight in patients with anterior ischemic optic neuropathy

目的探讨复方樟柳碱对老年前部缺血性视神经病变(AION)患者血液流变学和中心视力恢复的影响。方法AION患者43例52眼,随机分为治疗组23例28眼和对照组20例24眼,所有患者均使用常规扩血管药物葛根素等治疗,治疗组另加复方樟柳碱患侧颞浅动脉旁注射。疗程均为20 d。治疗前后通过彩色多普勒超声检测眼动脉(OA)、视网膜中央动脉(CRA)、睫状后短动脉(SPCA)的收缩期峰值血流速度(peak sys-tolic velocity,PSV)、舒张末期血流速度(end diastolic velocity,EDV)、时间平均最大血流速度(time averaged maximum velocity,TAMX)、搏动指数(pulsa-tility index,PI)、阻力指数(resistance index,RI)等,并比较治疗前后视力分布情况。结果对照组治疗后上述各血管的血流动力学参数PSV、EDV、TAMX较治疗前均有显著改善(P<0.05),并且CRA的PI和RI也有显著性改善(P<0.05);治疗组治疗后3种血管的各项血流动力学参数较治疗前均有显著改善(P<0.05),并且对CRA、SPCA的PI和RI均有显著影响(P<0.05)。治疗后视力提高的比例和视力≥1.0的比例治疗组明显高于对照组,而视力≤0.1的比例治疗组明显低于对照组(P<0.05)。结论以复方樟柳碱为主的综合疗法更有利于改善AION患者的血流动力学,更有利于中心视力恢复。

Objective To evaluate the effect of compound anisodine on the hemodynamics and central eyesight in senile patients with anterior ischemic optic neuropathy （AION）. Methods 43 cases 52 eyes with AION were randomly divided into treatment group （23 cases 28 eyes） and control group （20 cases 24 eyes）. All the patients were treated by puerarin injection and the patients in treatment group were treated additionally by compound anisodine. The eyesight and hemodynamic parameters such as peak systolic velocity （PSV） , end diastolic velocity （ EDV）, time averaged maximum velocity （ TAMX）, pulsatility index （ PI ）, resistance index （RI） of ophthalmic artery （OA）, central artery of retina （CRA）, short posterior ciliary artery （SPCA） were measured by color Doppler flow imaging （CDFL） before and after treatment. Results The hemodynamic parameters, such as PSV, EDV and TAMX, were improved significantly in both groups after treatment （ P 〈 0. 05 ） and the parameters were improved more significantly in treatment group than those in control group （ P 〈 0. 05 ）. Especially, the PI and RI of SPCA were improved significantly only in the treatment group. After treatment, the eyesight was improved more significantly in treatment group than that in control group （ P 〈 0. 05 ）. Conclusions The synthetic treatment, which mainly include compound anisodine, is more valuable to improve the hemodynamic parameters and central eyesight of the patients with AION.