葛根素对前部缺血性视神经病变早期血流动力学的影响

Puerarin on ocular blood velocity in early anterior ischemic optic neuropathy

目的探讨葛根素对前部缺血性视神经病变(anterior ischemic optic neuropathy,AION)早期患者血流动力学的影响。方法AION早期患者44例(44眼)随机分为2组,治疗组22例22眼给予葛根素注射液200mg溶于250mL生理盐水静脉滴注,每天1次,共14d;对照组22例22眼给予低分子右旋糖苷注射液500mL静脉滴注,每天1次,共14d。均使用醋氮酰胺、B族维生素、神经营养剂、地巴唑及烟酸口服14d。治疗前后2组患者分别检查视力、视野,同时应用彩色多普勒血流显像技术(color doppler flow imaging,CDFI),检测治疗前后患眼睫状后短动脉(posterior ciliary artery,PCA)、视网膜中央动脉(central retinal artery,CRA)血流动力学的变化,并与对照组进行比较分析。结果治疗组有效率(95.45%)明显高于对照组(59.09%,P<0.05)。治疗组中治疗前后PCA的收缩期峰值速度、舒张末期速度分别由(6.13±1.63)cm·s-1、(1.96±0.57)cm·s-1增加到(12.97±4.30)cm·s-1、(4.62±0.92)cm·s-1(P<0.01);治疗组中治疗前后CRA的收缩期峰值速度和舒张末期速度分别由(7.19±1.67)cm·s-1、(2.62±0.39)cm·s-1增加到(10.52±2.37)cm·s-1、(3.73±1.26)cm·s-1(P<0.01)。对照组各指标治疗后与治疗前比较差异无统计学意义(P>0.05)。2组治疗前的各指标比较差异无统计学意义(P>0.05),2组治疗后PCA血流参数除RI外、CRA血流参数除PI和RI外比较差异有统计学意义(P<0.05)。结论葛根素能有效改善早期AION患者PCA和CRA血流速度,提高疗效。

Objective To study the effect of Puerarin on ocular blood velocity in early anterior ischemic optic neuropathy （ AION ）. Methods Forty-four patients （44 eyes ） were randomly divided into two groups,treatment group and control group ,22 patients （22 eyes ） in each group. Treatment group （ 22 eyes ） were intravenously performed with 200 mg Puerarin plus 250 mL normal sodium once daily for 2 weeks, and 500 mL low molecule dextran were intravenously performed once daily for 2 weeks in control group. Acetazolamide,vitamin B group,neuro-nutritional agent, bandazol and niconacid were used for 2 weeks in 2 groups. Visual field,sight were detected before and after treatment. The peak systolic velocity （PSV） and end diastolic velocity（EDV） of the posterior ciliary artery（PCA） and central retinal artery（CRA） were detected by Colour Doppler portrait technology （CDFI） before and after treatment. All the date were analyzed through the statistical software （ SPASS 12.0 ）. Resuits The total effective rate of the treatment group （95.45%） was better than that of the control group （59.09%） （P〈0.05）. PSV,EDV in PCAs after administ raction of Puerarin increseaed from （ 6.13 ± 1.63 ） cm·s^-1,（1.96±0.57）cm·s^-1 to （12.97±4.33）cm·s^-1, （4.62±0.92）cm·s^-1 （P 〈0.01） ; PSV, EDV in CRA after administ ration of Puerarin increseaed from （ 7.19 ±1.67）cm·s^-1.（2.62±0.39）cm·s^-1 to （10.52± 2. 37）cm·s^-1,（3.73 ± 1.26）cm·s^-1（P 〈 0.01）. Every indexes were no significant difference in two groups before treatment （ P 〉 0.05 ）, there was no significant difference of every indexes in control group before and after treatment（ P 〉 0.05 ）, and compared with the control group each parameter of PCAs （except RI ） and CRA （except RI and PI ） was statistically significant after treatment（P 〈 0.05 ）. Conclusion Puerarin can effectively improve flow velocity of nasal and tempo short PCAs and CRA, and improve curative effect in patients with early AION.