川芎嗪对原发性慢性闭角型青光眼术后眼压控制在目标范围内患者视力和视野的影响

Effects of tetramethylpyrazine on visual acuity and visual field of primary chronic angle closure glaucoma patients with normal intraocular pressure after operation

目的探讨原发性慢性闭角型青光眼(PCACG)患者术后眼压控制在目标范围后视力和视野的变化,为该病的临床治疗提供理论依据。方法选择2010年1月至2011年12月在新乡医学院第三附属医院眼科住院的、已行手术治疗,且眼压控制在21 mmHg(1 mmHg=0.133 kPa)以下的PCACG患者40例54眼,随机分为治疗组20例26眼和对照组20例28眼。对照组术后应用维生素B12注射液50μg肌肉注射,每日1次;治疗组在对照组治疗的基础上给予川芎嗪注射液160 mg加入体积分数5%的葡萄糖250 mL中静脉滴注,每日1次,7 d为1个疗程,共3个疗程。观察2组患者治疗3个疗程后视力、视野变化。视野指标包括平均光敏感度(MS)和平均缺损(MD)。结果治疗3个疗程后,治疗组视力26眼中有效14眼,无效12眼,有效率53.8%;对照组视力28眼中有效2眼,无效26眼,有效率7.1%。2组有效率比较差异有统计学意义(χ2=30.311,P=0.003)。治疗组治疗后MS、MD[(19.09±0.74)、(8.19±0.75)dB]较治疗前[(23.53±0.62)、(6.73±0.63)dB]明显改善,差异均有统计学意义(t=3.37、3.57,P<0.05);对照组治疗后MS、MD[(18.64±0.83)、(8.76±0.84)dB]较治疗前[(19.18±0.72)、(8.32±0.82)dB]均有一定程度改善,但差异无统计学意义(t=0.54、0.32,P>0.05);2组患者治疗后MS、MD比较差异均有统计学意义(t=3.24、3.21,P<0.05)。结论川芎嗪可以明显改善PCACG术后眼压控制在目标范围内患者的视力和视野。

Objective To explore the changes of visual acuity,visual field of primary chronic angle closure glaucoma（PCACG）patients with normal intraocular pressure after operation,so as to provide theoretical basis for treatment of PCACG.Methods Forty cases（54 eyes）of PCACG patients,whose intraocular pressure were under 21 mmHg（1 mmHg=0.133 kPa） after operation from outpatient department of ophthalmology,the third hospital of Xinxiang medical college,from January 2010 to December 2011 were randomly divided into treatment group（n=20,26 eyes） and control group（n=20,28 eyes）.The control group was treated with vitamin B12 injection 50 μg by intramuscular injection,once a day.On the basis of control group,the treatment group was treated with tetramethylpyrazine injection 160 mg plus 250 mL 5% glucose by intravenous drip once a day for 3 courses of treatment,7 days as a course of treatment.The changes of visual acuity,visual field were observed in treatment group,control group after 3 courses of treatment.Visual field indexes included mean sensitivity（MS）and mean defect（MD）.Results After treatment for 3 courses,there were 14 eyes had progress,12 eyes kept invariant in the 26 eyes in treatment group,progress rate was 53.8%.There were 2 eyes had progress,26 eyes kept invariant in the 28 eyes in control group,progress rate was 7.1%.The difference of progress rate in the two groups had statistical significance（χ^2=30.311,P=0.003）.In treatment group,the MS,MD[（19.09±0.74）,（8.19±0.75）dB]had obvious improvement compared with pre-treatment[（23.53±0.62）,（6.73±0.63）dB],the differences had statistics significance（t=3.37,3.57,P〈0.05）.In control group,the MS,MD[（18.64±0.83）,（8.76±0.84）dB]had improvement to some degree compared with pre-treatment[（19.18±0.72）,（8.32±0.82）dB],the differences had no statistics significance（t=0.54,0.32,P〈0.05）.MS and MD in treatment group after treatment had obvious improvement compared with control group after treatment,the differences had statistics significance（t=3.24,3.21,P〈0.05）.Conclusion Tetramethylpyrazine can significantly improve visual acuity and visual field of PCACG patients with normal intraocular pressure after operation.