原发性开角型青光眼患者使用拉坦前列腺素前后24h眼压曲线比较

Compare 24-hour intraocular pressure curve in primary open-angle glaucoma patients before and after using latanoprost

目的通过观察原发性开角型青光眼（POAG）患者使用拉坦前列腺素前后24h眼压曲线的变化，评价其24h降眼压效果，为临床应用提供指导。方法回顾性分析2010年1月至2010年7月在首都医科大学附属北京同仁医院眼科中心接受24h眼压监测患者的病历，筛选出使用拉坦前列腺素进行初次治疗的POAC患者。比较在用药前后24h眼压曲线的变化。眼压测量使用回弹式眼压计，测量时间点为10：00、14：00、18：00、22：00、2：00、6：00和8：00。结果共有26例入选，其中男性12例，女性14例，平均年龄（49±15）岁。用药后不同时间点眼压降低的幅度在4．0-6．3mmHg，除2：00外，其余时间点用药前后的差别有统计学意义。用药前眼压的峰值、均值、24h波动值分别为（26．3±7．7）、（21．9±6_3）和（8．4±3．2）mmHg，用药后相应值分别为（21．7±5．6）、（16．9±4．0）和（8．4±4．1）mmHg，较用药前分别降低（4．6±3．8）mmHg（F=6．14，P=0．017）、（5．0±2．9）（F=11．33，P=0．001）和（0．1±4．3）mmHg（F=0．004，P=0．951）。结论除2：00点外，拉坦前列腺素在其他时间点均可明显降低眼压，24h眼压的峰值和均值亦有明显降低．但对眼压波动无明显影响。

Objective To evaluate the effect of latanoprost reducing the 24-hour intraocular pressure （lOP） and supply directions for clinical application, observing the change of 24-hour IOP in primary open-angle glaucoma （POAG） patients. Methods Retrospective analyzed the patients＇ case files who received the monitoring of 24-hour IOP in Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University from January to July, 2010. And those POAG patients who first received latanoprost therapy were selected. The differences of 24-hour IOP curve before and after medication were compared. Icare rebounder tonomer was used, the IOP were measured at 10 am, 2pm, 6pm, 10pm, 2am, 6am and 8am. Results The amplitude of lowering IOP after medication was 4.0-6.3mmHg in different time except for 2 am, there was a statistically significant difference before and after medication in other time. The peak, mean and 24-hour IOP were 26.3±7.7, 21.9±6.3, 8.4±3.2mmHg before medication, and 21.7±5.6, 16.9±4.0, 8.4±4.1mmHg after medication respectively. Separately reducing the IOP 4.6~3.8 （F =6.14,P =0.017）, 5.0±2.9 （F =11.33, P =0.001） and 0.1~4.3mmHg （F =0.004, P =0.951）. Conclusions Latanprost provide effective 24-hour IOP reduction except for 2 am. The peak and mean IOP are significantly reduced in 24-hour IOR However, latanoprost has no significantly effect for fluctuation of IOP.