大剂量尿激酶联合神经节苷脂治疗视网膜动脉阻塞的疗效观察

The effect of large dose urokinase and gangliosides on retinal arterial obstruction

目的 探讨应用大剂量尿激酶联合神经节苷脂对视网膜动脉阻塞的治疗效果.方法 从2007年1月至2011年1月收集到无凝血功能障碍的视网膜动脉阻塞患者36例（36只眼）,分为A、B两组,其中A组14例,B组22例.治疗方案：A组,活血化瘀、扩血管治疗,用药静脉点滴血栓通300 mg/日、七叶皂甙钠20 mg/日,球后注射地塞米松2.5 mg＋曲克芦丁0.5 ml,1次/h组：尿激酶60～80万单位/日,静脉点滴,联合神经节苷脂注射液40 mg/日,静脉点滴,球后注射尿激酶2000单位＋地塞米松2.5 mg,1次/日,两组均口服肌苷、维生素C、迈之灵,结合患者血压、血流变、血脂情况对应治疗,同时扩血管、活血化瘀治疗.结果 治疗前视力为光感～0.1,治疗后视力均有提高,A组有效率71.42%,B有效率90.9%.结论 尿激酶能溶解血栓,快速恢复视网膜血液循环.神经节苷脂能有效的恢复视神经功能,促进视力的提高.对于急性视网膜动脉阻塞,要综合治疗,联合用药.大剂量尿激酶联合神经节苷脂治疗是有效的.

Objective To investigate the therapeutic effect of large dose uroklnase combined with gangliesides on retinal arterial obstruction. Methods We analyzed 36 cases of patients with retinal arterial obstruction. All patents did riot have any other types of coagulation disorders. Patients were divided into 2 groups. One group （ 22 patients） received large dose urokinase （400kU to 800kU per day） combined with gangliesidas 40 mg per day. Other 12 patients received roufine vessel dilation therapy with combination of vasoactive medications and traditional Chinese herbs. Systemic blood pressure ocular blood flow, and serum lipid content were measured and compared between 2 groups. Results Visual acuity prior to treatment ranged from light perception to 0. 1. After treatment, average visual acuity improved to 0. 15 ~ 1.0. Effecfive rate was 90.9% with urokinase treatment and 71.42% with routine treatment. Conclusion Urokinase can dissolve clot and quickly recover circulation of the retina. Gangliosides can recover optic nerve function and improve vision. The therapeutic effect of large dose urokinase combined with gangliosides on retinal arterial obstruction was significant