噻吗洛尔与卡替洛尔联合曲伏前列素的降眼压作用及影响血脂的作用

Effect on intraocular pressure and serum lipid levels of timolol versus carteolol as adjunctive therapies to travoprost

目的比较0.5%马来酸噻吗洛尔联合0.004%曲伏前列素和2%盐酸卡替洛尔联合0.004%曲伏前列素2种联合用药方法,对于单用曲伏前列素效果不佳的患有开角型青光眼(OAG)或高眼压症(OHT)受试者的降眼压作用和影响血脂的作用。方法本试验为前瞻性、随机、单盲、平行对照试验。将受试者随机分为2组,分别接受2种联合用药方法,测定治疗前后眼压及空腹血脂水平。结果噻吗洛尔联合曲伏前列素组平均眼压从(23.4±3.5)mm Hg降到(17.2±1.9)mm Hg;卡替洛尔联合曲伏前列素组从(22.8±2.8)mm Hg降到(16.4±2.2)mm Hg。对于血脂的影响,噻吗洛尔联合曲伏前列素组高密度脂蛋白(HDL)从(524±162)mg/L降到(495±177)mg/L,总胆固醇/高密度脂蛋白(TC/HDL)从4.3升到4.6,卡替洛尔组HDL从(489±177)mg/L降到(482±181)mg/L,TC/HDL从4.5升到4.6。结论对于单用曲伏前列素降眼压效果不佳的OAG或OHT受试者,噻吗洛尔和卡替洛尔在作为辅助治疗药物时,都有较好的降眼压作用,且两药作用没有明显差别。但对于血脂水平的影响,噻吗洛尔组HDL和TC/HDL的变化对于受试者产生了不利的影响,而卡替洛尔组的变化对受试者基本没有影响。

Objective To compare the effect on intraocular pressure and serum lipid levels of 0.5% Timolol Maleate and 2.0% carteolol hydrochloride as adjunctive therapies to 0.004% Travoprost in adults with primary open-angle glaucoma（OAG） or ocular hypertension（OHT） whose IOP was inadequately controlled with travoprost monotherapy. Methods This was a prospective, randomized, double-blind, parallel trial. Patients were randomized to receive 1 of the 2 adjunctive therapies. IOP and 12 h fasting serum lipid levels were measured before and after the treatment. Results Mean IOP decreased from（23.4 ±3.5） mm Hg at baseline to（17.2 ±1.9） mm Hg after treatment in the timolol group, and from（22.8±2.8） mm Hg to（16.4±2.2） mm Hg in the carteolol group. Mean HDL decrease from a baseline level of（52.4 ±16.2） mg/L to（49.5 ±17.7） mg/L and TC/HDL changed from 4.3 to 4.6 in the timolol group,compared with（489±177） mg/L to（482±181） mg/L for mean HDL, and 4.5 to 4.6 for TC/HDL in the carteolol group.Conclusion For adults with primary OAG or OHT whose IOP was inadequately controlled with travoprost monotherapy, either timolol or carteolol as adjunctive therapy may result in reduced IOP. There was no significant difference in reducing IOP between timolol and carteolol. Carteolol demonstrated no statistical change from baseline for both HDL and TC/HDL ratio, whereas a negative influence was statistically associated with timolol therapy for both the HDL and the TC/HDL ratio.