布林佐胺联合曲伏前列素治疗开角型青光眼的临床疗效及安全性

Brinzolamide Combined with Travoprost in Treating Open Angle Glaucoma and Its Safety

目的探讨布林佐胺联合曲伏前列素治疗开角型青光眼的临床疗效及安全性。方法选取2014年1月至2015年1月医院收治的开角型青光眼患者64例（112眼）,随机分成对照组和观察组,各32例（56眼）。药物洗脱期后,对照组给予曲伏前列素每日1次滴眼治疗,观察组加用布林佐胺每日2次滴眼治疗。结果观察组总有效率为90.62%,显著高于对照组的76.67%（P〈0.05）,且观察组眼压降低较对照组更显著（P〈0.05）。两组患者泪膜破裂时间、泪液分泌值较治疗前下降,角膜荧光素染色、眼表虎红染色评分增加,印迹细胞分级0~1级眼数比例减少、2~3级增加,差异均有统计学意义（P〈0.05）;观察组角膜荧光素染色评分较对照组增加明显（P〈0.05）,其余变化两组无显著差异（P〉0.05）。观察组不良反应发生率为12.50%,与对照组的15.62%比较无明显差异（P〉0.05）。结论布林佐胺联合曲伏前列素治疗开角型青光眼可有效改善患者眼压情况,临床疗效佳,但可导致患者泪膜稳定性下降,泪液分泌减少,对结膜、角膜有一定损伤,对眼表的影响与单一用药相当。

Objective To evaluate the clinical efficacy of brinzolamide combined with travoprost in treating open- angle glaucoma and its safety. Methods 64 patients with open angle glaucoma（ 112 eyes） from January 2015 to January 2014 were randomly divided into control group and observation group,32 cases（ 56 eyes） in each group. After a washout period,the control group was treated with travoprost eye drops（ 1 time / d）, the observation group was added with brinzolamide eye drops（ 2 times / d） on the basis of the contro,group. Results After treatment, the total effective rate of the observation group was 90. 62%, which was significantly higher than76. 67% of the control group（ P 〈 0. 05）; the intraocular pressure（ IOP） reduction of the observation group was more significant than that of the control group（ P 〈 0. 05）. The tear break- up time,Schirmer values of the two groups decreased compared with before treatment, and the corneal fluorescein staining, ocular surface rose bengal staining score increased, imprinted cell grade 0- grade 1 reduced,and grade 2- grade 3 increased（ P 〈 0. 05）. The corneal fluorescein staining score of the observation group increased significantly compared with the control group（ P 〈 0. 05） and the rest showed no significant difference（ P 〉 0. 05）. The incidence rate of adverse reactions in the observation group was 12. 50%, which had no significantly difference between the control group（ P 〉 0. 05）.Conclusion Brinzolamide combined with travoprost in treating open angle glaucoma can effectively improve the IOP with good clinical efficacy. But it can also lead to a decrease in tear film stability and tear secretion,and has some damage on conjunctiva and cornea; its influence on the ocular surface is equal with the single drug use.