硝酸甘油诱发老年患者急性闭角型青光眼

Acute angle-closure glaucoma induced by nitroglycerin in an elderly patient

1例94岁男性冠心病患者因血压升高给予硝酸甘油10 mg静脉微泵注射，泵速20μg/min。连续用药约6 h，患者出现视物模糊，伴头痛、呕吐，诊断为急性闭角型青光眼。立即停用硝酸甘油，改用氨氯地平5 mg口服，1次/d，并给予20％甘露醇125 ml静脉滴注，1次；2％毛果芸香碱滴眼液滴眼，4次/d；醋甲唑胺25 mg口服，2次/d。2 d后，患者头痛、视物模糊改善；6 d后，患者头痛消失；9d后，患者视力完全恢复。

A 94-year-old male with coronary heart disease was given nitroglycerin 10 mg by intravenous micro pump for treating his elevated blood pressure,the injection pump speed was controlled at 20 μg/min. About 6 hours after continuous administration, the patient developed blurred vision with headache and vomiting. Acute angle-closure glaucoma was diagnosed. Nitroglycerin was stopped immediately and changed oral amlodipine 5 mg once daily. He was given an intravenous infusion of 20% mannitol 125ml,2% pilocarpine eye drops 4 times daily,oral methazolamide 25 mg twice daily. Two days later,the symptoms of headache and blurred vision improved. Four days later,the headache disappeared. Nine days later,the patient＇s vision completely recoveried.