毛果芸香碱治疗原发性急性闭角型青光眼的效果及对血流动力学的影响

Pilocarpine treatment of primary acute angle closure glaucoma and its effect on hemodynamics

目的探讨分析毛果芸香碱治疗原发性急性闭角型青光眼的效果及对患者血流动力学指标的影响。方法选择武汉市红十字医院2015年2月~2016年2月收治的原发性急性闭角型青光眼患者106例(109眼),按照随机数字表法将其随机分为观察组53例(55眼)、对照组53例(54眼),对照组给予拉坦前列素滴眼液,观察组在对照组基础上使用硝酸毛果芸香碱滴眼液。比较两组临床效果、眼压、视力变化以及血流动力学指标。结果观察组患者治疗总有效率显著高于对照组(P<0.05);治疗1个月及治疗3个月后,两组眼压、视力均明显优于治疗前,差异有统计学意义(P<0.05);治疗3个月后,两组眼压、视力均明显优于治疗1个月后,差异有统计学意义(P<0.05);治疗1个月及治疗3个月后,观察组眼压、视力均优于同期对照组,差异有统计学意义(P<0.05)。治疗3个月两组患者血流速度(EDV)较治疗前显著升高(P<0.05),而收缩期峰值血流速度(PSV)以及血管阻力指数(RI)较治疗前显著降低(P<0.05),且观察组患者各指标变化情况显著优于对照组(P<0.05);两组患者不良反应发生率无显著差异(P>0.05)。结论毛果芸香碱治疗原发性急性闭角型青光眼能够有效提高患者临床效果,降低患者眼压并提高患者视力,同时促进视网膜中央动脉血流动力学指标的改善,值得临床推广。

Objective To investigate the curative effect of pilocarpine treatment of primary acute angle closure glaucoma patients and the influence on hemodynamics. Methods From February 2015 to February 2016, 106 patients （109 eyes） with primary acute angle closure glaucoma at Wuhan Red Cross Hospital were selected and divided into observation group （53 cases, 55 eyes） and control group （53 cases, 54 eyes） according to the random number table method. Patients in the control group were treated by Latanoprost Eye Drops, and patients in the observation group were treated by Pilocarpine Nitrate Eye Drops and Latanoprost Eye Drops.The clinical efficacy, intraocular pressure, visual acuity and hemodynamics of the two groups were compared. Results The total effective rate of the observation group was signifi- cant higher than that of the control group （P 〈 0.05）. 1 month and 3 months after treatment, the intraocular pressure and visual acuity of observation group and the control group were better than those before treatment, with statistically significant difference （P 〈 0.05）; 3 months after treatment, the intraocular pressure and visual acuity of the two： groups were better than those 1 months after treatment, with statistically significant difference （P 〈 0.05）. 1 month and 3 months after treatment, the intraocular pressure and visual acuity of the observation group were better than those of the control group, with statistically significant difference （P 〈 0.05）. 3 months after treatment, EDV of the two groups patients were higher than those before treatment （P 〈 0.05）, PSV and RI were lower than those before treatment （P 〈 0.05）, and those of the observation group were significantly better than those of the control group （P 〈 0.05）.There was not significant difference in the incidence of adverse reactions between the two groups （P 〉 0.05）. Conclusion The pilocarpine treatment of primary acute angle closure glaucoma can effectively improve the clinical efficacy, reduce the intraocuiar pressure and improve visual acuity, meanwhile it can promote the development of the central retinal artery hemodynamics. It is worthy of clinical application