曲伏前列腺素滴眼液对原发性开角型青光眼患者眼压、血流动力学及ET-1、TIMP-2的影响

Effects of Travoprost Eye Drops on Intraocular Pressure, Hemodynamics,ET-1 and TIMP-2 in Patients with POAG

目的:探讨曲伏前列腺素滴眼液对原发性开角型青光眼(POAG)患者眼压、血流动力学及内皮素-1(ET-1)、基质金属蛋白酶-2抑制因子(TIMP-2)的影响。方法:选取2015年2月至2017年2月我院眼科收治的70例患者,按照随机数字表法分为对照组和观察组,每组各35例,对照组和观察组患者分别给予马来酸噻吗洛尔滴眼液和曲伏前列腺素滴眼液治疗,治疗周期为3个月。对比分析治疗前、治疗4周、8周及12周后两组患者的平均眼压(IOP)、昼夜IOP差,并对比治疗前、治疗12周后的睫状后动脉(PCA)、视网膜中央动脉(CRA)、收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、血管阻力指数(RI)、血浆ET-1及房水TIMP-2的改善情况。结果:治疗前两组患者平均IOP、昼夜IOP差、PCA和CRA血流动力学、血浆ET-1及房水TIMP-2差异无统计学意义(P>0.05);治疗4周、8周、12周后,两组平均IOP、昼夜IOP差明显低于治疗前,且治疗12周后观察组平均IOP、昼夜IOP差低于对照组,差异均有统计学意义(P<0.05);治疗12周后,观察组PCA和CRA的PSV、EDV高于治疗前,RI低于治疗前,差异均有统计学意义(P<0.05),且观察组PCA和CRA的PSV、EDV高于对照组,RI低于对照组,差异均有统计学意义(P<0.05);治疗12周后,两组患者血浆ET-1和房水TIMP-2较治疗前显著下降,且观察组血浆ET-1和房水TIMP-2含量低于对照组,差异均有统计学意义(P<0.05)。结论:曲伏前列腺素滴眼液治疗POAG患者,能够有效降低患者的眼压、血浆ET-1、房水TIMP-2水平,并改善患者PCA、CRA的血流动力学。

Objective： To investigate the effects of travoprost eye drops on intraocular pressure, hemodynamics and endothelin-1（ET-1） and matrix metalloproteinase-2（TIMP-2） in patients with primary open-angle glaucoma（POAG）. Methods： A total of 70 patients,who were treated in the 59 th Hospital of PLA from February 2015 to February 2017, were randomly divided into control group（n=35）and observation group（n=35）. The control group and the observation group were treated with timolol maleate eye drops and travoprost eye drops respectively for 3 months. The average intraocular pressure（IOP） and day and night IOP difference were comparatively analyzed before treatment, 4 weeks, 8 weeks and 12 weeks after treatment. The posterior ciliary artery（PCA）, central retinal artery（CRA）,peak systolic velocity（PSV）, end diastolic velocity（EDV） and vascular resistance index（RI）, plasma ET-1 and improve situation of aqueous humor TIMP-2 were compared before treatment and 12 weeks after treatment. Results： There were no significant differences in average IOP, day and night IOP difference, hemodynamics of PCA and CRA, plasma ET-1 and aqueous humor TIMP-2 between the two groups before treatment（P〉0.05）. After 4 weeks, 8 weeks and 12 weeks of treatment, average IOP and day and night IOP difference of the two groups were significantly lower than those before treatment, and average IOP and day and night IOP difference in the observation group were lower than those in the control group after 12 weeks treatment, the differences were statistically significant（P〈0.05）. After 12 weeks of treatment, the PSV and EDV of PCA and CRA in the observation group were higher than those before treatment, RI was lower than that before treatment, the differences were statistically significant（P〈0.05）. The PSV and EDV of PCA and CRA in the observation group were higher than those in the control group, RI was lower than that in the control group, the differences were statistically significant（P〈0.05）. After 12 weeks of treatment, the plasma ET-1 and aqueous humor TIMP-2 in the two groups were significantly lower than those before treatment, and the contents of plasma ET-1 and aqueous humor TIMP-2 in the observation group were lower than those in the control group, the differences were statistically significant（P〈0.05）. Conclusion： Travoprost eye drops can effectively reduce the levels of IOP, plasma ET-1 and aqueous humor TIMP-2 in the treatment of patients with POAG, and improve the hemodynamics of CRA and PCA.