长期局部应用β-受体阻滞剂影响泪液分泌及泪膜稳定性的研究

A study of influence on tear secretion and tear film stability due to long-term topical beta-blocker medication

目的 观察长期局部应用 β-受体阻滞剂对泪液分泌及泪膜稳定性的影响。方法 1994年 1月～2 0 0 1年 8月间青光眼患者 139例。年龄 14～ 83岁 ;男 84例 ,女 5 5例 ;病程 3月～ 4年。将 139例患者分成对照组(无局部用药组 ) 6 1例和 β-受体阻滞剂组 78例 (用药组 ,使用 β-受体阻滞剂≥ 18月 ,如 0 .5 %噻吗洛尔、0 .5 %贝特舒 (贝他洛尔 ) ,观察指标包括眼异物感、干涩灼热感、畏光感、结膜充血、分泌物及干眼症三项检查 Schirmer 试验、泪膜破裂时间 (BU T)和角膜荧光素染色 )。结果 β-受体阻滞剂组的干眼症状和体征明显 ,泪膜功能受损 ,与对照组比较差异有显著性 (P <0 .0 1) ;而两组在青光眼的类型、病程、年龄、性别等方面则差异均无显著性 (P >0 .0 5 )。结论 长期局部使用 β-受体阻滞剂可以因药物引起结膜的慢性炎症等副作用而导致泪液分泌减少和影响泪膜稳定性 。

Objective To investigate the influence on tear secretion and tear film stability due to long term topical beta blocker medication.Methods 139 cases with glaucoma were followed up from January 1994 to August 2001.The ages ranges from 14 to 83,including 84 male patients and 55 females totally.The attacked histories varied from 3 months to 4 years.They were invided into 2 groups.The control group and the beta blocker group(used beta blocker eye drops≥18 months,such as 0.5% Timolol maleate and 0.5% Betoptic s(Betaxolol hydrochloride) consisted of 61 and 78 cases.The observed symptoms included ocular foreign body sensation,dryness,burning,photophobia.The signs were conjunctival congestion,discharge,and the results of 3 kinds of clinical examination for dry eye(Schirmer I test,tear film break up time (BUT) and fluorescein staining of cornea).Results The ocular symptoms and signs of dry eye were manifest and tear film functions were significantly decreased in beta-blocker group (P<0.01).No significant difference between both groups in the types of glaucoma,attacked histories,ages and sex(P>0.05).Conclusion The long term use of topical beta blocker can lead to the decrease of tear secretion and instability of tear film resulted from the chronic conjunctivitis caused by adverse effects of medication.It is helpful to use of artificial tear for the cases to improve the conditions of dry eye