布林佐胺与噻吗洛尔滴眼液对新生血管性青光眼患者眼压及血清和房水IL-6、PEDF和VEGF水平的影响

Effect of Brinzolamide Combined with Timolol on the Postoperative Intraocular Pressure and IL-6, PEDF, VEGF Levels in Serum and Aqueous Humor of Patients with Neovascular Glaucoma

目的:探讨布林佐胺联合噻吗洛尔滴眼液对新生血管性青光眼(NVG)患者眼压及血清和房水中白细胞介素-6(IL-6)、色素上皮衍生因子(PEDF)、血管内皮生长因子(VEGF)水平的影响。方法:选取我院2014年6月～2016年12月择期行手术治疗的86例NVG患者,按照随机数字表法均分为两组。对照组术后采取噻吗洛尔滴眼液治疗,观察组在此基础上加用布林佐胺滴眼液治疗。记录比较两组临床疗效,治疗前后眼压及血清和房水中IL-6、PEDF和VEGF水平的变化及不良反应的发生情况。结果:术后6个月,观察组总有效率为95.3%,较对照组明显升高(79.1%,P<0.05)。与术前对比,两组术后7天、6个月时24 h眼压峰值、平均眼压、眼压波动值、血清和房水中IL-6、VEGF水平均显著下降(P<0.01),血清和房水中PEDF水平均显著上升(P<0.01),且观察组以上眼压指标较对照组同期改善更为明显(P<0.01)。对照组和观察组不良反应的发生率对比差异无统计学意义(7.0%vs 11.6%,P>0.05)。结论:术后应用布林佐胺联合噻吗洛尔滴眼液治疗NVG患者更能有效降低眼压和控制其波动,调节机体血管生成促进/抑制因子平衡,提高治疗效果,且安全性高。

Objective： To investigate the effect of brinzolamide combined with timolol on the intraocular pressure and interleukin-6（IL-6）, pigment epithelium-derived factor（PEDF）, vascular endothelial growth factor（VEGF） levels in serum and aqueous humor of patients with neovascular glaucoma（NVG）. Methods： The subjects of this study were selected from 86 cases of patients with NVG who accepted surgery in our hospital from June 2014 to December 2016. They were randomly divided into two groups on a evenly basis. After operation, the control group was administrated with timolol eye drops, while the observation the combination of brinzolamid and timolol. The clinical efficacy, changes of intraocular pressure as well as cell factors in serum and aqueous humor before and after treatment, and occurrence of adverse reactions were recorded and compared between the two groups. Results： The overall effective rate of observation group at 6 months after operation was 95.3%, whichwas much higher than 79.1% of the control group（P〈0.05）. Compared with those before the surgery, the intraocular pressure peaks at 24 h, average intraocular pressures, intraocular pressure fluctuation values,and the IL-6 and VEGF levels of both groups at 7 days, 6 months after the surgery were significantly declined（P〈0.01）, while the PEDF levels got evidently increased（P〈0.01） as compared with those before the surgery. The improvement in the aforesaid intraocular pressure indicators in the observation group was more significant than that in the control group over the same period（P〈0.01）. No significant difference was seen between the two groups in terms of incidence of adverse reactions（7.0% vs 11.6%, P〉0.05）. Conclusion： The combination of brinzolamide and timolol in treating postoperative NVG is safe and has a better effect in reducing patients＇ intraocular pressures,controlling intraocular pressure fluctuation, promoting the balance between enhancing factors and inhibitory factors, and improving the treatment outcomes.