组合降压药治疗原发性开角型青光眼和高眼压症的临床疗效

Clinical efficacy of combination antihypertensive drugs in the treatment of primary open-angle glaucoma and ocular hypertension

目的:比较曲伏前列腺素/噻吗洛尔固定组合及布林佐胺/溴莫尼定/噻吗洛尔治疗原发性开角型青光眼(primary open angle glaucoma,POAG)和高眼压症(ocular hypertension,OHT)患者的临床疗效及耐受性。方法:选择单一药物治疗无明显疗效的原发性青光眼和OHT患者147例270眼。将患者随机分为曲伏前列腺素/噻吗洛尔固定组合治疗组(A组,75例138眼)和布林佐胺/溴莫尼定/噻吗洛尔固定组合治疗组(B组,72例132眼)。比较2组患者治疗1,3,6个月时的眼压(intraocular pressure,IOP),治疗3个月、6个月时的眼表疾病指数(ocularsurface disease index,OSDI),以及治疗过程中发生的不良反应事件发生率。结果:2组患者治疗1个月时IOP(19.21±1.71vs19.16±1.75)比较差异无统计学意义(P>0.05),但在治疗3和6个月时,A组患者无论是在上午8点(15.11±1.37vs16.88±1.49;14.81±1.29vs16.15±1.36)还是10点(14.53±1.26vs15.39±1.33;13.79±1.15vs15.54±1.36),其IOP均显著低于B组患者,差异均有统计学意义(均P<0.05)。在治疗3个月时(15.42±3.61vs16.75±3.72)、6个月时(15.63±3.79vs16.99±3.88),A组患者OSDI均显著低于B组患者,差异均有统计学意义(均P<0.05)。A组患者治疗过程中不良反应发生率显著低于B组(25.33%vs44.00%),差异有统计学意义(P<0.05)。结论:曲伏前列腺素/噻吗洛尔固定组合治疗POAG或OHT临床疗效及耐受性均优于布林佐胺/溴莫尼定/噻吗洛尔固定组合治疗。

Objective: To compare clinical efficacy and tolerability of the fixed combination of travoprost/timolol and brinzolamide/brimonidine/timolol in treatment of patients with primary open-angle glaucoma and ocular hypertension. Methods: A total of 147 patients that 270 eyes with primary glaucoma and ocular hypertension which single-drug therapy had no significant effect were chosen for the study in First Hospital of Yulin from January 2013 to June 2015. Patients were divided randomly travoprost/timolol fixed combination treatment group (group A: 75 cases, 138 eyes) and brinzolamide /brimonidine/timolol fixed combination treatment group (group B: 72 cases, 132 eyes). The intraocular pressure (IOP) at time points of 1, 3, or 6 months, ocular surface disease index (OSDI) at time points of 3, 6 months and adverse events occurred in the two groups during the treatment process were compared. Results: There was no difference in IOP between the two groups after treatment for one month (19.21±1.71 vs 19.16±1.75;P>0.05), but the IOP in group A at 8:00 am (15.11±1.37 vs 16.88±1.49;14.81±1.29 vs 16.15±1.36) or 10:00 am (14.53±1.26 vs 15.39±1.33;13.79±1.15 vs 15.54±1.36) was significantly lower than group B after treatment for 3 and 6 months (all P<0.05). The OSDI in group A were significantly lower than group B after treatment for 3 (15.42±3.61 vs 16.75±3.72) and 6 months (15.63±3.79 vs 16.99±3.88), the difference was statistically significant (all P<0.05). The adverse events occurred in two groups were significantly different (25.33% vs 44.00%);group A was totally lower than B, the difference was statistically different (P<0.05). Conclusion: The clinical efficacy and tolerability of treatment of primary open-angle glaucoma or ocular hypertension using fixed combination of travoprost/timolol are better than fixed combination treatment of brinzolamide/brimonidine/timolol, and worthy for clinical use.