复方樟柳碱治疗外伤性视神经视网膜脉络膜缺血性病变50例疗效评价

Compound Anisodine Injection for Treating Traumatic Optic Retinal Choroidal Ischemic Lesions in 50 Cases

目的观察复方樟柳碱注射液治疗外伤性视神经视网膜脉络膜缺血性病变的疗效,并探讨其机制。方法选取2013年5月至2015年5月收治的外伤性视神经视网膜脉络膜缺血性病变患者100例,随机分为观察组和对照组,各50例。对照组患者给予妥拉苏林注射液,观察组患者给予复方樟柳碱注射液,均治疗21 d。结果治疗后,对照组患者有10例视力未改善,而观察组仅有1例未改善,视力状况较对照组明显提高(P<0.05);观察组患者视野缺损减少超过40%者19例,视野缺损的恢复情况也较对照组好(P<0.05);观察组患者眼动脉、视网膜中动脉和脉络膜前动脉的收缩期峰值血流速度(PAV)较对照组明显增高,阻力指数(RI)较对照组明显降低(P<0.05);两组患者血管内皮生长因子(VEGF)、缺氧诱导因子-1α(HIF-1α)阳性率均有下降,但观察组下降更明显(P<0.05);VEGF及HIF-1α与患者的视力、视野、眼动脉PAV、视网膜中央动脉PAV和脉络膜前动脉PAV呈显著负相关,与患者的眼动脉RI、视网膜中央动脉RI和脉络膜前动脉RI呈显著正相关。结论复方樟柳碱注射液对外伤性视神经视网膜脉络膜缺血性病变有较好的治疗效果,可显著改善患者的视力、视野及眼部动脉的血流动力学指标,可能与该药可降低患者的VEGF及HIF-1α表达有关。

Objective To investigate the efficacy and mechanism of Compound Anisodine Injection on traumatic optic retinal choroidal ischemic lesions.Methods 100 cases of traumatic optic retinal choroidal lesions from May 2013 to May 2015 were selected and randomly divided into two groups,50 cases in each group.The control group was given Tolazoline Injection,and the observation group was given Compound Anisodine Injection.Both groups were treated for 21 d.Results After treatment,the vision of 10 cases in the control group did not improve,but in the observation group there was only 1 case,the visual acuity of observation group improved significantly better compared with the control group( P < 0.05); the cases with visual field defects group reduction > 40% were up to 19 cases in the observation group,and visual field defects recovery were also good compared with the control group( P < 0.05).After treatment,the ophthalmic artery,retina and anterior choroidal artery PAV arteries( peak systolic velocity) of the observation group were significantly higher than those of the control group,RI( resistance index) was significantly lower than the control group( P < 0.05); the VEGF,HIF-1α positive rate decline of the two groups decreased,but the observation group decreased more significantly( P < 0.05); the VEGF,HIF- 1αwere significantly negatively correlated with visual acuity,field of vision,ophthalmic artery PAV,central retinal artery and anterior choroidal artery PAV,and significant positive correlated with the patient ophthalmic artery RI,central retinal artery and anterior choroidal artery RI.Conclusion Compound Anisodine Injection on traumatic optic retinal choroidal ischemic lesions has a better therapeutic effect,can significantly improve the patient's vision,vision and ocular hemodynamics arteries.This may be correlated with the fact that the drug can reduce the VEGF,HIF-1α expression of patients.