尼莫地平联合曲伏前列素滴眼液治疗原发性开角型青光眼的疗效观察
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摘要
目的探讨尼莫地平联合曲伏前列素滴眼液治疗原发性开角型青光眼的临床效果。方法选取2015年12月—2017年12月洛阳博爱眼科医院收治的原发性开角型青光眼患者80例,随机分成对照组(40例)和治疗组(40例)。对照组患者睡前滴入曲伏前列素滴眼液,1滴/次,1次/d。治疗组在对照组基础上口服尼莫地平片,1片/次,3次/d。两组均连续治疗12周。观察两组患者临床疗效,同时比较治疗前后两组患者24 h峰值眼压、视功能相关的生存质量量表-25(NEI VFQ-25)总分、视盘参数和视野平均缺损(MD)及视盘筛板血流参数。结果治疗后,对照组和治疗组临床有效率分别为75.0%和92.5%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组24 h峰值眼压显著下降(P<0.05),NEI VFQ-25总分显著升高(P<0.05),且治疗组24 h峰值眼压和NEI VFQ-25总分明显好于对照组(P<0.05)。治疗后,两组垂直杯盘比(C/D)、平均C/D和视野MD值均显著降低(P<0.05),盘沿面积(RA)值显著升高(P<0.05),且治疗组视盘参数和视野MD明显好于对照组(P<0.05)。治疗后,两组各视盘筛板血流速度、血流量和红细胞移动速率值均明显升高(P<0.05),且治疗组视盘筛板血流参数明显高于对照组(P<0.05)。结论尼莫地平联合曲伏前列素滴眼液治疗原发性开角型青光眼能明显控制患者眼压,改善筛板区血流状态,延缓病情进展,提高生活质量。
Objective To investigate the clinical effect of nimodipine combined with travoprost in treatment of primary open-angle glaucoma. Methods Patients(80 cases) with primary open-angle glaucoma in Luoyang Boai Ophthalmological Hospital from December 2015 to December 2017 were randomly divided into control(40 cases) and treatment(40 cases) groups. Patients in the control group were dropped administered with Travoprost Eye Drops at bedtime, 1 drop/time, once daily. Patients in the treatment group were po administered with Nimodipine Tablets on the basis of the control group, 1 tablet/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the 24 h peak IOP, NEI VFQ-25 scores, optic disc parameters, visual field MD, blood flow parameters of disc cribriform plates in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 75.0% and 92.5% respectively, and there were differences between two groups(P < 0.05). After treatment, the 24 h peak IOP in two groups was significantly decreased(P < 0.05), but NEI VFQ-25 scores were significantly increased(P < 0.05), and the 24 h peak IOP and NEI VFQ-25 scores in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the vertical C/D, average C/D and vision MD value in two groups was significantly decreased(P < 0.05), but RA value was significantly increased(P < 0.05), and the optic disc parameters, the visual field MD in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the blood flow rate, blood flow and erythrocyte migration rate of disc cribriform plates in two groups were significantly increased(P < 0.05), and the blood flow parameters of disc cribriform plates in the treatment group were significantly higher than that in the control group(P < 0.05). Conclusion Nimodipine combined with travoprost in treatment of primary open-angle glaucoma can obviously control the intraocular pressure of patients, improve the blood flow state in the cribriform plate area, delay the progress of the disease, and improve the quality of life.
Objective To investigate the clinical effect of nimodipine combined with travoprost in treatment of primary open-angle glaucoma. Methods Patients(80 cases) with primary open-angle glaucoma in Luoyang Boai Ophthalmological Hospital from December 2015 to December 2017 were randomly divided into control(40 cases) and treatment(40 cases) groups. Patients in the control group were dropped administered with Travoprost Eye Drops at bedtime, 1 drop/time, once daily. Patients in the treatment group were po administered with Nimodipine Tablets on the basis of the control group, 1 tablet/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the 24 h peak IOP, NEI VFQ-25 scores, optic disc parameters, visual field MD, blood flow parameters of disc cribriform plates in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 75.0% and 92.5% respectively, and there were differences between two groups(P < 0.05). After treatment, the 24 h peak IOP in two groups was significantly decreased(P < 0.05), but NEI VFQ-25 scores were significantly increased(P < 0.05), and the 24 h peak IOP and NEI VFQ-25 scores in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the vertical C/D, average C/D and vision MD value in two groups was significantly decreased(P < 0.05), but RA value was significantly increased(P < 0.05), and the optic disc parameters, the visual field MD in the treatment group were significantly better than those in the control group(P < 0.05). After treatment, the blood flow rate, blood flow and erythrocyte migration rate of disc cribriform plates in two groups were significantly increased(P < 0.05), and the blood flow parameters of disc cribriform plates in the treatment group were significantly higher than that in the control group(P < 0.05). Conclusion Nimodipine combined with travoprost in treatment of primary open-angle glaucoma can obviously control the intraocular pressure of patients, improve the blood flow state in the cribriform plate area, delay the progress of the disease, and improve the quality of life.
引文
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[13]孙霞,刘磊,杨文利,等.原发性开角型青光眼视盘及视网膜血流的研究[J].眼科新进展,2001,21(5):344-345.
[2]王雪琼,李军,黎卫平.原发性开角型青光眼的治疗现状[J].临床眼科杂志,2017,25(2):183-187.
[3]陈璐,童荣生,吕晶.降眼压新药--曲伏前列素[J].中国药房,2008,19(25):1981-1983.
[4]肖明,孙兴怀,沈颖.尼莫地平对开角型青光眼视盘筛板血流的作用研究[J].眼科新进展,2002,22(3):195-196.
[5]中华医学会眼科学分会青光眼学组.我国原发性青光眼诊断和治疗专家共识(2014年)[J].中华眼科杂志,2008,44(9):862-863.
[6]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:318-319.
[7]黄江,刘晓玲.中文视功能相关生存质量量表-25的初步应用评价[J].中华眼视光学与视觉科学杂志,2016,18(11):660-664.
[8]张永梅,于蒙,莫日根.原发性开角型青光眼发病机制的研究[J].内蒙古大学学报:自然版,2016,47(2):189-194.
[9]王静.原发性开角型青光眼降眼压药物治疗进展[J].医学信息,2012,25(5):446.
[10]韩宗红.曲伏前列素滴眼液的药理作用与临床评价[J].中外健康文摘,2007,4(9):74-76.
[11]刘静,姚毅,徐宁.尼莫地平的药代动力学及在眼科中的应用[J].医学综述,2003,9(Suppl):56-57.
[12]杨新光,刘钊,于敬妮,等.原发性青光眼早期视盘参数与视野缺损的关系[J].临床眼科杂志,2009,17(4):295-299.
[13]孙霞,刘磊,杨文利,等.原发性开角型青光眼视盘及视网膜血流的研究[J].眼科新进展,2001,21(5):344-345.