CAJ | 학술논문

背景:眼前部缺血性视神经病变(anteriorischemic optic neuropathy,AION)是由于视神经神经局部供血不足,引起视神经局部缺血缺氧,而视力下降、视野缺损的疾病,目前,AION确切的发病机理尚未证实.目的:观察灯盏花素注射液治疗眼前部缺血性视神经病变(AION)后患者血流动力学的变化.设计:以诊断为依据的病例对照研究.地点和对象:AION患者36例,为广东医学院附属医院1999-01/2002-02份住院患者,男16例,女20例,年龄最小40岁,最大76岁,平均55.4岁.干预:给予灯盏花素注射液50mg加入250mL生理盐水中静脉点滴,1次/d,每个疗程10 d.主要观察指标:应用彩色超声多普勒技术,检测36例(36只眼)AION患者应用灯盏花素注射液治疗前后眼动脉、睫状后短动脉、视网膜中央动脉血流动力的改变,并与对侧健眼进行比较.结果:应用灯盏花素治疗后,患者眼动脉收缩期血流速度舒张末期血流速度和阻力指数分别为(32.74±3.56)cm/s,(17.12±2.15)cm/s,0.63±0.03,睫状后短动脉收缩期血流速度舒张末期血流速度和阻力指数分别为(12.35±1.60)cm/s,(5.96±0.86)cm/s,0.59±0.03,视网膜中央动脉收缩期血流速度舒张末期血流速度和阻力指数分别为(15.41±1.62)cm/s,(5.71±0.830)cm/s,0.64±0.02,治疗后眼动脉、睫状后短动脉、视网膜中央动脉收缩期血流速度舒张末期血流速度明显增加,阻力指数明显下降,与治疗前[(8.53±2.15)cm/s,(2.98±0.94)cm/s,0.71±0.03]比较,差异有显著性意义(P＜0.01).结论:灯盏花素注射液治疗可以改善AION血流动力参数,疗效明显,未发现明显的不良反映.
배경:안전부결혈성시신경병변(anteriorischemic optic neuropathy,AION)시유우시신경신경국부공혈불족,인기시신경국부결혈결양,이시력하강、시야결손적질병,목전,AION학절적발병궤리상미증실.목적:관찰등잔화소주사액치료안전부결혈성시신경병변(AION)후환자혈류동역학적변화.설계:이진단위의거적병례대조연구.지점화대상:AION환자36례,위엄동의학원부속의원1999-01/2002-02빈주원환자,남16례,녀20례,년령최소40세,최대76세,평균55.4세.간예:급여등잔화소주사액50mg가입250mL생리염수중정맥점적,1차/d,매개료정10 d.주요관찰지표:응용채색초성다보륵기술,검측36례(36지안)AION환자응용등잔화소주사액치료전후안동맥、첩상후단동맥、시망막중앙동맥혈류동력적개변,병여대측건안진행비교.결과:응용등잔화소치료후,환자안동맥수축기혈류속도서장말기혈류속도화조력지수분별위(32.74±3.56)cm/s,(17.12±2.15)cm/s,0.63±0.03,첩상후단동맥수축기혈류속도서장말기혈류속도화조력지수분별위(12.35±1.60)cm/s,(5.96±0.86)cm/s,0.59±0.03,시망막중앙동맥수축기혈류속도서장말기혈류속도화조력지수분별위(15.41±1.62)cm/s,(5.71±0.830)cm/s,0.64±0.02,치료후안동맥、첩상후단동맥、시망막중앙동맥수축기혈류속도서장말기혈류속도명현증가,조력지수명현하강,여치료전[(8.53±2.15)cm/s,(2.98±0.94)cm/s,0.71±0.03]비교,차이유현저성의의(P＜0.01).결론:등잔화소주사액치료가이개선AION혈류동력삼수,료효명현,미발현명현적불량반영.
BACKGROUND: Anterior ischemic optic neuropathy(AION) is a kind of disease with eyesight declined and defect of visual field caused by deficiency of local blood supply inducing local ischemia of the optic nerve. The pathological mechanism of AION still remains unclear.OBJECTIVE: To observe the changes of AION patients' hemodynamics after Breviscapine injection.DESIGN: Case-control study based on diagnosis.SETTING and PARTICIPANTS: Thirty-six AION patients, who were the inpatients of Hospital Attached to Guangdong School of Medicine from January 1999 to February 2002, were composed of 16 males and 20 females,with age from 40 to 76, 55.4 years old on average.INTERVENTION: Mix solution of 50 mg Breviscapine and 250 mL normal sodium was injected into vein, once a day, and 10 days as a course.MAIN OUTCOME MEASURES: Multi-color Ultrasonic Doppler technique was used before and after injection of Breviscapine to detect hemodynamical changes of ophthalmic artery, short posterior ciliary artery and central retinal artery in 36 eyes of AION patients. The health eyes were treated as controls.RESULT: After treatment with Breviscapine injection, the blood flow velocity during systole and relaxing period and the resistant index of ophthalmic artery were(32.74 ± 3.56) cm/s, (17. 12 ± 2. 15) cm/s, 0. 63 ±0.03 respectively. Those of the short posterior ciliary artery were(12.35 ± 1.60) cm/s,(5.96±0.86) cm/s, 0.59±0.03, and(15.41±1.62) cm/s, (5.71±0. 830) cm/s and 0. 64 ± 0. 02 for central retinal artery. That was to say the blood flow velocity during systole and relaxed period of these arteries increased obviously, while the drag index declined clearly. Compared with the data get before treatment[(8.53±2.15) cm/s, (2.98±0.94) cm/s,0. 71 ±0. 03], the difference was significant( P ＜ 0. 01).CONCLUSIONS: AION hemodynamiccal parameters can be obviously improved by the injection of Breviscapine without obvious side effects.