中华眼底病杂志
中華眼底病雜誌
중화안저병잡지
CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
2013年
3期
253-256
,共4页
视神经病变,缺血性/治疗%高眼压/药物疗法%血流动力学%超声检查,多普勒,彩色
視神經病變,缺血性/治療%高眼壓/藥物療法%血流動力學%超聲檢查,多普勒,綵色
시신경병변,결혈성/치료%고안압/약물요법%혈류동역학%초성검사,다보륵,채색
Optic neuropathy,ischemic/therapy%Ocular hypertension/drug therapy%Hemodynamics%Ultrasonography,doppler,color
目的 观察降眼压治疗对非动脉炎性前部缺血性视神经病变(NAION)眼部血流动力学的影响.方法 临床确诊为NAION的68例患者68只眼纳入研究.采用随机数字表法将患者随机分为眼压干预组及对照组,分别为38例38只眼、30例30只眼.所有患者常规行甲基强的松龙200 mg 3 d冲击治疗,静脉滴注血栓通注射液300 mg扩血管治疗,鼠神经生长因子30μg视神经营养治疗及颞侧穴位注射复方樟柳碱2 ml.总疗程10d.眼压干预组在此基础上采用噻吗心胺滴眼液及布林佐胺滴眼液滴眼降低患者眼压至≥8 mm Hg(1 mm Hg=0.133 kPa)或降低眼压程度≥30％.对照组不作任何降眼压处理.治疗前后两组患眼行彩色多普勒超声血流成像检查,对比分析治疗前后两组眼动脉(OA)、视网膜中央动脉(CRA)及睫状后短动脉(PCA)的收缩期峰值血流速度(PSV)、搏动指数(PI)及阻力指数(RI)变化.结果 治疗前,眼压干预组及对照组OA、CRA及PCA的PSV(t=1.023、1.145、0.569)、PI(t=0.679、0.956、1.634)及RI(t=0.816、1.657、0.998)比较,差异均无统计学意义(P＞0.05).与治疗前比较,治疗后眼压干预组OA、CRA及PCA的PSV(t=3.150、7.650、3.520)、PI(t=2.420、5.430、7.650)明显增加,差异有统计学意义(P＜0.05)；RI(t=5.320、9.640、18.360)明显降低,差异有统计学意义(P＜0.05).与治疗前比较,治疗后对照组OA、CRA及PCA的PSV(t=2.090、-2.550、-2.100)、PI(t=-2.310、-2.230、-4.490)有所增加,差异有统计学意义(P＜0.05)；RI(t=2.970、2.160、2.690)有所降低,差异有统计学意义(P＜0.05).治疗后,眼压干预组OA、CRA及PCA的PSV(t=2.632、2.135、5.364)、PI(t=3.251、2.432、4.243)均较对照组明显增加,差异有统计学意义(P＜0.05)；RI(t=3.664、2.938、4.324)较对照组明显降低,差异也有统计学意义(P＜0.05).结论 降眼压治疗可改善NAION患者眼部血流动力学情况.
目的 觀察降眼壓治療對非動脈炎性前部缺血性視神經病變(NAION)眼部血流動力學的影響.方法 臨床確診為NAION的68例患者68隻眼納入研究.採用隨機數字錶法將患者隨機分為眼壓榦預組及對照組,分彆為38例38隻眼、30例30隻眼.所有患者常規行甲基彊的鬆龍200 mg 3 d遲擊治療,靜脈滴註血栓通註射液300 mg擴血管治療,鼠神經生長因子30μg視神經營養治療及顳側穴位註射複方樟柳堿2 ml.總療程10d.眼壓榦預組在此基礎上採用噻嗎心胺滴眼液及佈林佐胺滴眼液滴眼降低患者眼壓至≥8 mm Hg(1 mm Hg=0.133 kPa)或降低眼壓程度≥30％.對照組不作任何降眼壓處理.治療前後兩組患眼行綵色多普勒超聲血流成像檢查,對比分析治療前後兩組眼動脈(OA)、視網膜中央動脈(CRA)及睫狀後短動脈(PCA)的收縮期峰值血流速度(PSV)、搏動指數(PI)及阻力指數(RI)變化.結果 治療前,眼壓榦預組及對照組OA、CRA及PCA的PSV(t=1.023、1.145、0.569)、PI(t=0.679、0.956、1.634)及RI(t=0.816、1.657、0.998)比較,差異均無統計學意義(P＞0.05).與治療前比較,治療後眼壓榦預組OA、CRA及PCA的PSV(t=3.150、7.650、3.520)、PI(t=2.420、5.430、7.650)明顯增加,差異有統計學意義(P＜0.05)；RI(t=5.320、9.640、18.360)明顯降低,差異有統計學意義(P＜0.05).與治療前比較,治療後對照組OA、CRA及PCA的PSV(t=2.090、-2.550、-2.100)、PI(t=-2.310、-2.230、-4.490)有所增加,差異有統計學意義(P＜0.05)；RI(t=2.970、2.160、2.690)有所降低,差異有統計學意義(P＜0.05).治療後,眼壓榦預組OA、CRA及PCA的PSV(t=2.632、2.135、5.364)、PI(t=3.251、2.432、4.243)均較對照組明顯增加,差異有統計學意義(P＜0.05)；RI(t=3.664、2.938、4.324)較對照組明顯降低,差異也有統計學意義(P＜0.05).結論 降眼壓治療可改善NAION患者眼部血流動力學情況.
목적 관찰강안압치료대비동맥염성전부결혈성시신경병변(NAION)안부혈류동역학적영향.방법 림상학진위NAION적68례환자68지안납입연구.채용수궤수자표법장환자수궤분위안압간예조급대조조,분별위38례38지안、30례30지안.소유환자상규행갑기강적송룡200 mg 3 d충격치료,정맥적주혈전통주사액300 mg확혈관치료,서신경생장인자30μg시신경영양치료급섭측혈위주사복방장류감2 ml.총료정10d.안압간예조재차기출상채용새마심알적안액급포림좌알적안액적안강저환자안압지≥8 mm Hg(1 mm Hg=0.133 kPa)혹강저안압정도≥30％.대조조불작임하강안압처리.치료전후량조환안행채색다보륵초성혈류성상검사,대비분석치료전후량조안동맥(OA)、시망막중앙동맥(CRA)급첩상후단동맥(PCA)적수축기봉치혈류속도(PSV)、박동지수(PI)급조력지수(RI)변화.결과 치료전,안압간예조급대조조OA、CRA급PCA적PSV(t=1.023、1.145、0.569)、PI(t=0.679、0.956、1.634)급RI(t=0.816、1.657、0.998)비교,차이균무통계학의의(P＞0.05).여치료전비교,치료후안압간예조OA、CRA급PCA적PSV(t=3.150、7.650、3.520)、PI(t=2.420、5.430、7.650)명현증가,차이유통계학의의(P＜0.05)；RI(t=5.320、9.640、18.360)명현강저,차이유통계학의의(P＜0.05).여치료전비교,치료후대조조OA、CRA급PCA적PSV(t=2.090、-2.550、-2.100)、PI(t=-2.310、-2.230、-4.490)유소증가,차이유통계학의의(P＜0.05)；RI(t=2.970、2.160、2.690)유소강저,차이유통계학의의(P＜0.05).치료후,안압간예조OA、CRA급PCA적PSV(t=2.632、2.135、5.364)、PI(t=3.251、2.432、4.243)균교대조조명현증가,차이유통계학의의(P＜0.05)；RI(t=3.664、2.938、4.324)교대조조명현강저,차이야유통계학의의(P＜0.05).결론 강안압치료가개선NAION환자안부혈류동역학정황.
Objective To observe the effect of lowering intraocular pressure(IOP) treatment on ocular hemodynamics in patients with nonarteritic anterior ischemic optic neuropathy (NAION).Methods A total of 68 patients with NAION (68 eyes) were enrolled in this study.The patients were randomly divided into treatment group (38 eyes of 38 patients) and control group (30 eyes of 30 patients).All the patients were received methylprednisolone pulse therapy (200 mg,three days),vasodilator therapy with intravenous infusion of Xueshuantong solution (300 mg),optic nerve nutritional therapy with mouse nerve growth factor (30 μg) and acupoint injection in temporal with compound anisodine (2 ml).The total course was 10 days.The patients of treatment group received IOP lowering treatment to reduce the IOP to ≥ 8 mm Hg (1 mm Hg=0.133 kPa) or in a 30％ reduction.The patients of control group received no IOP lowering treatment.The peak systolic velocity (PSV),pulsatility index (PI) and resistance index (RI) of ophthalmic artery (OA),central retinal artery (CRA) and short posterior ciliary arteries (PCA) before and after treatment were comparatively analyzed by color doppler flow imaging.Results The differences of PSV (t=1.023,1.145,0.569),PI (t=0.679,0.956,1.634) and RI (t=0.816,1.657,0.998) of OA,CRA and PCA before treatment in treatment group and control group were not statistically significant (P＞ 0.05).Compared with before treatment,PSV (t=3.150,7.650,3.520) and PI (t=2.420,5.430,7.650) of OA,CRA and PCA increased obviously (P＜0.05),RI of OA,CRA and PCA decreased obviously (t=5.320,9.640,18.360; P＜0.05) after treatment in treatment group.In control group,the differences of PSV (t=2.090,-2.550,-2.100) and PI (t=-2.310,-2.230,-4.490) of OA,CRA and PCA between before and after treatment were not statistically significant (P＞0.05) ; but the differences of RI of OA,CRA and PCA between before and after treatment was statistically significant (t=2.970,2.160,2.690μ P＜0.05).Compared with control group,PSV (t=2.632,2.135,5.364) and PI (t=3.251,2.432,4.243) of OA,CRA and PCA increased obviously (P＜0.05),RI of OA,CRA and PCA decreased obviously (t=3.664,2.938,4.324; P＜0.05) after treatment in treatment group.Conclusion Lowering intraocular pressure treatment can improve the ocular hemodynamics in NAION patients.
