中华眼底病杂志
中華眼底病雜誌
중화안저병잡지
CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
2013年
6期
575-579
,共5页
王敏%王润生%王升%许淑云%贺静芳%马文婷%陈小瑾%赵铭
王敏%王潤生%王升%許淑雲%賀靜芳%馬文婷%陳小瑾%趙銘
왕민%왕윤생%왕승%허숙운%하정방%마문정%진소근%조명
眼%缺血/治疗%降压,控制性%血流动力学
眼%缺血/治療%降壓,控製性%血流動力學
안%결혈/치료%강압,공제성%혈류동역학
Eye%Ischemia/therapy%Hypotension,controlled%Hemodynamics
目的 观察缺血性眼病(IOP)患者眼压干预治疗后眼部血流动力学改善情况.方法 临床检查确诊且符合纳入标准的IOP患者106例106只眼纳入研究.患者中,非动脉炎性前部缺血性视神经病变(NAION) 74只眼(NAION组)、视网膜动脉阻塞(RAO)20只眼(RAO组)、眼缺血综合征(IOS) 12只眼(IOS组).各组再按随机数字表法随机分为眼压干预组和对照组.其中,NAION组分别为37、37只眼,RAO组分别为10、10只眼,IOS组分别为6、6只眼.眼压干预组在基础治疗基础上采用酒石酸溴莫尼定滴跟液患眼局部滴眼,根据眼压降低情况,加用布林佐胺、噻吗心胺滴眼液中任意一种联合治疗,至患眼眼压≤12 mm Hg(1 mm Hg=0.133 kPa)或降低眼压7～8 mm Hg,或降低基础眼压20％～30％.对照组除基础治疗外不作降眼压处理.治疗前及治疗后1周两组患眼行荧光素眼底血管造影(FFA)、彩色多普勒超声血流成像检查,对比分析患眼臂-视网膜循环时间(A-RCT),眼动脉(OA)、视网膜中央动脉(CRA)、睫状后短动脉(PCA)的收缩期血流峰值速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)变化.结果 治疗前,各组患者眼压干预组及对照组A-RCT比较,差异无统计学意义(t=0.869、0.119、0.000,P＞0.05). OA、CRA、PCA的PSV(OA:t=0.586,0.040,0.067;CRA:0.285,0.057,0.775;PCA:t=0.658、0.653、1.253)、EDV(OA:t=0.274、0.080、0.093; CRA:t=0.781、0.077、0.277; PCA:t=0.200、0.209、0.299)、RI(OA:t=0.121、0.153、0.138;CRA:t=0.172、0.242、0.642;PCA:t=1.053、1.066、0.266)比较,差异均无统计学意义(P＞0.05).治疗1周后,各组患者眼压干预组A-RCT均较对照组缩短,差异有统计学意义(t=2.573、2.236、2.607,P＜0.05);OA、CRA、PCA的PSV(OA:t=2.367、2.368、2.267;CRA:t=0.775、1.927、2.775;PCA:t=2.253、2.353、2.353)、EDV(OA:t=2.303、2.236、2.503;CRA:t=2.277、2.377、2.577;PCA:t=2.299、2.399、2.299)较对照组增高,RI较对照组降低(OA:t=2.238、2.387、2.228;CRA:t=2.342、2.442、2.542;PCA:t=2.266、2.366、2.266),差异均有统计学意义(P＜0.05).结论 眼压干预治疗可明显改善IOP患者眼部血流动力学指标.
目的 觀察缺血性眼病(IOP)患者眼壓榦預治療後眼部血流動力學改善情況.方法 臨床檢查確診且符閤納入標準的IOP患者106例106隻眼納入研究.患者中,非動脈炎性前部缺血性視神經病變(NAION) 74隻眼(NAION組)、視網膜動脈阻塞(RAO)20隻眼(RAO組)、眼缺血綜閤徵(IOS) 12隻眼(IOS組).各組再按隨機數字錶法隨機分為眼壓榦預組和對照組.其中,NAION組分彆為37、37隻眼,RAO組分彆為10、10隻眼,IOS組分彆為6、6隻眼.眼壓榦預組在基礎治療基礎上採用酒石痠溴莫尼定滴跟液患眼跼部滴眼,根據眼壓降低情況,加用佈林佐胺、噻嗎心胺滴眼液中任意一種聯閤治療,至患眼眼壓≤12 mm Hg(1 mm Hg=0.133 kPa)或降低眼壓7～8 mm Hg,或降低基礎眼壓20％～30％.對照組除基礎治療外不作降眼壓處理.治療前及治療後1週兩組患眼行熒光素眼底血管造影(FFA)、綵色多普勒超聲血流成像檢查,對比分析患眼臂-視網膜循環時間(A-RCT),眼動脈(OA)、視網膜中央動脈(CRA)、睫狀後短動脈(PCA)的收縮期血流峰值速度(PSV)、舒張末期血流速度(EDV)、阻力指數(RI)變化.結果 治療前,各組患者眼壓榦預組及對照組A-RCT比較,差異無統計學意義(t=0.869、0.119、0.000,P＞0.05). OA、CRA、PCA的PSV(OA:t=0.586,0.040,0.067;CRA:0.285,0.057,0.775;PCA:t=0.658、0.653、1.253)、EDV(OA:t=0.274、0.080、0.093; CRA:t=0.781、0.077、0.277; PCA:t=0.200、0.209、0.299)、RI(OA:t=0.121、0.153、0.138;CRA:t=0.172、0.242、0.642;PCA:t=1.053、1.066、0.266)比較,差異均無統計學意義(P＞0.05).治療1週後,各組患者眼壓榦預組A-RCT均較對照組縮短,差異有統計學意義(t=2.573、2.236、2.607,P＜0.05);OA、CRA、PCA的PSV(OA:t=2.367、2.368、2.267;CRA:t=0.775、1.927、2.775;PCA:t=2.253、2.353、2.353)、EDV(OA:t=2.303、2.236、2.503;CRA:t=2.277、2.377、2.577;PCA:t=2.299、2.399、2.299)較對照組增高,RI較對照組降低(OA:t=2.238、2.387、2.228;CRA:t=2.342、2.442、2.542;PCA:t=2.266、2.366、2.266),差異均有統計學意義(P＜0.05).結論 眼壓榦預治療可明顯改善IOP患者眼部血流動力學指標.
목적 관찰결혈성안병(IOP)환자안압간예치료후안부혈류동역학개선정황.방법 림상검사학진차부합납입표준적IOP환자106례106지안납입연구.환자중,비동맥염성전부결혈성시신경병변(NAION) 74지안(NAION조)、시망막동맥조새(RAO)20지안(RAO조)、안결혈종합정(IOS) 12지안(IOS조).각조재안수궤수자표법수궤분위안압간예조화대조조.기중,NAION조분별위37、37지안,RAO조분별위10、10지안,IOS조분별위6、6지안.안압간예조재기출치료기출상채용주석산추막니정적근액환안국부적안,근거안압강저정황,가용포림좌알、새마심알적안액중임의일충연합치료,지환안안압≤12 mm Hg(1 mm Hg=0.133 kPa)혹강저안압7～8 mm Hg,혹강저기출안압20％～30％.대조조제기출치료외불작강안압처리.치료전급치료후1주량조환안행형광소안저혈관조영(FFA)、채색다보륵초성혈류성상검사,대비분석환안비-시망막순배시간(A-RCT),안동맥(OA)、시망막중앙동맥(CRA)、첩상후단동맥(PCA)적수축기혈류봉치속도(PSV)、서장말기혈류속도(EDV)、조력지수(RI)변화.결과 치료전,각조환자안압간예조급대조조A-RCT비교,차이무통계학의의(t=0.869、0.119、0.000,P＞0.05). OA、CRA、PCA적PSV(OA:t=0.586,0.040,0.067;CRA:0.285,0.057,0.775;PCA:t=0.658、0.653、1.253)、EDV(OA:t=0.274、0.080、0.093; CRA:t=0.781、0.077、0.277; PCA:t=0.200、0.209、0.299)、RI(OA:t=0.121、0.153、0.138;CRA:t=0.172、0.242、0.642;PCA:t=1.053、1.066、0.266)비교,차이균무통계학의의(P＞0.05).치료1주후,각조환자안압간예조A-RCT균교대조조축단,차이유통계학의의(t=2.573、2.236、2.607,P＜0.05);OA、CRA、PCA적PSV(OA:t=2.367、2.368、2.267;CRA:t=0.775、1.927、2.775;PCA:t=2.253、2.353、2.353)、EDV(OA:t=2.303、2.236、2.503;CRA:t=2.277、2.377、2.577;PCA:t=2.299、2.399、2.299)교대조조증고,RI교대조조강저(OA:t=2.238、2.387、2.228;CRA:t=2.342、2.442、2.542;PCA:t=2.266、2.366、2.266),차이균유통계학의의(P＜0.05).결론 안압간예치료가명현개선IOP환자안부혈류동역학지표.
Objective To observe the effect of ophthalmotonus intervention on ocular hemodynamics in patients with ischemic ophthalmopathy (IOP).Methods 106 IOP patients (106 eyes) were enrolled in this study,including 74 eyes with nonarteritic anterior ischemic optic neuropathy (NAION),20 eyes with retinal artery occlusion (RAO) and 12 eyes with ocular ischemia syndrome (IOS).The patients were randomly divided into ophthalmotonus intervention group and control group.There were 37 NAION eyes,10 RAO eyes and six IOS eyes in each group.The patients of ophthalmotonus intervention group received lowering intraocular pressure treatment in addition to the basic therapy to reduce the intraocular pressure to ≤12 mm Hg (1 mm Hg=0.133 kPa) or decreased by 7-8 mm Hg,or in a 20％-30％ reduction.The patients of control group avoided lowering intraocular pressure treatment.The arm-retinal circulation time (A-RCT) and the peak systolic velocity (PSV),end diastolic velocity (EDV) and resistance index (RI) of ophthalmic artery (OA),central retinal artery (CRA) and short posterior ciliary arteries (PCA) before and one week after treatment were comparatively analyzed by fluorescence fundus angiography (FFA) and color Doppler flow imaging.Results The differences of A-RCT before treatment in ophthalmotonus intervention group and control group in NAION,RAO and IOS patients were not statistically significant (t=0.869,0.119,0.000; P＞0.05).The differences of PSV (OA:t=0.586,0.040,0.067; CRA..t=0.285,0.057,0.775; PCA:t=0.658,0.653,1.253),EDV (OA:t=0.274,0.080,0.093; CRA:t=0.781,0.077,0.277; PCA:t=0.200,0.209,0.299) andRI (OA:t=0.121,0.153,0.138; CRA:t=0.172,0.242,0.642; PCA:t=1.053,1.066,0.266) of OA,CRA and PCA before treatment in ophthalmotonus intervention group and control group were not statistically significant (P＞0.05).Compared with control group,A-RCT shortened obviously (t =2.573,2.236,2.607 ; P＜ 0.05) in ophthalmotonus intervention group one week after treatment.Compared with control group,PSV (OA:t=2.367,2.368,2.267; CRA:t=0.775,1.927,2.775; PCA:t=2.253,2.353,2.353) and EDV (OA:t=2.303,2.236,2.503; CRA:t=2.277,2.377,2.577; PCA:t=2.299,2.399,2.299) of OA,CRA and PCA increased obviously (P＜0.05),RI of OA,CRA and PCA decreased obviously (OA:t=2.238,2.387,2.228; CRA..t=2.342,2.442,2.542; PCA:t=2.266,2.366,2.266; P＜0.05) one week after treatment in treatment group.Conclusion Ophthalmotonus intervention can improve the ocular hemodynamics in IOP patients.
