CAJ | 학술논문

目的观察和分析Eales病患者视网膜光凝治疗前后血浆一氧化氮（NO）及一氧化氮合酶（NOS）活性的变化。方法选取80例（131只眼）Eales病患者作为观察组，将其中接受视网膜光凝治疗的44例患者（60只眼）作为激光治疗组，将其中未接受视网膜光凝治疗的36例患者（71只眼）作为非激光治疗组，选取40例排除眼病的健康人作为对照组。对所有研究对象治疗前及激光治疗组患者术后1、3、6个月的血浆NO水平及血浆总NOS（ tNOS）、结构型NOS（cNOS）和诱导型NOS（iNOS）水平进行检测和比较，并对激光治疗组患者的治疗有效率和视力恢复情况进行评价。结果观察组患者的血浆NO水平、tNOS水平、cNOS水平均显著低于对照组（t ＝6．128、3.465、4．053，P ＜0．05），激光治疗组与非激光治疗组患者治疗前的血浆NO水平、tNOS水平、iNOS水平、cNOS水平的差异均无统计学意义（t ＝0．625、0．511、0．426、0．637，P ＜0．05）；经视网膜光凝治疗后，激光治疗组中视力稳定或提高的患眼数占全部患眼的90％，疗效评价有效的患眼数占全部患眼的88．3％，而患者在治疗前，术后1、3、6个月各时点的血浆NO水平、tNOS水平、iNOS水平、cNOS水平的差异均无统计学意义（F ＝0．728、0．635、0．608、0.942，P ＜0．05）。结论 Eales病患者表现为血浆NO、NOS水平显著下降，但这一变化的程度与其视网膜病变程度无关，视网膜光凝治疗能够有效缓解患者的视网膜病变、恢复患者的视力，但对于纠正上述引发Eales病的病理机制无显著作用。
목적관찰화분석Eales병환자시망막광응치료전후혈장일양화담（NO）급일양화담합매（NOS）활성적변화。방법선취80례（131지안）Eales병환자작위관찰조，장기중접수시망막광응치료적44례환자（60지안）작위격광치료조，장기중미접수시망막광응치료적36례환자（71지안）작위비격광치료조，선취40례배제안병적건강인작위대조조。대소유연구대상치료전급격광치료조환자술후1、3、6개월적혈장NO수평급혈장총NOS（ tNOS）、결구형NOS（cNOS）화유도형NOS（iNOS）수평진행검측화비교，병대격광치료조환자적치료유효솔화시력회복정황진행평개。결과관찰조환자적혈장NO수평、tNOS수평、cNOS수평균현저저우대조조（t ＝6．128、3.465、4．053，P ＜0．05），격광치료조여비격광치료조환자치료전적혈장NO수평、tNOS수평、iNOS수평、cNOS수평적차이균무통계학의의（t ＝0．625、0．511、0．426、0．637，P ＜0．05）；경시망막광응치료후，격광치료조중시력은정혹제고적환안수점전부환안적90％，료효평개유효적환안수점전부환안적88．3％，이환자재치료전，술후1、3、6개월각시점적혈장NO수평、tNOS수평、iNOS수평、cNOS수평적차이균무통계학의의（F ＝0．728、0．635、0．608、0.942，P ＜0．05）。결론 Eales병환자표현위혈장NO、NOS수평현저하강，단저일변화적정도여기시망막병변정도무관，시망막광응치료능구유효완해환자적시망막병변、회복환자적시력，단대우규정상술인발Eales병적병리궤제무현저작용。
Objective To observe and analyze the changes of plasma nitric oxide (NO)and nitric oxide synthase (NOS)levels in patients with Eales disease before and after retinal photocoagulation. Methods Totally 80 patients with Eales disease (131 eyes)were enrolled. Forty four patients (60 eyes)were treated with retinal photocoagulation (laser group)and 36 patients (71 eyes)received standard non-laser treatment (non-laser group). Additional 40 healthy people were selected as the control group. The plasma levels of NO and total NOS (tNOS),structural NOS (cNOS)and inducible NOS (iNOS)were measured before and after treatment at 1 month,3 months,6 months. Visual acuity and the efficiency of laser treatment were evaluated. Results The plasma NO level,tNOS level and cNOS level of the patients received laser treatment were significantly lower than those of control group (t = 6. 128,3. 465,4. 053,P < 0. 05),but not significantly different from those of the patients received non-laser treatment (t = 0. 625,0. 511 and 0. 426,0. 637,P > 0. 05). After retinal photocoagulation,improved or stable visual acuity was found in 90% of the patients treated with laser,and the over-all effectiveness rate was 88. 3% . However,plasma NO,tNOS,iNOS and cNOS levels did not change significantly in these patients at each time point before and after the retinal coagulation (F = 0. 728,0. 635,0. 608,0. 942,P > 0. 05). Conclusion The patients with Eales disease show significant decreases in plasma NO and NOS levels,but the extents of the changes are independent of the degree of the patients’retinopathy. The retinal photocoagulation treatment can effective-ly alleviate the patients’retinopathy,restore patient's visual acuity,but puts no significant effects on correcting the patho-logical mechanism of Eales disease.