玻璃体腔注射曲安奈德后的眼压改变  

Changes of intraocular pressure after intravitreous injection with triamcinolone acetonide

作　　者：钱彤[1] 黎晓新[1] 

机构地区：[1]北京大学人民医院眼科,100044

出　　处：《中华眼底病杂志》2007年第2期115-117,共3页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察玻璃体腔注射曲安奈德（TA）后眼压变化规律及其影响因素。方法回顾分析在我院接受TA玻璃体腔注射治疗的125例患者125只眼的临床资料。其中，男性52例，女性73例；年龄17～83岁，平均年龄56.5岁。糖尿病视网膜病变（DR）49例，占39.20%；视网膜静脉阻塞（RVO）56例，占44.80%；渗出型老年性黄斑变性（AMD）20例，占16.00%。治疗前1dGoldmann眼压计测量的基础眼压为7.00～31mm Hg（1mm Hg=0.133kPa），平均眼压为（14.69±3.72）mm Hg。根据眼压检查结果将患者分为基础眼压偏低（〈15.00mm Hg）、偏高（≥15.00mm Hg）2组，分别为64、61例。所有患者均接受4mgTA常规玻璃体腔注射治疗。治疗后1、3d，1、2周，1个月同样方法测量眼压，以后每一个月复查眼压1次。随诊3～21个月，平均随诊时间5个月。以眼压≥21.00mm Hg为眼压升高。对比分析患者治疗前后、不同病种以及不同年龄的眼压变化规律。结果治疗后36例患者眼压升高，占28.8%。97.2%的患者眼压升高发生在治疗后3个月内，治疗后7个月恢复到基础水平。其中，基础眼压偏低组11例，占17．19％；基础眼压偏高组25例，占40．98％，两组差异有统计学意义（P〈0．01）。治疗后随访期峰值平均眼压（20．09±7．58）mmHg，较治疗前平均眼压升高5．43mmHg，差异有统计学意义（P〈0．001）；53例治疗后峰值眼压比治疗前眼压高5．00mmHg，占42．4％。随访期峰值平均眼压DR组为（18．19±4．73）mmHg，RVO组为（22．50±9．30）mmHg，AMD组为（18．12±6．09）mmHg。RVO组眼压升高发生率显著高于DR组和AMD组。3组间差异有统计学意义（P〈0．01）。以年龄为自变量，治疗后峰值眼压为因变量的回归分析显示：年龄与治疗后眼压升高有关，年龄小，治疗后发生高眼压的风险大，差异有统计学意义（P=0．000）。结论TA玻璃体腔注射后眼压升�Objective To observe the changes of intraocular pressure （IOP） after intravitreous injection wih triameinolone acetonide （TA） and their affected factors. Methods The clinical data of 125 patients （125 eyes） who had undergone intravitreous injection with TA were retrospectively analyzed. The patients （52 males and 73 females） aged from 17 to 83 years with the average age of 56.5. There were 49 patient （39.2%） with diabetic retinopathy （DR）, 56 （44.8%） with retinal vein occlusion （RVO）, and 20 （16.0%） with exudative age-related maeular degeneration （AMD）. One day before the treatment, IOP was measured by Goldmann applanation tonometry, and the basic IOP was 7～31 mm Hg （1 mm Hg= 0. 133 kPa） and the average IOP was （14.69±3.72） mm Hg. The patients were divided into two groups according to the basic IOP：below 15 mm Hg group （n=64） and 15 mm Hg or above group （n=61）. All of the patients underwent intravitreous injection with 4mg TA. IOP was measured 1 day, 3 days, 1 week, 2 weeks, and 1 month after the treatment in the same way, respectively, and later was measured once every 1 month. The follow-up period was 3～21 months with the mean of 5 months. The elevation of IOP would be defined as the pressure of 21mmHg or higher. The changes of IOP in patients before and after the treatment, and with different diseases and ages were analyzed. Resuits Thirty-six patients （28.8%） had elevation of IOP after the treatment, out of whom 97. 2% had the elevation within 3 months after the injection and decreased to the basic level 7 months after the injection. In these patients, there were 11 （17. 19%） in the below 15 mm Hg group and 25 （40. 98%） in 15 mm Hg or above group, and the difference between the two groups was statistically significant （P〈0.01）. During the follow-up period, the mean maximum IOP was （20.09±7.58） mmHg, which was 5.43 mmHg higher than that before the treatment （P〈0.001）.The mean maximum IOP of 53 patients （42.4%） after

关 键 词：曲氨奈德 眼内压 糖皮质激素/副作用 眼疾病/药物疗法 

分 类 号：R686[医药卫生—骨科学]