视网膜中央动脉阻塞早期眼动脉溶栓治疗前后视力改变  

Visual acuity changes of the patients with recent central retinal artery occlusion after the treatment of intra-arterial thrombolysis

作　　者：吴航[1] 刘大川[1] 张旭香[1] 杨慧清[1] 宫丽萍[2] 李勇[2] 

机构地区：[1]首都医科大学宣武医院眼科,北京100053 [2]首都医科大学病理生理学院

出　　处：《中国实用眼科杂志》2012年第2期152-155,共4页Chinese Journal of Practical Ophthalmology

基　　金：首都医科大学基临合作课题资助项目（2007JL14）

摘　　要：目的 选择性眼动脉溶栓治疗早期视网膜中央动脉阻塞患者治疗前后视力变化的临床研究.方法 收集2006年9月至2009年7月经确诊并在发病12h内进行溶栓的视网膜中央动脉阻塞患者.所有患者均记录年龄、性别、全身病史、发病至溶栓时间、眼底镜检查、眼底荧光血管造影（fundus fluorescein angiography,FFA）、术后48 h复查视力、眼底镜检查、眼底荧光血管造影,术后1月复查,记录视力及眼底检查,并进行对比.结果 24例患者发病至溶栓的平均时间（8.39±3.24）h,溶栓治疗前臂一视网膜动脉显影时间明显延长,平均（29.34±7.83）s,治疗48 h后眼底血管造影显示,臂一视网膜动脉充盈时间明显缩短,平均（15.48±4.33）s,与治疗前对比差异显著有统计学意义；治疗后1月,复查荧光血管造影,臂一视网膜动脉显影时间平均为（15.76±3.12）s,与治疗48 h对比无差异.发病时视力低于0.05患者20例占83.3％,0.05～0.1者4例占16.7％,治疗48 h后视力低于0.05患者7例29.2％,0.05～0.1,6例占25％,高于0.1者11例占45.8％,其中2例高于0.5,占8.3％；治疗前及治疗后48 h患眼视力获得提高的病人数量对比变化显著有统计学意义P＜0.01,治疗后1月视力低于0.05患者5例占20.8％,0.05～0.1者6例占25％,超过0.1患者13例占54.2％,与治疗前患者视力相比差异显著有统计学意义.结论 局部动脉溶栓治疗视网膜中央动脉阻塞,可及时有效恢复早期阻塞的视网膜神经组织的血流灌注,改善早期视网膜中央动脉阻塞患者的视力,但此研究缺乏与传统治疗方法对照研究,同时该治疗方法还需要多中心大样本的临床对比.Objective To study the visual acuity improvement in the patients with central retinal artery occlusion （CRAO） by the treatment of intra-arterial thrombolysis in early stage. Methods The study included 24 patients with recent CRAO by the treatment of intra-arterial thrombolysis,the improvement of visual acuity,retinal circulation changes,detailed results of visual acuity and FFA were evaluated and compared at initial and follow- up visits. Results The delay between the onset of symptoms and the initiation of fibrinolytic treatment varied from just under 3.5 h to 12 h in the patients with CRAO,the mean time was 8.39±3.24h,significant improvement of visual acuity and retinal circulation after the treatment was observed. Conclusions Intra-arterial thrombolysis can improve visual acuity and retinal circulation significantly.The execution of randomized,controlled trials is greatly needed

关 键 词：视网膜中央动脉阻塞 选择性眼动脉溶栓 视力 

分 类 号：R774.1[医药卫生—眼科]