大剂量糖皮质激素治疗前部缺血性视神经病变的疗效观察  

Therapeutic effect of high-dose glucocorticoid on anterior ischemic optic neuropathy

作　　者：高雪辉[1] 曹东[1] 杨兴旺[1] 李强[1] 

机构地区：[1]解放军第三医院眼科,陕西宝鸡721004

出　　处：《西北国防医学杂志》2013年第3期221-223,共3页Medical Journal of National Defending Forces in Northwest China

摘　　要：目的:观察大剂量糖皮质激素治疗前部缺血性视神经病变(anterior ischemic optic neuropathy,AION)的疗效。方法:临床确诊的AION患者44例49只眼,其中19例患者的20只眼接受大剂量糖皮质激素静脉滴注治疗(实验组);另外25例患者的29只眼接受其他药物治疗(对照组)。在15 d治疗期内,治疗后第1,3,8,15天记录两组患者用药后每天观察视力、眼底变化,治疗前有视野检查者复查视野。结果:实验组视力提高程度明显好于对照组,两组间有显著统计学差异(t=10.685,P<0.01);用药1 d,两组视力提高程度差异无统计学意义(t=0.049,P>0.05);自第3天起,实验组视力提高程度明显好于对照组,其差异有统计学意义(t=2.667,P<0.05;t=3.667,P<0.05;t=4.220,P<0.01);实验组的20只患眼在治疗后视野缺损均较治疗前缩小,治疗15 d时,实验组与对照组的光敏度结果比较统计学差异显著(t=2.79,P<0.01)。治疗前两组的视力和30°中心视野内的光敏度数值比较均无显著性差异(t=-0.525,P>0.05;t=1.97,P>0.05)。在治疗的第3,8,15天实验组视力提高程度均显著高于对照组(t=2.667,P<0.05;t=3.667,P<0.05;t=4.220 P<0.01)。治疗结束后实验组视野缺损明显改善,30°中心视野内的光敏度数值显著高于对照组(t=2.79,P<0.01)。结论:大剂量糖皮质激素治疗可在短时间内有效提高AION患眼的视力及缩小视野缺损。Objective：To investigate the therapeutic effect of high - dose glucocorticoid on anterior ischemic optic neuropathy （AION）. Methods： In 44 patients（49 eyes）who were diagnosed as AION , 19 patients （20 eyes） accepted intravenous high - dose glucocorticoid treatment （ treatment group）, and the other 25patients （29 eyes） accepted basic medication treatment （control group）, the course of treatment was 15 days. The changes of visual acuity and ocular fundus of the patients after treatment were recorded, the visual field was counterchecked in the patients who had undergone the examination before the treatment. Results： The visual acuity was significantly improved in treatment group in comparison with congtrol group （t = 10.685, P 〈 0.01 ）, the visual acuity in treat-ment group improved obviously from the third day after treatment （ t = 2. 667, P 〈 0 . 05 ; t = 3. 667, P 〈 0.05 ; t = 4. 220 ,P 〈0.01 ）. The defect of visual field were reduced in all eyes in the treatment group after high - dose glu-cocorticoid treatment. There was a significant difference in the data of visual field between treatment group and con-trol group on 15th day（t =2.79 ,P 〈0.01 ）. Conclusion： High - dose glucocorticoid is effective in the treatment of AION, by which, the visual acuity and visual field may be improved in a short time.

关 键 词：视神经疾病 药物疗法 糖皮质激素 

分 类 号：R774.6[医药卫生—眼科]