复方樟柳碱注射液治疗慢性中心性浆液性脉络膜视网膜病变的临床研究  

Clinical study of compound anisodine injection in the treatment of chronic central serous chorioretinopathy

作　　者：苏雯琪 胡立影 李筱荣 李志清 SU Wen-Qi;HU Li-Ying;LI Xiao-Rong;LI Zhi-Qing(Eye Hospital,Tianjin Medical University,Tianjin 300110,China)

机构地区：[1]天津医科大学眼科医院,天津市300110

出　　处：《眼科新进展》2018年第12期1137-1140,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金面上项目(编号:81670875);天津市自然科学基金项目(编号:17JCYBJC27200;18JCQNJC10700)~~

摘　　要：目的研究复方樟柳碱注射液治疗慢性中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)的有效性及安全性。方法非随机同期对照研究。收集慢性CSC患者,根据入选标准和排除标准将研究对象分成复方樟柳碱注射液颞浅动脉旁注射联合常规药物治疗组(治疗组)及单纯常规药物治疗组(对照组)。通过观察治疗后3个月及6个月视力、光学相干断层扫描(optical coherence tomography,OCT)及光学相干断层扫描血管造影(optical coherence tomography angiography,OCTA)图像及通过手动测量及Image J量化OCTA图像,比较两组最佳矫正视力、视网膜下液面积、黄斑区脉络膜毛细血管层血流密度较基线的改变均值。结果对照组10例11眼,治疗组17例18眼。两组年龄、性别匹配。治疗后3个月、6个月治疗组最佳矫正视力较基线提升比对照组明显(P <0. 01);治疗后3个月、6个月时治疗组与对照组黄斑区视网膜下液面积较基线均下降,但治疗组治疗后6个月内视网膜下液面积持续下降;治疗组在治疗后3个月、6个月时,脉络膜毛细血管层血流密度较基线明显增加,且与对照组有明显差异(P <0. 05)。结论复方樟柳碱注射液在治疗慢性CSC中可以促进视网膜下液吸收和脉络膜毛细血管血液循环,增加血流密度,改善视网膜深层及脉络膜缺血状态,有效提高慢性CSC患者的视力。Objective To study the efficacy and safety of compound anisodine(CA)injection in the treatment of chronic central serous chorioretinopathy(CSC).Methods A non-randomized simultaneous controlled study.Patients with chronic serous chorioretinopathy were collected.According to the inclusion criteria and exclusion criteria,the subjects were divided into two groups:CA injection combined with conventional drug therapy group and simple conventional drug treatment group.The experimental group received at least two courses of injection,and the course of injection could be increased according to the need.By observing the OCT and OCTA images of the two groups after 3 and 6 months of treatment,the best corrected visual acuity(BCVA),the area of subretinal fluid(SRF),the vessel density of the choriocapillaries layer(CCL)in the macula were tested.Results Total 10 patients(11 eyes)were treated with conventional drugs,and 17 patients(18 eyes)were treated with CA injection combined with conventional drug therapy.There was no significant difference in baseline between the two groups.The improvement of BCVA in the treatment group was significantly higher than that in the control group in 3 months and 6 months compared with the baseline(P<0.01).At 6 months,the area of SRF in treatment group and control group were both decreased comparing with baseline.However,the decreased area of SRF in the treatment group was sustaining during 6 months.The vessel density of CCL was significantly higher than that of the baseline at 3 and 6 months after treatment,and there was a significant difference between the two groups(P<0.05).Conclusion CA injection can promote the absorption of SRF and increase CCL vessel density at 6 months.Thus,we consider that CA injection combined with conventional drug therapy can relieve the choroidal ischemic state of chronic CSC so that the BCVA of patients with chronic CSC can be improved effectively.The safety of CA injection was confirmed by no adverse events in treatment group.

关 键 词：中心性浆液性脉络膜视网膜病变 复方樟柳碱注射液 光学相干断层扫描 光学相干断层扫描血管造影 血流密度 视网膜色素上皮 

分 类 号：R774[医药卫生—眼科]