甘露醇联合扩血管药物治疗早期视网膜动脉阻塞临床观察  

Clinical Study of Mannitol Combined with Vasodilators in the Treatment of Early Retinal Artery Occlusion

作　　者：杜丽敏[1] 季红英[1] 王艳娜[1] 杨林青[1] Du Limin;Ji Hongying;Wang Yanna;Yang Linqing(First Department of Fundus Disease,Handan Eye Hospital(Third Hospital of Handan City),Hebei Handan 056001,China)

机构地区：[1]邯郸市眼科医院(邯郸市第三医院)眼底病一科,河北邯郸056001

出　　处：《中国药师》2022年第2期281-284,共4页China Pharmacist

基　　金：邯郸市科学技术研究与发展计划项目(编号:19422083013)。

摘　　要：目的:对比扩血管药物分别联合前房穿刺或甘露醇治疗视网膜动脉阻塞(RAO)的效果。方法:80例RAO患者随机分为对照组和观察组各40例。两组均给予常规扩血管药物治疗,对照组联合前房穿刺治疗,观察组联合甘露醇治疗。14 d后比较两组临床疗效、最佳矫正视力(BCVA)、眼压、眼部血流动力学(视网膜中央动脉舒张末期血流速EDV、收缩期峰值血流速PSV及阻力指数RI)及眼电生理指标(视觉诱发电位潜时及波幅),记录不良反应或并发症发生情况。结果:观察组总有效率为95.00%,明显高于对照组(P<0.05)。治疗7,14 d后,两组患眼BCVA均高于治疗前,且观察组高于对照组(P<0.05)。治疗1,7,14 d后,两组患眼眼压均低于治疗前(P<0.05);观察组治疗1 d眼压高于对照组,治疗7,14 d的眼压低于对照组,同时治疗7,14 d患眼眼压达标比例均高于对照组(P<0.05)。较治疗前治疗后两组EDV、PSV均增加,RI下降,视觉诱发电位潜时均缩短,波幅增加(P<0.05),且观察组上述指标均优于对照组(P<0.05)。两组总不良反应发生率差异无统计学意义(P>0.05)。结论:静滴甘露醇联合扩血管等药物治疗可更持久降低RAO患者患眼眼压,改善患眼电生理及眼局部血流动力学,提高患眼视力,整体治疗效果优于前房穿刺联合药物治疗,值得临床推广。Objective:To compare the effects of vasodilator drugs combined with anterior chamber puncture or with mannitol in the treatment of retinal artery occlusion(RAO),and study their effects on intraocular pressure,electrophysiology and ocular hemodynamics.Methods:Totally 80 cases of RAO patients were randomly divided into control group and observation group with 40 cases in each group.Both groups were treated with conventional drugs,the control group was combined with anterior chamber puncture treatment,and the observation group was combined with mannitol treatment.The clinical efficacy,best corrected visual acuity(BCVA),intraocular pressure,ocular hemodynamics[central retinal artery end-diastolic blood velocity(EDV),peak systolic blood velocity(PSV)and resistance index R]and ocular electrophysiological indexes(latent time and amplitude of visual evoked potential)after 14-day treatment were compared between the two groups,and the occurrences of adverse reactions and complications were recorded.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).The BCVA of eyes on the 7;and 14;day of treatment in both groups was higher than that before treatment,and the observation group was higher than the control group(P<0.05).The intraocular pressure on the 1;,7;and 14;days of the patients in the two groups was lower than that before treatment(P<0.05),the intraocular pressure of the patients in the observation group was higher than that of the control group on the 1;day of treatment,while the intraocular pressure of the patients on the 7;and 14;days of treatment were lower than that of the control group,and at the same time,the proportion of patients with intraocular pressure reaching the standard on the 7 th and 14 th day was higher than that of the control group(P<0.05).After treatment,the EDV and PSV of the two groups increased compared with those before treatment,while the RI decreased,the latency of visual evoked potential was shortened,and the amplitude was increased(P<0

关 键 词：视网膜动脉阻塞 前房穿刺 甘露醇 眼压 电生理 血流动力学 

分 类 号：R988.1[医药卫生—药品]