丹参注射液离子导入治疗视网膜静脉阻塞疗效及对结膜分泌物中乙酰肝素酶、串珠素表达的影响  

Efficacy of Danshen injection iontophoresis on retinal vein occlusion and its influence on the expression of heparanase and perlecan in conjunctival secretions

作　　者：李亚坤[1] 刘志强[1] 郭向东[1] 梁春利[1] 段文杰 赵萱萱 杨慧静 白玫[1] 吕佳 LI Yakun;LIU Zhiqiang;GUO Xiangdong;LIANG Chunli;DUAN Wenjie;ZHAO Xuanxuan;YANG Huijing;BAI mei;LV Jia(Department of Ophthalmology,the Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100;Department of Surgical Anesthesiology,the Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100;Department of Pharmacy,the Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100;Department of Laboratory Medicine,the Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100)

机构地区：[1]河北北方学院附属第二医院眼科,河北张家口075100 [2]河北北方学院附属第二医院手术麻醉科,河北张家口075100 [3]河北北方学院附属第二医院药剂科,河北张家口075100 [4]河北北方学院附属第二医院检验科,河北张家口075100

出　　处：《河北中医》2023年第7期1089-1092,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：张家口市科学技术局重点研发计划项目(编号:2021070D)。

摘　　要：目的观察丹参注射液离子导入治疗视网膜静脉阻塞的临床疗效,并分析其对结膜分泌物中乙酰肝素酶及串珠素表达的影响。方法将90例(180眼)视网膜静脉阻塞患者按照随机数字法分为2组,对照组45例(90眼)予雷珠单抗注射液玻璃体腔注射治疗,治疗组45例(90眼)在对照组基础上加用丹参注射液离子导入治疗。2组均连续治疗3个月后统计疗效,比较2组治疗前后结膜分泌物中乙酰肝素酶及串珠素水平表达情况,比较2组治疗前后视网膜电图(PERG)指标b波潜伏期、波幅变化情况,比较2组治疗前后黄斑中心凹视网膜厚度(CMT)及视网膜循环时间(RCT)变化情况,观察2组治疗期间出现的不良反应情况。结果治疗组总有效率97.78%(88/90),不良反应总发生率11.11%(5/45),对照组总有效率90.00%(81/90),不良反应总发生率4.44%(2/45),治疗组总有效率高于对照组(P<0.05),但2组不良反应总发生率比较差异无统计学意义(P>0.05)。与本组治疗前比较,2组治疗后结膜分泌物中乙酰肝素酶及串珠素水平均降低(P<0.05),且治疗组治疗后乙酰肝素酶及串珠素水平均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后PERG的b波波幅均升高(P<0.05),潜伏期均缩短(P<0.05),且治疗组治疗后b波波幅高于对照组(P<0.05),潜伏期短于对照组(P<0.05)。与本组治疗前比较,2组治疗后CMT及RCT均降低(P<0.05),且治疗组治疗后CMT及RCT均低于对照组(P<0.05)。结论丹参注射液离子导入治疗视网膜静脉阻塞临床疗效确切,可有效改善患者黄斑功能,减轻眼底病变程度,提高视力,且安全性高,其作用机制可能与抑制乙酰肝素酶及串珠素的过度表达有关。Objective To investigate the clinical efficacy of Danshen injection iontophoresis on retinal vein occlusion(RVO),and to analyze its influence on the expression of heparanase and perlecan in conjunctival secretions.Methods A total of 90 RVO patients(180 eyes)were randomly divided into the control group(n=90 eyes)and the treatment group(n=90 eyes).All patients were treated with routine ranibizumab intravitreal injection,patients of the treatment group were additionally treated with Danshen injection iontophoresis.The treatment was performed for 3 months to statistically analyze the curative effects of the two groups.Conjunctival secretions were collected to analyze the differences in the expression levels of heparanase and perlecan.The latency and amplitude of the b-wave of pattern electroretinogram(PERG)before and after treatment were counted between groups.The changes of central macular thickness(CMT)and retinal circulation time(RCT)before and after treatment were assessed between groups.The adverse reactions were observed.Results After treatment,the total effective rate in the treatment group was significantly higher than that in the control group(97.78%[88/90]vs 90.00%[81/90],P<0.05).There was no significant difference in the incidence of adverse reactions(11.11%[5/45]vs 4.44%[2/45],P>0.05).The levels of heparanase and perlecan in the conjunctival secretions significantly decreased in the two groups(P<0.05),which were more pronounced in the treatment group(P<0.05).After treatment,the both groups showed significantly increased b-wave amplitude and shortened latency,and significantly decreased CMT and RCT levels(all P<0.05),with the most significant changes in the treatment group than in the control group(all P<0.05).Conclusion Danshen injection iontophoresis has a significant effect on RVO,which can effectively improve the macular function,reduce the degree of fundus lesions,improve vision by inhibiting the overexpression of heparanase and perlecan,and it has high safety.

关 键 词：视网膜静脉阻塞 丹参注射液 离子导入 乙酰肝素酶 串珠素 

分 类 号：R289.6[医药卫生—方剂学]