长春胺对原发性缺血性视神经视网膜脉络膜病变疗效观察

长春胺对原发性缺血性视神经视网膜脉络膜病变疗效观察 长春胺对原发性缺血性视神经视网膜脉络膜病变疗效观察 作者: 刘艳，张倩，黄丹琳，李莹 【摘要】 目的 观察长春胺注射液对原发性缺血性视神经视网膜脉络膜病变的疗效和安全性。 采用随机对照方法，将原发性缺血性视神经视网膜脉络膜病变患者60例随机分为对照组(30例)、治疗组(30例)，对照组采用妥拉唑林注射液25 mg 患眼颞侧颞浅动脉旁皮下注射，治疗组采用妥拉唑林注射液25 mg 患眼颞侧颞浅动脉旁皮下注射同时应用长春胺注射液20 mg+0(9%NS 250 ml 静滴，1次/d，疗程为20 d。结果 有效率治疗组为76(7%，对照组为40(0%，两者比较，差异有显着统计学意义(U=203(5，P0(01)。治疗组除3例患者有短暂恶心，头昏，2例有短暂腹痛外，与对照组均无严重不良反应。 结论 长春胺对原发性缺血性视神经视网膜脉络膜病变的治疗是有效和安全的。 【关键词】 视神经疾病 脉络膜缺血性病变 长春胺 Abstract: Objective To investigate the treatment effect of vinpocetine injection on primary ischemic optic neuropathy and choroidoretinopathy and its safety. Methods A randomized and controlled study was applied to 60 patients with primary ischemic optic neuropathy and choroidoretinopathy. The patients were assigned into two groups at random: 30 patients in control group and the other 30 ones in trial group. Vinpocetine (2 ml) was injected to the trial group once per day, while tolazoline (25 mg) was given in the same way to the control group for 20 days. Visual acuity, visual field and fundus condition were examined so that the effect of treatment could be evaluated. The safety of the treatment was studied via intraocular pressure, blood pressure, electrocardiogram, routine blood and urine examination, and blood tests for renal and liver function. The main subjects of the two groups before treatment were parable (P0.05). Results The difference in effective rate between trial group (76.7%) and control group (40.0%) was significant (P0.01). There were a few of side effects in some patients and the parameters related to the safety had no significant change before and after treatment. Conclusion Vinpocetine is a safe and effective drug to treat primary ischemic optic neuropathy and choroidoretinopathy. Key words: optic nerve disease; choroidoretinitis; vinpocetine 原发性视神经视网膜脉络膜缺血性病变是一种多发生于中老年人的急性缺血性疾病，系眼底营养血管发生急性循环障碍所致。其主要为前部缺血性视神经病变(anterior ischemic optic neuropathy，AION)和视网膜中央动脉分支阻塞(branchretinalarteryocclusion，BRAO)。临床以突然无痛性视力减退，视盘水肿及视野缺损为特点，起病急、进展快，常造成严重视功能障碍，甚至失明。本研究应用长春胺注射液治疗眼底缺血性病变30例，疗效较好。 1 资料与方法 1(1 病例选择 1(1(1 病例入选 (1)经询问病伤史，视力、眼底、视野等检查符合原发性缺血性病变诊断的患者; (2)病程不超过3个月; (3)疾病程度不限; (4)年龄?18周岁?65周岁。 1(1(2 病例排除标准 (1)并发影响视功能的其他眼病及颞动脉炎性AION; (2)孕妇或哺乳期妇女; (3)眼外伤引起的继发性缺血性病变; (4)因全身状况不允许完成各项检查者; (5)对试验药物过敏者;(6)无光感超过7 d 者。 1. 1.3 病例分组 共选出符合本试验条件的患者60例，利用随机数字将患者随机分为治疗组和对照组各30例，两组患者年龄、病种、病变程度基本相近，具有可比性。 1(2 治疗方法 治疗组应用长春胺注射液(商品名: 润坦，郑州羚锐制药有限公司)，20 ml+0(9%NS 250 ml 静滴，1次/d，同时应用妥拉唑林注射液25 mg，患眼颞侧颞浅动脉旁皮下注射。对照组应用妥拉唑林注射液25 mg，患眼颞侧颞浅动脉旁皮下注射，两组疗程均为20 d。