目的 探讨血栓通注射液联合鼠神经生长因子治疗非动脉炎性前部缺血性视神经病变(AION)的疗效观察。方法 选取2013年6月—2015年6月沈阳市第四人民医院眼科收治的非动脉炎性AION患者88例,按治疗方案的差别将患者分为对照组和治疗组,每组各44例。对照组肌肉注射注射用鼠神经生长因子,18 μg/次加入到0.9%生理盐水或灭菌注射用水2 mL中溶解,1次/d。治疗组在对照组治疗基础上静脉滴注血栓通注射液,5 mL加入到0.9%生理盐水250 mL,1次/d。两组患者均连续治疗4周。观察两组的临床疗效,同时比较两组视野缺损(MD)、P₁₀₀波潜伏期、视盘各象限视神经纤维层厚度(ATRNFL)、视力提高行数。结果 治疗后,对照组和治疗组的总有效率分别为77.27%、93.18%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者MD、P₁₀₀潜伏期较治疗前显著减小,同组治疗前后差异具有统计学意义(P<0.05);且治疗组的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组ATRNFL均较治疗前减小,但治疗后治疗组ATRNFL较对照组高,两组比较差异具有统计学意义(P<0.05);并且治疗后对照组ATRNFL较正常值低。治疗组的视力提高行数高于对照组,两组比较差异具有统计学意义(P<0.05)。结论 血栓通注射液联合鼠神经生长因子治疗非动脉炎性AION具有较好的临床疗效,可明显改善视力,有效提高视野,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Xueshuantong Injection combined with mouse nerve growth factor in treatment of nonarteritic anterior ischemic optic neuropathy. Methods Patients (88 cases) with nonarteritic anterior ischemic optic neuropathy in Department of Ophthalmology from Shenyang the Fourth Hospital of People from June 2013 to June 2015 were enrolled in this study. According to the different treatment plan, patients were divided into treatment group (44 cases) and control group (44 cases). The patients in the control group were im administered with Mouse Nerve Growth Factor for injection, 18 μg/time added into 0.9% normal saline or sterilization injection water 2 mL, once daily. The patients in the treatment group were iv administered with Xueshuantong Injection on the basis of control group, 5 mL added into 0.9% normal saline 250 mL, once daily. The patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the MD, the incubation period of P₁₀₀ wave, ATRNFL of each quadrant optic, the line number of improve eyesight in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.27% and 93.18%, respectively, and there were differences between two groups (P < 0.05). After treatment, MD and the incubation period of P₁₀₀ wave in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, ATRNFL in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, ATRNFL in the treatment group was significantly higher than that in the control group, with significant difference between two groups (P < 0.05). After treatment, ATRNFL in the control group was lower than normal level. The line number of improve eyesight in the treatment group was higher than that in the control group, with significant difference between two groups (P < 0.05). Conclusion Xueshuantong Injection combined with mouse nerve growth factor has clinical curative effect in treatment of nonarteritic anterior ischemic optic neuropathy, and can obviously improve vision, also can improve the field of vision, which has a certain clinical application value.