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[摘要]
目的 探讨尼莫地平联合曲伏前列素滴眼液治疗原发性开角型青光眼的临床效果。方法 选取2015年12月—2017年12月洛阳博爱眼科医院收治的原发性开角型青光眼患者80例,随机分成对照组(40例)和治疗组(40例)。对照组患者睡前滴入曲伏前列素滴眼液,1滴/次,1次/d。治疗组在对照组基础上口服尼莫地平片,1片/次,3次/d。两组均连续治疗12周。观察两组患者临床疗效,同时比较治疗前后两组患者24 h峰值眼压、视功能相关的生存质量量表-25(NEI VFQ-25)总分、视盘参数和视野平均缺损(MD)及视盘筛板血流参数。结果 治疗后,对照组和治疗组临床有效率分别为75.0%和92.5%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组24 h峰值眼压显著下降(P<0.05),NEI VFQ-25总分显著升高(P<0.05),且治疗组24 h峰值眼压和NEI VFQ-25总分明显好于对照组(P<0.05)。治疗后,两组垂直杯盘比(C/D)、平均C/D和视野MD值均显著降低(P<0.05),盘沿面积(RA)值显著升高(P<0.05),且治疗组视盘参数和视野MD明显好于对照组(P<0.05)。治疗后,两组各视盘筛板血流速度、血流量和红细胞移动速率值均明显升高(P<0.05),且治疗组视盘筛板血流参数明显高于对照组(P<0.05)。结论 尼莫地平联合曲伏前列素滴眼液治疗原发性开角型青光眼能明显控制患者眼压,改善筛板区血流状态,延缓病情进展,提高生活质量。
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[Abstract]
Objective To investigate the clinical effect of nimodipine combined with travoprost in treatment of primary open-angle glaucoma. Methods Patients (80 cases) with primary open-angle glaucoma in Luoyang Boai Ophthalmological Hospital from December 2015 to December 2017 were randomly divided into control (40 cases) and treatment (40 cases) groups. Patients in the control group were dropped administered with Travoprost Eye Drops at bedtime, 1 drop/time, once daily. Patients in the treatment group were po administered with Nimodipine Tablets on the basis of the control group, 1 tablet/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the 24 h peak IOP, NEI VFQ-25 scores, optic disc parameters, visual field MD, blood flow parameters of disc cribriform plates in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 75.0% and 92.5% respectively, and there were differences between two groups (P<0.05). After treatment, the 24 h peak IOP in two groups was significantly decreased (P<0.05), but NEI VFQ-25 scores were significantly increased (P<0.05), and the 24 h peak IOP and NEI VFQ-25 scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the vertical C/D, average C/D and vision MD value in two groups was significantly decreased (P<0.05), but RA value was significantly increased (P<0.05), and the optic disc parameters, the visual field MD in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the blood flow rate, blood flow and erythrocyte migration rate of disc cribriform plates in two groups were significantly increased (P<0.05), and the blood flow parameters of disc cribriform plates in the treatment group were significantly higher than that in the control group (P<0.05). Conclusion Nimodipine combined with travoprost in treatment of primary open-angle glaucoma can obviously control the intraocular pressure of patients, improve the blood flow state in the cribriform plate area, delay the progress of the disease, and improve the quality of life.
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