目的 探讨复方樟柳碱注射液联合盐酸卡替洛尔滴眼液治疗开角型青光眼的临床疗效。方法 选取辽宁省朝阳市中心医院2017年1月—2019年6月收治的开角型青光眼患者82例（150眼）作为研究对象。将患者随机分为对照组与观察组，每组各41例。对照组给予盐酸卡替洛尔滴眼液治疗，每日早午饭后滴1滴眼液于结膜囊内，手指压迫内眦角泪囊部5 min， 2次/d，治疗4周。观察组患者在对照组的基础上联合复方樟柳碱注射液治疗，于患眼同侧颞浅动脉旁皮下注射樟柳碱2 mL， 1次/d，14 d为一个疗程，连续治疗2个疗程。观察两组患者的临床疗效，比较治疗前后两组患者的眼压、视力、视野平均缺损（MD）、视野神经宽度、以及眼部血管眼动脉（OA）、睫状后短动脉（PCA）、视网膜中央动脉（CRA）的血管收缩期峰值血流速度（PSV）、舒张末期容量（EDV）、阻力指数（RI）、搏动指数（PI）等指标。结果 治疗后，观察组改善率为96.05%，显著高于对照组的81.08%（P<0.05）。治疗后，两组视力水平显著升高，眼压均显著下降（P<0.05）；观察组视力水平和眼压显著优于对照组（P<0.05）。治疗后与随访3个月，观察组MD与视神经宽度水平均显著高于治疗前（P<0.05）。治疗后，两组CRA、PCA的PSV、EDV呈升高趋势，观察组与治疗前相比差异显著（P<0.05），且与对照组相比差异明显（P<0.05）。与治疗前相比，观察组OA的PSV、EDV值显著升高，差异有统计学意义（P<0.05）。随访3个月，与治疗前相比，观察组CRA的PSV降低，EDV升高（P<0.05），PCA和OA的PSV、EDV均降低（P<0.05），观察组随访3个月的CRA的PSV较对照组低、EDV更高，PCA的PSV、EDV较对照组低（P<0.05）。结论 复方樟柳碱注射液联合盐酸卡替洛尔滴眼液治疗开角型青光眼患者可有效控制眼压，同时还具有较好的视神经保护作用，主要表现为改善视野平均缺损、视神经宽度、眼血管血流参数，延缓视功能损害，疗效显著，值得临床推广。

Objective To explore the clinical effect of Compound Anisodine Hydrobromide Injection combined with Carteolol Hydrochloride Eye Drops in treatment of open-angle glaucoma. Methods A total of 82 patients (150 eyes) with open-angle glaucoma treated in Chaoyang Central Hospital from January 2017 to June 2019 were randomly divided into control group and observation group, and each group had 41 case. Patients in the control group were treated with Carteolol Hydrochloride Eye Drops, one drop was put into the conjunctival sac after brunch every day, fingers compressed the lacrimal sac at the inner canthus angle for 5 min, twice daily, and the treatment lasted for 4 weeks. Patients in the observation group were treated with Compound Anisodine Hydrobromide Injection on the basis of the control group, 2 mL was injected subcutaneously in the same side of temporal superficial artery of the affected eye, once daily, 14 days as a course of treatment, two courses of treatment were continuous. The clinical efficacy in two groups were observed, and the visual acuity, intraocular pressure, MD, optic nerve width, and the indexes of PSV, EDV, RI, and PI in the OA, PCA and CRA before and after treatment were compared. Results After treatment, the improvement rate of the observation group was 96.05%, which was significantly higher than 81.08% of the control group (P<0.05). After treatment, the visual acuity of in two groups was increased significantly, but the intraocular pressure was decreased significantly (P<0.05).After treatment, visual acuity and intraocular pressure in the observation group were significantly better than those in the control group (P<0.05). After treatment and follow-up for 3 months, MD and the width of and optic nerve in the observation group was significantly higher than those before treatment (P<0.05). After treatment, the PSV and EDV of CRA and PCA in two groups showed an increasing trend, and the difference between the observation group and the control group was significant (P<0.05). Compared with before treatment, PSV and EDV values of OA in the observation group were significantly increased (P<0.05). In the follow-up for 3 months, compared with that before treatment, PSV of the CRA was decreased, but EDV in the observation group were significantly decreased (P<0.05), and PSV and EDV of PCA and OA were decreased (P<0.05). The PSV of CRA in the observation group were lower than that in the control group, but EDV of the CRA in the observation group after 3-month follow-up were higher than that in the control group, and the PSV and EDV of the PCA were lower than those in the control group (P<0.05). Conclusion Compound Anisodine Hydrobromide Injection combined with Carteolol Hydrochloride Eye Drops in treatment of openangle glaucoma patients can effectively control the intraocular pressure, but also has good optic protection, mainly in order to improve the average visual defect, width of the optic nerve, eye vascular blood flow parameters, and delay the visual function damage, curative effect is distinct, which was worth clinical promotion.

R988.1