灯盏细辛注射液对选择性激光小梁成形术术后眼压已控制的开角型青光眼患者视神经保护作用探讨

摘要

目的 探讨灯盏细辛注射液对选择性激光小梁成形术(SLT)术后眼压已控制的开角型青光眼患者视神经保护作用.方法 选取医院2016年2月至2017年6月收治的SLT术后眼压已控制的开角型青光眼患者147例,采用回顾性分析,按治疗方法不同分为对照组(64例)和研究组(83例).对照组患者予以口服安慰剂治疗,研究组患者予以灯盏细辛注射液治疗,均治疗2个月.结果 治疗后,对照组患者眼动脉(OA)、睫状后短动脉(SPCA)、视网膜中央动脉(CRA)的收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)较治疗前无明显改善(P＞ 0.05);研究组患者除OA的PSV较治疗前无明显改善外,其余各项均较治疗前明显改善(P ＜0.05),且较对照组显著(P ＜0.05).对照组患者治疗后臂-视网膜循环时间(A-CT)、视网膜充盈时间(A-VT)与治疗前比较无明显差异(P＞ 0.05);研究组患者治疗后A-CT和A-VT均较治疗前及对照组患者明显缩短(P ＜0.05).对照组患者治疗后视网膜视神经纤维层厚度(RNFL)及视盘沿面积较治疗前比较无明显差异(P＞ 0.05);研究组患者治疗后RNFL较治疗前明显增厚,视盘沿面积较治疗前明显增大(P ＜0.05),且与对照组患者差异显著(P ＜0.05).结论 灯盏细辛注射液可有效改善SLT术后眼压已控制的开角型青光眼患者眼血流动力学指标,改善视盘血液循环,改善RNFL及视盘盘沿面积,从而达到保护视神经功能的作用.%Objective To investigate the protective effect of Dengzhan Xixin Injection on optic nerve of open angle glaucoma patients with controlled intraocular pressure after selective laser trabeculoplasty (SLT). Methods Totally 147 open angle glaucoma patients with controlled intraocular pressure after SLT from February 2016 to June 2017 were selected and analyzed retrospectively. The patients were divided into the control group (64 cases) and the study group (83 cases) according to different treatment methods. The control group was treated with oral placebo, while the study group was treated with Dengzhan Xixin Injection for 2 months. Results After treatment, the peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI) of ophthalmic artery (OA), short posterior ciliary artery (SPCA) and central retinal artery (CRA) in the control group were not significantly improved (P＞ 0. 05). In the study group, except for the PSV of OA, the other items were significantly improved compared with those before treatment and those in the control group after treatment (P ＜ 0. 05). After treatment, there was no significant difference in A-CT and A-VT in the control group compared with those before treatment (P＞ 0. 05), but the A-CT and A-VT in the study group were significantly shorter than those before treatment (P ＜ 0. 05), and those were significantly shorter than those in the control group (P ＜ 0. 05). After treatment, there was no significant difference in the RNFL and area of optic disc in the control group compared with those before treatment (P＞ 0. 05), but the RNFL in the study group was significantly thicker than that before treatment, and the area of optic disc in the study group was significantly increased compared with that before treatment (P ＜ 0. 05), and those in the study group were significantly different from those in the control group (P ＜ 0. 05). Conclusion Dengzhan Xixin Injection can effectively improve the hemodynamics of open angle glaucoma patients with controlled intraocular pressure after SLT, it can also improve the blood circulation of the optic disc, improve the thickness of RNFL and the area of optic disc, so as to protect the optic nerve function.