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目的:观察拉坦前列素与噻吗洛尔不同联用方案治疗原发性开角型青光眼(POAG)的临床疗效与安全性。方法:采用2×2自身交叉对照方案,选择2014年1月-2016年11月在三亚市人民医院接受治疗的50例POAG患者,按随机数字表法分为A、B两个治疗顺序组,各25例。A组患者先行传统用药方案(拉坦前列素滴眼液每晚 1 次,每次 1 滴+马来酸噻吗洛尔滴眼液早晚各滴 1 次,每次 1 滴),治疗8周后,经48 h洗脱期,再行改进用药方案(拉坦前列素滴眼液每晚1次,每次 1 滴+马来酸噻吗洛尔滴眼液每日早上1次,每次1滴)治疗8周;B组患者则先行改进治疗方案治疗,治疗8周后,经48 h洗脱期,再行传统治疗方案治疗8周。比较两种用药方案患者用药前后24 h平均眼压、峰值眼压、谷值眼压及眼压波动值,并记录其眼部血流动力学[最大舒张末期血流速度(EDV)、最大收缩期峰值血流速度(PSV)、阻力指数(RI)]及不良反应发生情况。结果:两种用药方案治疗后,患者24 h平均眼压、峰值眼压、谷值眼压、眼压波动值及RI均显著低于治疗前,EDV、PSV均显著高于治疗前,差异均有统计学意义(P<0.05),但两组间比较差异均无统计学意义(P>0.05)。改进用药方案患者的不良反应总发生率显著低于传统用药方案(4.0% vs. 22.0%),差异均有统计学意义(P<0.05)。结论:将拉坦前列素联合噻吗洛尔的传统联用方案中的噻吗洛尔早晚2次用药改为早上1次用药,不改变其疗效,但用药不良反应有所减少。
OBJECTIVE: To observe the clinical efficacy and safety of different combination regimens of latanoprost combined with timolol in the treatment of primary open-angle glaucoma (POAG). METHODS: By 2×2 self-cross controlled regimen, a total of 50 POAG patients were selected from Sanya Municipal People’s Hospital during Jan. 2014-Nov. 2016, and then divided into group A and B according to random number tablet, with 25 cases in each group. Group A received traditional regimens (Latanoprost eye drops, once every night, one drop each time+Timolol maleate eye drops, once in the morning and evening, one drop each time); after 8 weeks of treatment and 48 h washout period, group A was given modified regimen (Latanoprost eye drops, once every night, one drop each time+Timolol maleate eye drops, once every morning, one drop each time) for 8 weeks. Group B was given modified regimen; after 8 weeks of treatment and 48 h washout period, then was given traditional regimen for 8 weeks. The 24 h average intraocular pressure, peak and trough intraocular pressure before and after medication, ocular hemodynamics [end diastolic velocity(EDV), peak systolic velocity (PSV), resistance index (RI)] and ADR were recorded in 2 regimens. RESULTS: After received two regimens, 24 h average intraocular pressure, peak and trough intraocular pressure, intraocular pressure fluctuation and RI were significantly lower than before treatment, while EDV and PSV were significantly higher than before treatment, with statistical significance (P<0.05). There was no statistical significance between 2 groups (P>0.05). The total incidence of ADR in patients receiving modified regimen was significantly lower than those receiving traditional regimen (4.0% vs. 22.0%), with statistical significance (P<0.05). CONCLUSIONS: In traditional combination regimen of latanoprost combined with timolol, the frequency of timolol use was changed from twice in the morning and evening to once in the morning, which doesn’t influence therapeutic efficacy but reduce ADR.
拉坦前列素噻吗洛尔原发性开角型青光眼24 h 眼压眼部血流动力学
LatanoprostTimololPrimary open-angle glaucoma24 h intraocular pressureOcular blood flow
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