拉坦前列素、曲伏前列素与贝美前列素治疗原发性开角型青光眼的临床疗效观察

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贝美前列素和曲伏前列素治疗开角型青光眼和高眼压症的疗效对照研究

贝美前列素和曲伏前列素治疗开角型青光眼和高眼压症的疗效对照研究

vol.20No.5May 2011Acta Academiae Medicinae CPAF[收稿日期]2010-09-13;[修回日期]2010-12-18[作者简介]李斌(1964-),男,籍贯山东安丘,副主任医师,主要从事眼科临床工作。

贝美前列素和曲伏前列素治疗开角型青光眼和高眼压症的疗效对照研究李斌,李俊逸,王翠青,郭丽,李瑞国(武警山东总队医院眼科,山东济南250014)摘要:【目的】评价贝美前列素和曲伏前列素替代拉坦前列素治疗原发性开角型青光眼和高眼压症的临床效果和安全性。

【方法】采用前瞻性、随机、单盲、平行对照临床试验,选择使用拉坦前列素不能达到目标眼压的原发性开角型青光眼和高眼压症患者并随机分两组,分别滴用贝美前列素或曲伏前列素,均为每晚1次,每次1滴。

测量替换用药前、1个月和3个月时的眼压,观察不良反应。

【结果】两组平均基线日间眼压无统计学差异。

替换治疗后1个月和3个月的平均日间眼压,贝美前列素组较曲伏前列素组有显著性下降。

总体上,在替换治疗1个月和3个月时,22%贝美前列素组患者和12.1%曲伏前列素组患者平均日间眼压降幅达到15%以上,两组差异有统计学意义(P <0.05)。

在3个月时平均日间眼压下降幅度贝美前列素组为2.1mmHg (11.0%),曲伏前列素组为1.4mmHg (7.4%),两组差异有统计学意义(P <0.05)。

贝美前列素组3例(8.8%)和曲伏前列素组2例(5.7%)出现了与治疗相关的不良反应。

与治疗有关的结膜充血患者发生率,贝美前列素组为3.1%,曲伏前列素组为1.5%,两组间无统计学差异(P >0.05)。

无严重不良反应和全身不良反应发生。

【结论】经拉坦前列素治疗不能达到目标眼压的患者,更换贝美前列素或曲伏前列素后,短时间内的日间眼压下降前者比后者更明显,替换用药后结膜充血发生率二者均较低。

关键词:拉坦前列素;曲伏前列素;贝美前列素;青光眼;高眼压症【文章编号】1008-5041(2011)05-0355-05【中图分类号】R775.2【文献标识码】AComparison of bimatoprost and travoprost in treating primary open angle glaucoma and ocular hypertensionLI Bin,LI Jun-yi,WANG Cui-qing,GUO Li,LI Rui-guo (Department of Ophthalmology,Shandong Provincial Corps Hospital of Chinese People's Armed Police Force,Ji’nan 250014,China)Abstract:【Objective 】To evaluate the efficacy and safety of replacing latanoprost with bimatoprost or travoprost in treating primary open angle glaucoma or ocular hypertension requiring additional intraocular pressure (IOP)lowering while on latanoprost.【Methods 】Prospective,randomised,investigator-masked and parallel-group clinical trial were used.In patients on latanoprost monotherapy requiring additional IOP lowering latanoprost was discontinued and were randomised to bimatoprost or travoprost management.Patients were instructed to instill one drop of the selected medication in each eye once daily in the evening and were scheduled for follow-up visits at months 1and 3.IOP was measured at latanoprost-treated baseline and after 1month and 3months of replacement therapy.【Results 】Baseline mean diurnal IOP on latanoprost was similar to two tested groups.The mean diurnal IOP was significantly lower with bimatoprost than with travoprost at 1month (P <0.05)and 3months (P <0.05).Overall,22.0%of bimatoprost patients versus 12.1%of travoprost patients achieved a ≥15%reduction in diurnal IOP from latanoprost-treated baseline at both months 1and 3(P <0.05).At month 3,the additional mean diurnal IOP reduction from latanoprost-treated baseline was 2.1mmHg (11.0%)with bimatoprost and 1.4mm Hg (7.4%)with travoprost (P <0.05).Hyperaemia was reported as a treatment-related adverse event in 3.1%of bimatoprost and 1.5%of travoprost patients (P >0.05).【Conclusion 】Patients on latanoprost requiring lower IOP achieve a greater additional short-term diurnal IOP reduction when latanoprost was replaced by bimatoprost as compared with travoprost.Low rates of hyperaemia is observed in patients treated with bimatoprost or travoprost after switching from latanoprost.Key words:Latanoprost;Travoprost;Bimatoprost;Glaucoma;Ocular hypertensiondoi:10.3969/j.issn.1008-5041.2011.05.007丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐丐论著青光眼是具有病理性高眼压或视盘灌注不良致视神经损害和视功能障碍的眼病,其治疗的目标首先是降眼压,主要手段包括药物、激光和手术治疗。

拉坦前列素治疗开角型青光眼的疗效观察

拉坦前列素治疗开角型青光眼的疗效观察

拉坦前列素治疗开角型青光眼的疗效观察张敏;宋艳梅;冯玮【期刊名称】《国际眼科杂志》【年(卷),期】2018(018)006【摘要】目的:探讨拉坦前列素治疗开角型青光眼的疗效.方法:选择2015-08/2017-08期间在我院就诊的开角型青光眼患者100例作为研究对象,根据治疗方法的不同分为观察组和对照组,各50眼.对照组采用噻吗洛尔滴眼液治疗,2次/d,每次1滴,连续治疗12wk;观察组采用拉坦前列素滴眼液治疗,1次/d,每次1滴,连续治疗12wk.比较两组患者治疗前后眼压、眼部血流动力学指标、视野缺损度及不良反应发生情况.结果:治疗前两组患者眼压水平相比,差异无统计学意义(P>0.05);治疗4、8、12wk后观察组眼压均低于对照组,差异均有统计学意义(P<0.05).对照组治疗前后视网膜中央动脉(CRA)、睫状后短动脉(PCA)血流动力学指标相比,差异均无统计学意义(P>0.05);观察组CRA、PCA的舒张末期血流速度(EDV)与收缩期血流速度(PSV)均较治疗前显著升高,而血管阻力指数(RI)明显下降,差异均有统计学意义(P<0.05).治疗前两组各方位视野缺损程度相比,差异无统计学意义(P>0.05);治疗后两组各方位缺损范围均明显缩小,且观察组患者视野缺损程度明显小于对照组,差异均有统计学意义(P<0.05).两组患者不良反应发生率相比,差异无统计学意义(P>0.05).结论:开角型青光眼采用拉坦前列素滴眼液治疗效果显著,能够明显降低眼压,改善眼部血流动力学,缩小视野受损范围,具有良好的安全性.%· AIM:To explore the effect and mechanism of latanoprost on open-angle glaucoma.· METHODS:Totally 100 patients with open angle glaucoma who had been seeking treatment in our hospital between August 2015 andAugust 2017 were selected as the research subjects.These patients were divided into an observation group and a control group according to the random table method,with 50 cases in each group.The control group was treated with timolol maleate eye drops,1 drop per time,2 times aday,treated consecutively for 12wk.The observation group was given latanoprost eye drops for treatment,1 drop per time,1 time a day,for a continuous treatment of 12wk.The lOP,ocular hemodynamics,visual field defects and adverse reactions in the two groups were compared.· RESULTS:Before treatment,there was no statistically significant difference found on the intraocular pressure between the two groups (P>0.05);at 4,8,12wk after the treatment,the intraocular pressure at different time points in the observation group was shown to be lower than that in the control group,where the difference was statistically significant (P<0.05).There was no statistically significant difference shown in the artery hemodynamics indexes of CRA and PCA before and after treatment in the control group (P>0.05);the indicators of EDV and PSV of CRA,PCA indicators in the observation group significantly increased,while the RI index decreased significantly,with the difference being statistically significant (P< 0.05).Before treatment,there was no statistically significant difference in all of the visual field defects between the two groups before treatment (P > 0.05);after treatment,however,the scope of visual field defects was shrunk in both groups,with changes in the observation group more significant than the control group,and the difference was statistically significant (P<0.05) There was no statistically significant differenceregistered in the incidence of adverse reactions between the two groups (P >0.05).· CONCLUSION:For patients with open angle glaucoma,latanoprost eye drops is with significant curative effects and of relatively high value,which can significantly reduce the intraocular pressure,improve the ocular hemodynamics,and reduce the scope of eye damage with high safety.【总页数】4页(P1068-1071)【作者】张敏;宋艳梅;冯玮【作者单位】071000 中国河北省保定市第一医院眼科;071000 中国河北省保定市第一医院眼科;071000 中国河北省保定市第一医院眼科【正文语种】中文【相关文献】1.马来酸噻吗洛尔联合拉坦前列素治疗开角型青光眼的效果评价 [J], 刘慧露2.拉坦前列素及噻吗心安治疗开角型青光眼的疗效观察及安全性评估 [J], 胡杨;赵鸣;丁洁3.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的临床观察 [J], 吴书;张开颜;陈炳荣;王玲玲4.拉坦前列素治疗开角型青光眼的疗效及其对患者眼部血流动力学、视野缺损程度的影响 [J], 汪梦园;王娟;孙惠斌;张英杰;贾雪松;张慧芝5.拉坦前列素、噻吗洛尔和曲伏前列素治疗原发性开角型青光眼的疗效观察 [J], 韩宝雁; 米强; 贾冠美; 仝春梅因版权原因,仅展示原文概要,查看原文内容请购买。

三种前列腺素衍生剂的Meta分析

三种前列腺素衍生剂的Meta分析

三种前列腺素衍生剂的Meta分析[目的]根据临床研究文献,采用Meta分析法综合评价三种前列腺素衍生剂治疗原发性开角型青光眼和高眼压症的有安全性和有效性。

[方法]检索CNKI、维普、万方、SCI、Pubmed、Science Direct等数据库中1995至2015年期间发表的有关前列腺衍生剂治疗原发性开角型青光眼和高眼压症的临床研究资料,采用Review Manager 5.3软件,对入选的国内外11篇相关研究文献进行综合定量分析。

[结果]Meta分析结果显示,拉坦前列素、曲伏前列素、贝美前列素降低眼压的效果均优于噻吗洛尔,有统计学意义(p<0.05)。

在降压效果上,贝美前列素稍好于拉坦前列素和曲伏前列素,但三者差异不大。

可近似认为降压效果上相当。

主要不良反应是结膜充血,拉坦前列素不良反应发生率最低,曲伏前列素最高。

[结论]拉坦前列素、曲伏前列素、贝美前列素在降低眼压上效果接近,拉坦前列素不良反应发生率较低。

但三者的临床有效性尚需要更多高质量的临床试验来证实。

标签:拉坦前列素;曲伏前列素;贝美前列素;原发性开角型青光眼;Meta 分析青光眼是全球第二位致盲眼病,仅次于白内障。

2010年全世界约有6050万青光眼患者,预计到2020年,患者总数将上升至7960万,在我国,青光眼患者超过940万人。

原发性开角型青光眼(POAG)是最为常见的青光眼类型。

前列腺素衍生剂(PGAs)是新一代降眼压药物,其具有降压幅度大、效果持久、昼夜眼压波动小、严重副作用少、点药次数少等优点,是比较理想的降眼压药物。

目前,PGAs主要是0.005%拉坦前列素、0.004%曲伏前列素和0.03%贝美前列素。

回顾以往研究,对三种PGAs的直接比较研究较少。

在报道的多个国际大型多中心临床试验中,普遍采用0.5%马来酸噻吗洛尔作为对照组来对比各种药物降低眼压的效果。

所以本研究拟使用间接比较,通过三种PGAs药物和噻吗洛尔在各项临床试验中的疗效数据来比较他们相互之间的安全性和有效性。

曲伏前列素对原发性开角型青光眼患者的临床应用效果

曲伏前列素对原发性开角型青光眼患者的临床应用效果

·58·□临床研究/Clinical Research现代医学与健康研究2021年第5卷第10期[4] 侯东哲, 张颖, 巫嘉陵, 等. 中文版Barthel 指数的信度与效度研究[J]. 临床荟萃, 2012, 27(3): 219-221.[5] 丁美兰, 杜宁娜, 李红梅. 早期肠内 - 肠外联合营养对高血压脑出血患者术后免疫功能及预后的影响[J]. 医学临床研究, 2018, 35(12): 2377-2379.[6] 龙晓东, 刘之彝, 杨与敏. 超早期小骨窗微创颅内血肿清除术对高血压脑出血患者生活质量和ET 、A VP 水平的影响[J]. 脑与神经疾病杂志, 2019, 27(3): 169-173.[7] 孙彩霞. 颅内血肿微创清除术对高血压脑出血患者并发症和神经功能的影响[J]. 内科急危重症杂志, 2018, 24(2): 163-164, 174.[8] 罗科辉, 张美彪, 孙钒, 等. 微创颅内血肿清除术治疗高血压脑出血的效果及对血清基质金属蛋白酶9, 白细胞介素8, 神经元特异性烯醇化酶表达的影响[J]. 中国基层医药, 2020, 27(16): 2017-2021.曲伏前列素对原发性开角型青光眼患者的临床应用效果赵红梅(河西学院附属张掖人民医院眼科,甘肃 张掖 734000)摘要:目的 研究曲伏前列素对原发性开角型青光眼患者血流动力学及血清内皮素 -1(ET-1)、基质金属蛋白酶抑制剂 -2(TIMP-2)水平的影响。

方法 选取河西学院附属张掖人民医院2018年6月至2019年11月收治的160例原发性开角型青光眼患者,按照随机数字表法将其分为对照组(80例,马来酸噻吗洛尔治疗)与试验组(80例,曲伏前列素治疗),1个疗程为7 d ,两组患者均治疗4个疗程。

比较两组患者治疗前后视功能、血流动力学指标及血清ET-1、TIMP-2水平。

结果 治疗后两组患者视力、视野光敏感度、舒张末期血流速度(EDV )、收缩期峰值血流速度(PSV )水平均升高,且试验组高于对照组;而两组患者视野平均缺损、眼压、血管阻力指数(RI )及血清ET-1、TIMP-2水平均降低,且试验组低于对照组(均P < 0.05)。

拉坦前列素、曲伏前列素和噻吗洛尔治疗原发性开角型青光眼的疗效比较分析

拉坦前列素、曲伏前列素和噻吗洛尔治疗原发性开角型青光眼的疗效比较分析

拉坦前列素、曲伏前列素和噻吗洛尔治疗原发性开角型青光眼的疗效比较分析李俊【摘要】Objectives To compare the effect of latanoprost, travoprost and timolol in primary open angle glauco-ma ( POAG) patients.Methods 120 patients with POAG were randomly divided into 3 groups, with 40 cases in each group.Group A, group B and group C were treated once daily with latanoprost, travoprost and timolol eyedrops respective-ly, and a drop was given at 8 PM every night for every time in four weeks.Results There was no difference of intraocular pressure (IOP) before the treatment among the three groups ( P >0.05), but IOP became lower among the three groups 4 weeks after the treatment, the differences were statistically significant ( P <0.05).The mean IOP reducation were signifi-cantly differernt among the groups, specifically, the latanoprost group and travoprost group in comparison to the timolol group at week 4 ( P <0.05) .Conclusions Latanoprost, travoprost and timolol eyedrops are all effective and hosting in reducing IOP in POAG, but the curative effect of latanoprost and travoprost eyedrops are better than timolol eyedrops.%目的:比较拉坦前列素、曲伏前列素及噻吗洛尔滴眼液治疗原发性开角型青光眼( POAG)的效果。

拉坦前列素、曲伏前列素及贝美前列素滴眼液治疗原发性开角型青光眼降眼压效果比较

拉坦前列素、曲伏前列素及贝美前列素滴眼液治疗原发性开角型青光眼降眼压效果比较

拉坦前列素、曲伏前列素及贝美前列素滴眼液治疗原发性开角
型青光眼降眼压效果比较
陈光胜;王冬梅;阳昇;黄红波
【期刊名称】《中国老年学杂志》
【年(卷),期】2013(033)002
【摘要】引起我国人群致盲的主要疾病是青光眼,其致盲风险不仅高且致盲为不可逆性。

青光眼致盲的主要机制为眼压增高引起视神经损害,因此,降低眼压是缓解症状行之有效的方法。

本研究探讨拉坦前列素、曲伏前列素及贝美前列素滴眼液治疗原发性开角型青光眼降眼压的效果。

【总页数】2页(P445-446)
【作者】陈光胜;王冬梅;阳昇;黄红波
【作者单位】柳州市眼科医院,广西柳州 545001;柳州市眼科医院,广西柳州545001;柳州市眼科医院,广西柳州 545001;柳州市眼科医院,广西柳州 545001【正文语种】中文
【中图分类】R775
【相关文献】
1.拉坦前列素、曲伏前列素和噻吗洛尔治疗原发性开角型青光眼的疗效比较分析[J], 李俊
2.曲伏前列素滴眼液治疗原发性开角型青光眼和高眼压症的降眼压效果及安全性研究 [J], 周春花
3.拉坦前列素、曲伏前列素用于高眼压症、POAG患者治疗效果及安全性对照分析[J], 纪舒昱;钟华;李雷;冯诗婷
4.拉坦前列素、曲伏前列素用于高眼压症、POAG患者治疗效果及安全性对照分析[J], 纪舒昱; 钟华; 李雷; 冯诗婷
5.原发性开角型青光眼或高眼压患者中非类固醇消炎滴眼液对拉坦前列素降低眼压的影响 [J], Chiba T.;Kashiwagi K.;Chiba N.;Tsukahara S.;韩静
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不同种类前列腺素类滴眼液治疗原发性开角型青光眼的降眼压效果对比

不同种类前列腺素类滴眼液治疗原发性开角型青光眼的降眼压效果对比

不同种类前列腺素类滴眼液治疗原发性开角型青光眼的降眼压效果对比作者:杨洪涛来源:《中国医药导报》2014年第18期[摘要] 目的比较拉坦前列素、曲伏前列素及贝美前列素滴眼液治疗原发性开角型青光眼患者6周后的降眼压的效果。

方法选取2012年10月~2013年10月于承德市中心医院门诊就诊的原发性开角型青光眼患者78例(141只眼)。

将其按照给药方法分为三组,每组均为26例,其中Ⅰ组给予拉坦前列素滴眼液(47只眼);Ⅱ组给予曲伏前列素滴眼液(47只眼);Ⅲ组给予贝美前列素滴眼液(47只眼),三组均每日不同时间点滴眼1次,疗程为4周,测量比较三组用药前后的24 h内、不同时间点的眼压以及用药前后4周内眼压。

结果三组治疗前眼压比较,差异无统计学意义(P > 0.05);三组治疗后24 h内各时间点眼压均明显下降,差异有统计学意义(P < 0.05),但各组间眼内压比较,差异无统计学意义(P > 0.05);三组用药后4周眼压比较,差异无统计学意义(P > 0.05)。

结论采用拉坦前列素、曲伏前列素及贝美前列素滴眼液治疗原发性开角型青光眼患者4周后的降眼压的效果显著,且三种滴眼液治疗效果无明显差异。

[关键词] 前列腺素类滴眼液;开角型青光眼;眼压[中图分类号] R775.2[文献标识码] A[文章编号] 1673-7210(2014)06(c)-0070-04Effects comparison of tree prostaglandin eyedrops in reducing open-angle glaucoma intraocular pressureYANG HongtaoDepartment of Ophthalmology, the Central Hospital of Chengde City, Hebei Province, Chengde 067000, China[Abstract] Objective To compare the effect of latanoprost, travoprost and bimatoprost on the 24 h intraocular pressure (IOP) curve in open-angle glaucoma patients. Methods 78 patients with open-angle glaucoma were randomly divided into 3 groups according to different kinds of administration methods, with 26 cases in each group. Group Ⅰ, group Ⅱ and group Ⅲ were treated once daily with latanoprost, travoprost and bimatoprost eyedrops for four weeks,respectively. Before and 4 weeks after the treatment, IOP was measured and compared at 4 time opints in 24 hours. Results There was no difference of IOP before the treatment among the three groups (P > 0.05), but IOP became lower at various time points among the three groups 4 weeks after the treatment, the differences were statistically significant (P < 0.05). There were no significant differences of IOP among the three groups (P > 0.05). There was no significant difference of IOP among the three groups after 4 weeks'treatment (P > 0.05). Conclusion The method is quite obvious by using latanoprost, travoprost and bimatoprost on the IOP in open-angle glaucoma patients.[Key words] Prostaglandin eyedrops; Open-angle glaucoma; Intraocular pressure青光眼是指眼压间断或持续升高的一种眼病,持续的高眼压可以给眼球各部分组织和视功能带来损害,如不及时治疗,视野可以全部丧失而至失明[1]。

曲伏前列素滴眼液治疗原发性开角型青光眼临床分析

曲伏前列素滴眼液治疗原发性开角型青光眼临床分析

曲伏前列素滴眼液治疗原发性开角型青光眼临床分析杜彩霞【摘要】Objective To observe the clinical effect of Travoprost Eye Drops in the treatment of primary open angle glaucoma.Methods102 cases of primary open angle glaucoma patients, according to the random number method, divided into the observation group and the control group, 51 cases, stop using other types of anti glaucoma drug for one week, the observation group used the tune bends down the front row element drop eye lfuid 1 times every night, every time the affected eye drops, while the control group was treated with timolol eye drops in the morning and evening 8:00 administered twice from each eye drops.Results Two groups of patients with baseline IOP level diurnal IOP difference comparison, the difference was not statistically significant (P>0.05), 1 month and 6 months after treatment observation group the diurnal IOP difference(4.09±0.75)mm Hg, (3.87±0.68) mm Hg below the control group's(4.92±0.97)mm Hg, (4.76±0.89)mm Hg (P<0.05), control group of drug adverse reactions 35.29% and observation group 29.22%, the difference was not statistically significant (P>0.05). Conclusion The application of Travoprost Eye Drops has good effect and high safety, and it is a valuable antigen for open angle glaucoma.%目的:观察曲伏前列素滴眼液治疗原发性开角型青光眼的临床效果。

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拉坦前列素、曲伏前列素与贝美前列素治疗原发性开角型青光眼
的临床疗效观察
【摘要】目的探讨拉坦前列素、曲伏前列素与贝美前列素治疗原发性开角性青光眼的方法及其临床疗效,总结临床经验以提高自身用药水平。

方法将2009年8月——2013年5月我科收治的135例原发性开角型青光眼患者随机分为a组、b组、c组,分别给予拉
坦前列素、曲伏前列素、贝美前列素治疗,记录并作回顾性分析。

结果治疗2、4周后三组患者眼压低于治疗前且差异具有统计学意
义(p0.05)。

结论拉坦前列素、曲伏前列素、贝美前列素治疗原发性开角型青光眼的临床疗效肯定,三种药物之间的效果无显著性差异,值得推广。

【关键词】原发性开角型青光眼;拉坦前列素;曲伏前列素;贝美前列素
原发性开角型青光眼(primary open angle glaucoma,pocg)
是青光眼的一种,其特点为眼压升高、房角始终开放,即房水在小梁网schlemm流出时受阻[1]。

前列素类是常用的治疗药物,现将
我科采用拉坦前列素、曲伏前列素与贝美前列素治疗pocg的相关
临床情况报告如下。

1资料及方法
1.1一般资料选择2009年8月——2013年5月我科收治的135
例pocg患者作为研究对象,随机、双盲、平均分为a组、b组、c 组,每组各45例。

a组患者男性27例,女性18例;年龄17-81岁,
平均年龄为55.2岁。

b组患者男性26例,女性19例;年龄19-82岁,平均年龄为56.5岁;c组患者男性28例,女性17例;年龄18-80岁,平均年龄为55.1岁。

三组患者在性别、年龄及病情等方面的差异经比较无统计学意义(p>0.05)且具备可比性。

1.2病例入院及排除标准入选标准:患者均符合pocg诊断标准,即不同时间连续3次测量眼压均大于21mmhg,出现青光眼性视野缺损,眼压增加时前房角处于开放状态,正在使用降眼压药物治疗需要停药4周,矫正视力不低于0.1。

排除标准:未予治疗时眼压大于35mmhg或低于21mmhg;继发性或闭角型青光眼患者,前房角窄、前房浅,前房角可能关闭者;既往眼部手术史者;角膜疾病影响眼压测定者;任何其他急性或慢性眼病者,心、肺、肾、肝功严重障碍者;妊娠、哺乳期妇女;正在使用糖皮质激素、其他的降眼压药等患者[2]。

1.3治疗方法a组患者给予拉坦前列素滴眼液,每晚1次,1滴/次;b组患者给予曲伏前列素滴眼液,每晚1次,1滴/次;c组患者给予贝前列素滴眼液,每晚1次,1滴/次;疗程均为4周[3]。

治疗前及治疗2、4周后的当天8:00、11:00、13:00及16:00测定眼压,取平均值作为眼压结果。

3讨论
pocg的有效治疗措施是降低眼内压,抗青光眼药物主要是通过减少房水生成、增加房水流出容易、降低眼内渗透液等中的一种或几种机制而使眼内压降低[4]。

常用药物有拉坦前列素、曲伏前列素、
贝美前列素滴眼液等,国外研究表明上述3种药物的降眼内压临床疗效可达到30%以上[5],与本研究一致。

前列腺素类药物为一种新型的抗青光眼药物,与传统抗青光眼药物降低眼内压的作用方式差异大,它作用在睫状肌与巩膜-葡萄膜通道上的基质金属蛋白酶,松弛睫状肌,增加肌间隙的宽度,同时增强基质金属蛋白酶的活性,降低房水的外流阻力,增加房水通过巩膜-葡萄膜通道的外流量[4]。

前列素类药物通常每天使用1次就可以显著降低患者眼内压,因此,常作为首选青光眼的首选治疗药物,为了达到且维持目标眼内压,常常选择一种药物要优于选用多种降低眼内压的药物,这样能够更好地确保依从性与减轻局部甚至全身不良反应所致的风险[6]。

本研究中三组患者治疗2、4周后的眼压均低于治疗前,降眼压效果肯定,但拉坦前列素、曲伏前列素及贝美前列素滴眼液三种药物的临床疗效相当;临床医师在临床工作中应该认真对待每一位pocg患者,观察三种药物的治疗效果,总结临床用药经验以提高自身治疗水平。

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[6]李斌,李俊逸,王翠青,等.贝美前列素和曲伏前列素治疗开角型青光眼和高眼压症的疗效对照研究[j].武警医学院学报,2011,20(5):357.。

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