尼莫地平联合拉坦前列腺素治疗原发性开角型青光眼的疗效及对房水EPO ET-1 sCD44的影响

doi:10.3969/j.issn.1006-6233.2019.01.007

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摘要 目的:探讨尼莫地平联合拉坦前列腺素治疗原发性开角型青光眼的疗效及对房水促红细胞生成素(EPO)、内皮素-1(ET-1)、可溶性CD44(sCD44)的影响。方法:选择2015年6月至2017年6月我院接诊的91例原发性开角型青光眼患者进行研究,通过随机数表法分为观察组46例和对照组45例。对照组给予拉坦前列腺素治疗,观察组在对照组基础上,给予尼莫地平治疗,均连续治疗6个月。比较两组临床疗效、视力相关指标、视盘筛板血流、房水EPO、ET-1、sCD44的变化及不良反应。结果:治疗后,观察组临床疗效总有效率为93.48%(43/46),明显高于对照组的77.78%(35/45)(P<0.05);观察组眼压、视野缺损明显低于对照组[(16.57±1.54)mmHg vs(18.72±1.85)mmHg,(9.21±1.10)dB vs(11.37±1.20)dB],视网膜光敏感度、视力明显比对照组高[(18.74±2.30)dB vs(16.89±2.03)dB,(0.76±0.12)vs(0.71±0.09)](P<0.05);视盘筛板血流结果中,观察组血流速度、血流量、红细胞移动率均明显比对照组高[(188.42±20.56)mm/s vs(167.34±17.57)mm/s,(15.68±1.62)L/min vs(12.73±1.50)L/min,(1.04±0.15)vs(0.83±0.10)](P<0.05);观察组房水EPO、ET-1、sCD44均明显比对照组低[(7.05±1.17)mU/mL vs(8.49±1.45)mU/mL,(43.72±4.59)ng/L vs(51.04±5.64)ng/L,(13.40±1.39)ng/mL vs(18.15±1.70)ng/mL](P<0.05);治疗期间,两组不良反应总发生发生率分别为10.87%(5/46)和8.89%(4/45),差异无统计学意义(P>0.05)。结论:在原发性开角型青光眼患者中使用尼莫地平联合拉坦前列腺素效果显著,其内在机制可能和降低房水EPO、ET-1、sCD44表达相关,且用药安全性高,值得应用推广。

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	刘爽
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关键词 ：原发性开角型青光眼, 拉坦前列腺素, 尼莫地平, 促红细胞生成素, 内皮素-1, 可溶性CD44

Abstract：Objective: To study the curative efficacy of nimodipine combined with latanoprost in treatment of primary open-angle glaucoma and effects on the aqueous humor erythropoietin(EPO), endothelin-1(ET-1), soluble CD44(sCD44) levels. Methods: 91 patients of primary open-angle glaucoma who received therapy from June 2015 to June 2017 in our hospital were selected as research objects, according to the random number table, those patients were divided into the 46 cases of observation group and the 45 cases of control group. The control group was treated with latanoprost, while the observation group was treated with nimodipine on the basis of the control group, they were continuous treatment for 6 months. The clinical efficacy, the changes of visual related index, optic disc sieve plate blood flow, aqueous humor EPO, ET-1, sCD44 levels and adverse reactions were compared between the two groups. Results: After treatment, the total effective rate of the observation group was 93.48% (43/46), which was significantly higher than that of the control group 77.78% (35/45) (P<0.05). The intraocular pressure and visual field defect in the observation group were significantly lower than that of the control group [(16.57±1.54)mmHg vs(18.72±1.85)mmHg,(9.21±1.10)dB vs(11.37±1.20)dB], the retinal light sensitivity and visual acuity were significantly higher than that of the control group[(18.74±2.30)dB vs(16.89±2.03)dB,(0.76±0.12)vs(0.71±0.09)](P<0.05). In the optic disc sieve plate blood flow, the blood flow velocity, blood flow and erythrocyte mobility in the observation group were significantly higher than that of the control group [(188.42±20.56)mm/s vs(167.34±17.57)mm/s,(15.68±1.62)L/min vs(12.73±1.50)L/min,(1.04±0.15)vs(0.83±0.10)](P<0.05); and the aqueous humor EPO, ET-1, sCD44 levels in the observation group were significantly lower than that of the control group [(7.05±1.17)mU/ml vs (8.49±1.45)mU/ml,(43.72±4.59)ng/L vs(51.04±5.64)ng/L,(13.40±1.39)ng/ml vs(18.15±1.70)ng/ml](P<0.05). During the treatment, the incidence of adverse reactions in the two groups was 10.87% (5/46) and 8.89% (4/45) respectively, and the difference was not statistically significant (P>0.05). Conclusion: The effect of nimodipine combined with latanoprostaglandin in patients with primary open angle glaucoma is remarkable. Its intrinsic mechanism may be related to the reduction of EPO, ET-1 and sCD44 expression in aqueous humor. Moreover, the safety of nimodipine combined with latanoprostaglandin is high, and it is worth popularizing.

Key words： Primary open-angle glaucoma Latanoprost Nimodipine Erythropoietin Endothelin-1 Soluble CD44

基金资助:北京市自然科学基金资助,(编号:7082043)

引用本文:

刘爽, 孔凡宏, 施歌. 尼莫地平联合拉坦前列腺素治疗原发性开角型青光眼的疗效及对房水EPO ET-1 sCD44的影响[J]. 河北医学, 2019, 25(1): 25-29.
LIU Shuang, KONG Fanhong, et al. Curative Efficacy of Nimodipine combined with Latanoprost in Treatment of Primary Open-angle Glaucoma and Effects on the Aqueous Humor EPO ET-1 sCD44 Level. HeBei Med, 2019, 25(1): 25-29.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2019.01.007 或 http://www.hbyxzzs.cn/CN/Y2019/V25/I1/25

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