噻吗洛尔或卡替洛尔联合曲伏前列素的降眼压作用及对心血管系统的影响

目的比较噻吗洛尔与卡替洛尔分别联合曲伏前列素对原发性开角型青光眼（POAG）或高眼压症（OHT）患者的降眼压作用及对心血管系统的影响。方法随机双盲对照试验。将纳入的162例患者随机分为噻吗洛尔组和卡替洛尔组，噻吗洛尔组患者使用噻吗洛尔滴眼液联合曲伏前列素滴眼液点眼；卡替洛尔组患者使用卡替洛尔滴眼液联合曲伏前列素滴眼液点眼。在患者治疗后第14天、28天进行疗效评价及心血管不良反应、其他药物不良反应评价。采用重复测量资料的方差分析对数据进行比较。结果2组患者治疗前人口基线特征差异均无统计学意义。2组患者用药后14、28 d与治疗前比较，眼压均下降（P＜0.05），组间差异无统计学意义。用药后28 d，2组心率均下降（P＜0.05），噻吗洛尔组较卡替洛尔组的心率抑制作用明显（P＜0.05）；22∶00-04∶00时间段内患者心率与治疗前相比差异具有统计学意义（P＜0.05）；噻吗洛尔组心率过缓发生率增加，而卡替洛尔组下降，00∶00-04∶00时间段内卡替洛尔组心动过缓的发生率低于噻吗洛尔组（χ²=4.077，P＜0.05）。治疗后收缩压、舒张压均下降，治疗前后差异有统计学意义（P＜0.05），组间差异无统计学意义。结论对于POAG或OHT患者，噻吗洛尔或卡替洛尔联合曲伏前列素均具有较好的降眼压效果。在22∶00以后，卡替洛尔联合曲伏前列素引起心动过缓和心率下降的比率较低。

Intraocular pressure and cardiovascular effects of timolol or carteolol in combination with travoprost in patients with primary open-angle glaucoma and ocular hypertension

Objective To compare the effects of timolol or carteolol in combination with travoprost on intraocular pressure (IOP) and cardiovascular system in patients with primary open-angle glaucoma (POAG) and ocular hypertension (OHT).Methods In a randomized,double-masked controlled trial of patients with POAG or OHT,all participants were treated with travoprost in combination with either timolol or carteolol.Pulse rate and blood pressure data were gathered by ambulatory blood pressure monitoring.The experimental data at 14 and 28 days of treatment were analyzed by repeated measures analysis of variance (ANOVA).Results Before treatment,the baseline characteristics had no significant difference between the two groups.After 14 d and 28 d treatment,IOP of timolol group and carteolol group decreased respectively (P＜0.05).There was no significant differences between the two groups.The change in heart rate had a significant difference between the two groups during hours 22:00-04:00 (P＜0.05).After treatment,the incidence of bradycardia in timolol group increased and carteolol group decreased.The incidence of bradycardia of in the carteolol group was less than timolol group during hours 00:00-04:00 (x2=4.077,P＜0.05).Systolic and diastolic blood pressures decreased in both groups (P＜0.05).Conclusion In patients with POAG or OHT,the combinations of both travoprost with either timolol or carteolol lowered lOP.Travoprost with timolol caused a greater decrease of night time mean heart rate and more nocturnal bradycardia than the combination of travoprost and carteolol.