曲伏前列素滴眼液降眼压疗效的临床观察

目的:评价苏为坦(0.004%曲伏前列素滴眼液)降眼压的效果及安全性.方法:对16例(31眼)使用其它降眼压药物眼压控制不佳或无法耐受其它降眼压药物的开角型青光眼和高眼压症患者单独应用苏为坦,每晚1次每次1滴,共随访12周.用药后2周、4周、8周、12周在同一时段复查眼压一次,用药12周后在同一天的8点、11点、14点、16点分别检查眼压.并随访视力、视野及眼部和全身不良反应.结果:用药前眼压为24.67±2.63 mmHg,4次随访眼压分别为19.54±4.18 mmHg、18.45±3.23 mmHg、18.67±3.01 mmHg、16.23±2.91 mmHg,眼压下降率最大为35.1%,用药后眼压与基础值比较差异有统计学意义(P＜0.01).治疗12周时不同时间点眼压下降值比较差异无统计学意义(P＞0.05).用药后部分病例出现轻到中部的结膜充血、眶周色素沉着等.未发现明显的其它眼部改变和全身副作用.结论:苏为坦能显著降低原发性开角型青光眼和高眼压症患者的眼压,而且安全稳定、具有良好的耐受性和依从性.     

IOPIDINE滴眼液治疗青光眼的临床观察

目的:观察apraclonidine制剂0.5% IOPIDINE滴眼液对青光眼的降眼压作用及对青光眼患者中心视野的影响。方法:选择青光眼患者16例21眼,每眼每日点用0.5％IOPIDINE三次,连续使用3个月。用药前及用药后分别测定眼压、眼前节结构以及中心视野一次,比较用药前后眼压、眼前节结构以及视野的变化情况。结果:用药后眼压显著下降,最大下降幅度为38mmHg,最小下降幅度为3.7mmHg,眼压平均下降幅度为15.1±13.4mmHg。用药后视野较用药前视野明显的改善。用药前后眼前节结构无明显改变。结论:IOPIDINE滴眼液是一种降眼压效果较好的药物,且可改善青光眼患者的视功能。     

0.2%brimonidine对开角型青光眼及高眼压症的临床疗效

目的 :评价 0 .2 %brimonidine滴眼对原发性开角型青光眼及高眼压症的降眼压效果及安全性。方法 :2 5例患者 4 1只眼纳入为期 6个月的前瞻性研究。在停用其他抗青光眼药物足够长的时间后测量基础值 ,予 0 .2 %bri monidine点眼每日两次 (8AM ,8PM) ,每月复查一次 ,测量低谷眼压 (用药 12h后眼压 )和高峰眼压 (用药 2h后眼压 )等 ,每 3个月复查视野一次。结果 :每次随访中 0 .2 %brimonidine均能显著降低患者低谷及高峰眼压 (P <0 .0 5 ) ;复查2 4h眼压波动每一时间眼压均较用药前显著降低 (P <0 .0 5 ) ;用药后 3月及 6月复查视野示药物对视功能无明显影响 (P >0 .0 5 )。观察期间未发现严重全身副作用。结论 :0 .2 %brimonidine对开角型青光眼及高眼压症具有稳定的降眼压效果 ,是一种具有良好耐受性 ,同时安全、有效的抗青光眼新药     

高眼压下青光眼滤过手术临床观察

目的　探讨高眼压状态下行青光眼滤过性手术的疗效。方法　对应用药物治疗不能控制眼压的青光眼患者行小梁切除术 ,巩膜下巩膜咬切术。结果　 5 8例 (5 8只眼 )中 ,5 2眼术后眼压 <2 0mmHg ,占 89 67% ,眼压在 2 1～2 4mmHg有 6眼 ,占 10 3 3 % ,术后需加用局部抗青光眼药物。视力提高者 49眼 ,占 84 48% ,无变化 5眼 ,占 8 62 %。下降4眼 ,占 6 90 %。结论　对于药物不能有效控制眼压的青光眼患者 ,在持续高眼压状态下行青光眼滤过性手术治疗成功率高 ,视力恢复快 ,但须在术前、术中及术后采取必要措施     

曲伏前列素治疗超声乳化联合房角分离术后的闭角型青光眼

目的:观察曲伏前列素滴眼液治疗超声乳化联合房角分离术后的闭角型青光眼患者的降眼压效果。方法:超声乳化联合房角分离术后眼压控制不理想的闭角型青光眼11例(11眼),术后4周测量眼压后予每晚1次0.004%曲伏前列素滴眼液滴眼,分别于用药后1、2、4周测量9时及16时眼压、视野及房角。比较用药前后的眼压值。结果:与曲伏前列素滴眼液治疗前相比,用药后1、2、4周眼压下降明显(P0.01)。结论:曲伏前列素滴眼液治疗超声乳化联合房角分离术后高眼压的闭角型青光眼是安全、有效的。     

三联术治疗青光眼合并白内障18例体会

目的　探讨小梁切除联合白内障超声乳化及人工晶体植入术 (三联手术 )治疗青光眼合并白内障的效果。方法　应用三联术对 1 8例 (2 0眼 )青光眼合并白内障患者进行手术治疗。术后随访 3～ 36个月 ,平均 1 8个月。结果　术前平均眼压 2 2 38mmHg ,术后随访最终平均眼压降至 1 5 88mmHg(P <0 0 1 )。术后随访最终矫正视力范围 0 0 5～ 1 0 ,其中≥ 0 5者 1 6眼 (80 % )。术后早期 2眼使用降眼压药物 ,随访后期无需使用。术后早期角膜水肿 4眼 (2 0 % )、浅前房 1眼 (5 % )。结论　三联术治疗青光眼合并白内障患者 ,具有恢复有用视力快、滤过泡失败率低、眼压控制稳定、角膜散光小、减少术后用药及并发症少等理想效果     

小梁切除术前行前房穿刺术治疗青光眼高眼压持续状态

目的 探讨青光眼高眼压持续状态下施行小梁切除术前行前房穿刺术的有效性、安全性及小梁切除术的技术要点.方法 21例21眼青光眼高眼压持续状态患者,术前经最大剂量降眼压药物治疗后眼压仍≥5.33 kPa,在小梁切除术前先行前房穿刺术缓放房水,一次或多次,使眼压平缓下降.待眼压降至安全范围后,择机再行小梁切除术.结果 全部病例无1例发生暴发性脉络膜出血、视网膜出血、恶性青光眼等严重并发症.术后观察9～18个月,21眼中有17眼(80.95%)术后不用抗青光眼药物,眼压能控制在2.80 kPa以下,4眼(19.05%)局部予一种降眼压药物眼压控制正常;11眼(52.38%)视力有所提高.结论 青光眼高眼压持续状态下施行小梁切除术前行前房穿刺术缓放房水降眼压是安全有效的,并认为只要掌握了各项技术要点,,这些患者小梁切除术后仍能拥有较高的成功率.     

青光眼引流阀植入术治疗难治性青光眼疗效观察

目的 评价青光眼引流阀植入术治疗难治性青光眼的疗效.方法 回顾分析我院2007年4月～2011年8月32例接受青光眼引流阀植入术的难治性青光眼的疗效,观察手术前后视力、眼压、并发症及手术成功率.结果 术后视力提高者16眼,视力无改变者12眼,视力下降者为4眼,术前眼压为28～ 67 mmHg,平均眼压为(44.3±8.9)mmHg,术后末次随诊时眼压为7.5～23.8 mmHg,平均眼压为(15.2±3.7)mmHg,术后并发症主要有术后早期浅前房、术后早期高眼压、前房出血等,手术成功率82％.结论 青光眼引流阀植入术为难治性青光眼开辟了新的有效的治疗途径;注意手术技巧可减少术后部分并发症的发生.     

超声生物显微镜对早期闭角型青光眼药物治疗的临床观察

目的 用超声生物显微镜观察早期闭角型青光眼药物治疗前后房角的变化.方法 30例(50只眼)早期闭角型青光眼分A、B、C三组,确诊后A组10例16眼使用1%匹罗卡品滴眼液滴眼,B组10例20眼使用0.5%噻吗心胺滴眼液滴眼,C组10例14眼使用1%派立明滴眼液滴眼治疗,用药前后均利用超声生物显微镜观察房角开放度和虹膜膨隆度的变化.结果 A组房角开放距离增加129 μm,小梁虹膜角增加7°,晶体虹膜角减少9°,虹膜悬韧带距离减少24 μm,A组平均眼压下降8.1 mmHg;B组平均眼压下降6.4 mmHg,房角开放度及虹膜膨隆度无变化;C组平均眼压下降5.1 mmHg,房角开放度及虹膜膨隆度改变不明显.结论 1%毛果芸香碱使虹膜小梁角明显开放,碳酸酐酶抑制剂和β-阻滞剂对前房角无明显增大,三种药物局部应用完全可以控制早期闭角型青光眼眼压于目标眼压范围.     

复合小梁切除术治疗抗青光眼术后眼压不降的临床体会

目的探讨抗青光眼术后眼压不降的原因,观察复合小梁切除术治疗抗青光眼术后眼压不降的临床效果,分析复合小梁切除术在治疗抗青光眼术后眼压不降再次手术中的重要作用。方法对22例22眼抗青光眼术后眼压不降患者再次接受复合小梁切除术治疗的患者进行回顾性分析。其中第1次抗青光眼手术中：虹膜周边切除术有6例,激光虹膜周切术3例,小梁切除术13例。结果 22例患者术前眼压19～66mmHg,术后眼压水平6～14mmHg。手术后眼压下降率41%～80%不等,平均下降率59.8%。术后视力能够提高一行或者以上的有6例,基本维持不变的有7例,下降一行的有5例,下降两行或以上的有4例。结论复合小梁切除术可以作为抗青光眼失败后再次行滤过手术时的一个很好选择,它具有安全、有效、可重复的特性,值得在临床工作中广泛推广。     

Intraocular pressure lowering efficacy and safety of travoprost 0.004% as a replacement therapy in patients with open angle glaucoma or ocular hypertension

Background Travoprost has been widely used for the treatment of patients with open-angle glaucoma （OAG） or ocular hypertension （OH）. The aim of this study was to evaluate the intraocular pressure （lOP） lowering efficacy of travoprost 0.004% monotherapy in patients previously treated with other topical hypotensive medications, and in previously untreated patients. Methods This open-label, 12-week study in 1651 adult patients with ocular hypertension or open-angle glaucoma who were untreated or required a change in therapy （due to either inadequate efficacy or safety issues） as judged by the investigator was conducted at 6 sites in China. Previously treated patients were instructed to discontinue their prior medications at the first visit. All the patients were dosed with travoprost 0.004% once-daily at 8 p.m. in both eyes for 12 weeks. Efficacy and safety evaluations were conducted at week 4 and 12. lOP measurements were performed at the same time of day at the follow-up visits. Results For patients transitioned to travoprost, mean lOP reductions from baseline in untreated and treated patients with different prior medications at week 12 were： latanoprost, （4.3±4.6） mmHg; β-blocker, （6.3±4.0） mmHg; α-agonist, （7.5±4.3） mmHg; topical carbonic anhydrase inhibitors, （8.0±4.9） mmHg. All mean lOP changes from baseline were statistically significant （P 〈0.001）. No treatment-related serious adverse events were reported in this study. Conclusions In patients treated with other hypotensive medications or untreated, the lOP reduction with travoprost was significant. The results of this study demonstrated the potential benefit of using travoprost as a replacement therapy in order to ensure adequate lOP control. Travoprost administered once daily was safe and well tolerated in patients with glaucoma or ocular hypertension.     

0．2％brimonidine对开角型青光眼及高眼压症的临床疗效

目的：评价0．2％brimonidine滴眼对原发性开角型青光眼及高眼压症的降眼压效果及安全性。方法：25例患者41只眼纳入为期6个月的前瞻性研究。在停用其他抗青光眼药物足够长的时间后测量基础值，于0．2％brimonidine点眼每日两次（8 AM，8PM），每月复查一次，测量低谷眼压（用药12h后眼压）和高峰眼压（用药2h后眼压）等，每3个月复查视野一次。结果：每次随访中0．2％brimonidine均能显著降低患者低谷及高峰眼压（P＜0．05）；复查24h眼压波动每一时间眼压均较用药前显著降低（P＜0．05）；用药后3月及6月复查视示药物对视功能无明显影响（P＞0．05）。观察期间未发现严重全身副作用。结论：0．2％brimonidine对开角型青光眼及高眼压症具有稳定的降眼压效果，是一种具有良好耐受性，同时安全、有效的抗青光眼新药。     

探讨复方滴眼剂治疗眼部细菌感染的安全性和有效性

目的通过对比研究0．5％莫西沙星和0．1％地塞米松组成的复方滴眼剂与0．5％莫西沙星和0．1％地塞米松滴眼液的使用效果,评价复方莫西沙星滴眼液治疗眼部细菌感染和炎症（睑缘炎、角膜炎、结膜炎）的安全性和有效性。方法2007年1月～2011年12月在我院眼科就诊,年龄18岁以上诊断为睑缘炎、角膜炎或结膜炎患者纳人本研究,采用随机、双盲和平行对照试验。根据患者不同的给药方式分为复方药物组和对照组,评价药物的临床效果、体征、症状和安全性。结果两组药物的临床效果以及抗微生物疗效都没有显著统计学差异。两组患者眼睛症状和体征随着时间好转,治疗7d后无显著统计学差异,但复方药物组患者眼睑红斑临床疗效显著好于对照组（P=0．0194）,眼睑蜕皮结痂疗效显著好于对照组（P=0．0337）。两种给药方法安全且耐受性好。结论0．5％莫西沙星、0．1％地塞米松组成的复方药物与分开同时使用在疗效和耐受性等效。     

δ-氨基酮戊酸光动力疗法治疗皮肤癌的评估

目的 :探讨和评估δ 氨基酮戊酸光动力疗法 (ALA PDT)治疗皮肤癌的疗效。方法 :88例患者首次接受ALA PDT治疗 ,其中包含 34例基底细胞癌 (BCC) ,32例鳞状细胞癌 (SCC) ,2例基底 鳞状细胞癌 (BSCC) ,1例疣状癌 ,9例Bowen病 ,2例乳房Paget病和 8例乳房外Paget病。随访 1～ 3年。结果 :经过 1～ 4次ALA光动力治疗后 ,所有BCC病例 ,包括 1例浅表型和 2 9例实体型病变 ,都获得完全反应 (CR)。除 1例腺样SCC(Ⅲ级 )外 ,全部SCC病例 (Ⅰ、Ⅱ级 )经过 3～ 6次治疗后CR。 9例Bowen病经 1～ 4次治疗后都获得CR。对于Paget病 ,单纯ALA PDT不能使之治愈 ,但可以控制其症状。随访 1～ 3年 ,BCC的复发率为 11% (4 34) ,SCC为 2 2 % (7 2 2 ) ,再次治疗有效。结论 :ALA PDT是一种疗效好、无痛苦、无创伤、无副作用的治疗方法 ,尤其适用于年迈体弱以及肿瘤部位特殊的患者。     

HTP方案联合全脑放疗治疗非小细胞肺癌脑转移疗效评价

目的:评价HTP方案联合全脑放疗治疗非小细胞肺癌脑转移的疗效及不良反应。方法:我院2006年10月～2008年10月收治的NSCLC脑转移患者50例,随机分为两组,每组25例,一组(联合治疗组)给予HTP方案同步联合WBRT治疗,一组(对照组)单纯给予WBRT治疗,观察两组患者临床疗效及不良反应的发生情况。结果:治疗后,联合治疗组脑转移灶和肺部原发灶的客观有效率、疾病控制率为64.0%、88.0%明显高于对照组(P<0.05);联合治疗组的1年生存率、3年生存率以及中位生存时间分别为48.0%、24.0%和13个月明显高于对照组的28.0%、8.0%和10个月(P<0.05);对照组I级和II级胃肠道不良反应发生率明显低于联合治疗组(P<0.05)。结论:HTP方案联合全脑放疗治疗NSCLC脑转移患者,具有较高的有效率及生存率,毒性可耐受。     

A Comparative Assessment of the Efficacy of Carbomer Gel and Carboxymethyl Cellulose Containing Artificial Tears in Dry Eyes

The present study aimed to compare the clinical efficacy of a 0.4% carbomer gel and 1% carboxymethyl cellulose （CMC） containing artificial tears in treatment of dry eye patients. Sixty subjects with mean age of 45.89 years who had symptoms and signs of dry eye were enrolled in this prospective, investigator-masked and stratified random sampling study. The subjects were divided into two parallel groups with 30 subjects （60 eyes） in each group. One group received carbomer gel, and the other group received 1% CMC containing artificial tears. Subjects received the drops 3 to 4 times or more per day for 3 months. At the first visit time, the precorneal residence time of these two drops was measured. The efficacy was assessed by comparing the subjective symptoms （ocular dry- ness, foreign body sensation, burning sensation and pain）, and the objective test results of tears breakup time, Schirmer＇s test and corneal fluorescein staining prior to the study and after the treat- ment. As a result, the ocular residence time of carbomer gel was significantly longer than that of 1% CMC （P〈0.001）. Most of the primary subjective symptoms and objective test results were improved after treatment in both carbomer gel group and 1% CMC group. As to the improvement of each symptom and objective test result, carbomer gel was more effective than 1% CMC group （P〈0.01）. In conclusion, carbomer gel had longer precorneal residence time and was more effective than 1% CMC in the treatment of patients with dry eyes.     

玻璃体视网膜手术在重症眼外伤治疗中的应用

目的观察不同手术方式对重症眼外伤不治疗的效果。方法：５８例重症眼外伤病人行玻璃 切手术，其中１２例行玻璃体视网膜手术（ＶＲ）。经ＶＲ手术的病例组，术后网膜脱离和增殖性玻璃体视网膜病变（ＰＶＲ）的发生明显少于对照组；结论：ＶＲ手术为重症眼外伤的治疗提供了新途径。     

异长春花碱联合顺铂治疗晚期NSCLC的研究

目的观察异长春花碱(Vinorelbine,NVB)联合顺铂(Cisplatin,DDP)治疗晚期非小细胞肺癌(NSCLC)的近期、远期疗效和毒副反应。方法110例晚期NSCLC患者。化疗方案:NVB 25～30mg/m2,静注,第1、8天,DDP 50mg/m2,静滴,第2、3天;3～4周为1周期。结果NVB加DDP治疗NSCLC有效率为35.24%,临床受益率78.09%;初治与复治有效率分别为41.06%和18.52%, 差异有显著性意义(P<0.05),初治与复治的临床受益率差异无显著性意义(P>0.05);治疗后中位缓解期为20周;中位生存期为38周;一年生存率为32.73%。主要毒副反应Ⅲ-Ⅳ度恶心/呕吐发生率31.82%,Ⅲ-Ⅳ度白细胞抑制率32.73%,Ⅲ-Ⅳ度便秘发生率34.56%,静脉炎发生率50.91%。结论异长春花碱加顺铂治疗晚期NSCLC,有较好的近期疗效和远期疗效,恶心/ 呕吐和骨髓抑制和其它毒副反应可耐受,是治疗晚期NSCLC的一线化疗方案。     

Efficacy and safety of secukinumab in Chinese patients with moderate-to-severe plaque psoriasis: a real-life cohort study

Background:There have been few real-life dose-comparing studies on the efficacy and safety of secukinumab in Chinese patients with plaque psoriasis. We conducted a real-life cohort study to investigate the efficacy and safety of secukinumab 150 and 300 mg in Chinese patients with moderate-to-severe plaque psoriasis.Methods:A total of 106 patients with moderate-to-severe plaque psoriasis were included in this study. Patients received either secukinumab 150 mg or secukinumab 300 mg according to patients’ weights and severity of psoriasis. The treatment continued for at least 24 weeks. The efficacy was evaluated by improvement in the psoriasis area and severity index (PASI) scores. The safety was also analyzed.Results:Fifty-nine patients (55.7%) were treated with secukinumab 300 mg and 47 patients (44.3%) were treated with secukinumab 150 mg. After 12-week treatment, PASI75/90/100 responses were achieved in 100%, 97.8%, and 95.7% of patients, respectively, in secukinumab 150 mg group, and the efficacy was maintained to week 24. In secukinumab 300 mg group, PASI75/90/100 responses were achieved in 93.2%, 81.4%, and 76.3% of patients, respectively, at week 12. In this group, PASI75/90/100 responses reached 91.5%, 86.4%, and 79.9%, respectively, at week 24. Biologic-experienced patients had lower responses than biologic-naïve patients. Secukinumab 150 and 300 mg were well tolerated. Five patients discontinued treatment due to poor response, adverse event, or economic reasons.Conclusions:This real-life study demonstrated that high PASI 90 and PASI 100 responses were achieved in Chinese psoriasis patients receiving secukinumab 150 or 300 mg. Biologic-naïve was associated with better clinical efficacy.