血栓通联合等容血液稀释对视网膜静脉阻塞患者视网膜微循环的影响

目的 :探讨血栓通 (PNS)、等容血液稀释 (IHD)及二者结合治疗视网膜静脉阻塞 (RVO)对视网膜微循环的影响。方法 :采用PNS ,IHD及PNS +IHD随机对照治疗RVO患者 73例 ,观察治疗前后视网膜微循环时间 (RCT)和视网膜出血、水肿、毛细血管渗漏及黄斑囊样水肿 (CME)、无灌注区面积等的改变。结果 :与另两种方法比较 ,PNS +IHD使RCT ,尤其非缺血型和分支静脉阻塞患者RCT缩短更明显 ,视网膜出血、水肿、毛细血管渗漏及CME消退更快 ,并使病程小于两周的早期患者无灌注区发生率减低 ,缺血型者无灌注区边缘毛细血管充盈增加 ,但无灌注区面积无显著缩小。结论 :PNS结合IHD能显著缩短RVO患者RCT ,促进视网膜出血、水肿和毛细血管渗漏及CME的消退 ,可能还有减少早期患者无灌注区形成的作用。

Effect of Panax notoginseng saponins combined isovolumic haemodilution on the retinal microcirculation of patients with retinal vein occlusion

Objective:To study the effect of Panax notoginseng saponins (PNS) or isovolumic haemodilution (IHD) and combination of PNS with IHD on retinal microcirculation of patients with retinal vein occlusion (RVO). Method: Seventy three patients with RVO were allocated at random to three groups which were treated with PNS, IHD, or PNS+IHD respectively. The retinal circulation time (RCT) and retinal hemorrhage, edema, leakage of capillary, cystoid macular edema (CME), and nonperfusion area of capillary in retina were observed before and after treatment. Result: RCT of patients with RVO was shortened by three treating methods. RCT in the patients who treated by PNS+IHD was the shortest, especially in the patients with nonischemic RVO and branch retinal vein occlusion(BRVO). The retinal hemorrhage, edema,leakage of capillary, and CME in the patients treated by PNS+IHD disappeared quicker than those treated by PNS or IHD. At the same time,the incidence of nonperfusion area in patients whose course of disease was shorter than fourteen days was decreased. The perfusion of capillaries was increased at the edge of nonperfusion area which existed before the treatment. But the effect for nonperfusion area which existed before the treatment in the type of ischemic RVO was not obvious. Conclusion:The treatment of PNS+IHD can both shorten RCT of patients with RVO, and promote absorption of retinal hemorrhage, edema, leakage of capillary,and CME. It is possible that PNS+IHD treatment also has an effect to decrease the forming of nonperfusion area in patients whose course of disease is at early stage.