拉坦前列素联合马来酸噻吗洛尔对原发性开角型青光眼的疗效和安全性评价

目的探讨0.005%拉坦前列素联合0.5%马来酸噻吗洛尔固定组合滴眼液降低眼压的效果和安全性。方法对31例原发性开角型青光眼患者,单独用0.005%拉坦前列素滴眼液治疗后伴有眼压(IOP)下降不佳,停用后不经历洗脱期,即采用0.005%拉坦前列素联合0.5%马来酸噻吗洛尔固定组合滴眼液治疗。分别比较换药后第1,3,6月与换药前眼压,随访时调查不良反应发生率。结果换药前,眼压平均值为(17.3±2.7)mmHg,换药后1个月眼压为(15.5±2.6)mmHg,3个月为(14.9±2.4)mmHg,6个月为(15.1±2.2)mmHg,提示换药后眼压明显下降。第1个月眼压的下降率为(9.9±11.5)%,第3个月为(13.1±10.9)%,第6个月为(11.2±11.8)%。有2例患者(6.45%,瘙痒和心动过缓各1例)由于不良反应停止联合治疗。结论0.005%拉坦前列素联合0.5%马来酸噻吗洛尔固定组合滴眼液降低眼压效果优于单用0.005%拉坦前列素滴眼液,使用更方便、安全、满意。

Study on Efficacy and Safety of Latanoprost Combined with Timolol Maleate in Treating Primary Open-Angle Glaucoma

Objective To investigate the efficacy and safety of the combination eyedrops of 0. 005% clatanoprost combined 0.5% timolol malcate on reducing the intraocular pressure（IOP）. Methods 31 cases of primary open-angle glaucoma showing the poor perfor mance in IOP decrease after using 0. 005% latanoprost eyedrops alone were enrolled. After withdrawal of 0. 005% latanoprost eyedrops, the combination eyedrops of 0. 005% latanoprost and 0.5% timolol maleate were initiated without any washout period, lOP was com- pared before medication change and in 1,3,6 months after medication change. The incidence rate of adverse reactions was investigated at every follow- up visit. Results The average lOP was （17. 3± 2. 7） mmHg before the medication change, （15.5 ±2. 6） mmHg in I month after the medication change,（14.9 ±2.4） mmHg in 3 months after the medication change and （15.1±2. 2） mmHg in 6 months after the medication change, indicating that IOP was decreased significantly after the medication change. The IOP decline rate was （9.9 ±11.5）% after 1 month, （13. 1 ± 10.9）% after 3 months and （11.2% ± 11.8）% after 6 months. 2 cases （6.5%） discontinued the therapy due to itchiness （1 case） and bradycardia （1 case）. Conclusion The combination eyedrops of 0.005% clatanoprost com- bined 0.5% timolol maleate is superior to single 0. 005% latanoprost eyedrops in reducing IOP with significant effect of reducing IOP, which is convenient,safe and satisfactory in use.