川芎嗪对术后眼压正常的原发性慢性闭角型青光眼血流动力学的影响

目的探讨川芎嗪对术后眼压正常的原发性慢性闭角型青光眼(primary chronic angle closure glaucoma,PCACG)血流动力学的影响。方法选择2010年1月至2011年12月于我院就诊的PCACG患者40例(54眼),均已行手术治疗,且眼压控制在21mmHg(1kPa=7.5mmHg)以下,随机分为治疗组20例(26眼)和对照组20例(28眼)。对照组术后应用维生素B12注射液50μg肌肉注射;治疗组在对照组的基础上予川芎嗪注射液160mg加入50g·L-1葡萄糖250mL静脉滴注。观察治疗组、对照组治疗前后眼部血流动力学变化。血流动力学指标包括眼动脉(ocular artery,OA)、睫状后短动脉(short posterior ciliary ar-tery,SPCA)、视网膜中央动脉(central retinal artery,CRA)的收缩期峰值流速(peak systolic velocity,PSV)、舒张末期流速(end di-astolic velocity,EDV)、时间平均最大血流速(time averaged maximum velocity,TAMV)和阻力指数(resistance index,RI)等。结果治疗组治疗后OA和CRA的PSV、EDV、RI、TAMV较治疗前均有一定程度改善,但差异均无统计学意义(均为P>0.05);SPCA的PSV、EDV、TAMV无明显改善,差异均无统计学意义(均为P>0.05),RI显著降低,差异有统计学意义(P<0.05)。对照组治疗后OA、SPCA和CRA的PSV、EDV、RI、TAMV较治疗前均无明显变化,差异均无统计学意义(均为P>0.05)。治疗组治疗后与对照组治疗后比较,OA和CRA的PSV、EDV、RI、TAMV有一定改善,但差异均无统计学意义(均为P>0.05);SPCA的PSV、EDV、TAMV有一定程度改善,但差异均无统计学意义(均为P>0.05),RI显著降低,差异有统计学意义(P<0.05)。结论川芎嗪能改善PCACG术后眼压控制在正常范围内患者眼部血流动力学,降低SPCA的RI。

Effects of tetramethylpyrazine on hemodynamics of primary chronic angle closure glaucoma patients with normal intraocular pressure after operation

Objective To explore the effects of tetramethylpyrazine on hemodynamics of primary chronic angle closure glaucoma(PCACG)patients with normal intraocular pressure after operation.Methods Forty cases(54 eyes)of PCACG patients,whose intraocular pressure under 21 mmHg(1 kPa=7.5 mmHg) after operation in our hospital from January 2010 to December 2011,were randomly divided into treatment group(20 cases,26 eyes) and control group(20 cases,28 eyes).The control group was injected intramuscularly with 50 μg vitamin B12,and based on this treatment,the treatment group was dripped intravenously with tetramethylpyrazine injection 160 mg plus 250 mL 50 gL-1 glucose in addition.The changes of hemodynamics were observed in two groups before and after treatment.Hemodynamics indexes included peak systolic velocity(PSV),end diastolic velocity(EDV),time averaged maximum velocity(TAMV) and resistance index(RI) in ophthalmic artery(OA),short posterior ciliary artery(SPCA) and central retinal artery(CRA).Results In treatment group,PSV,EDV,RI and TAMV in OA and CRA after treatment improved to some degree compared with that before treatment,but there was no statistical difference(both P>0.05);PSV,EDV and TAMV in SPCA after treatment had no changes compared with that before treatment,there was no statistical difference(both P>0.05),but RI in SPCA was significantly decreased,there was statistical difference(P<0.05).In control group,PSV,EDV,RI and TAMV in OA,SPCA and CRA after treatment had no changes compared with that before treatment,there was no statistical difference(both P>0.05).PSV,EDV,RI and TAMV in OA and CRA in treatment group after treatment improved to some degree compared with control group after treatment,but there was no statistical difference(both P>0.05);PSV,EDV and TAMV in SPCA improved to some degree,but there was no statistical difference(both P>0.05),RI was significantly decreased,there was statistical difference(P<0.05).Conclusion Tetramethylpyrazine can improve the hemodynamics and decrease RI of SPCA in PCACG patients with normal intraocular pressure after operation.