杨育彬(广州市番禺区何贤纪念医院眼科， 广东 广州　511400)



脑蛋白水解物注射剂对原发性青光眼患者血清金属蛋白酶2组织抑制因子和视神经功能的影响

杨育彬*(广州市番禺区何贤纪念医院眼科， 广东 广州511400)

DOI10.14009/j.issn.1672-2124.2016.02.012

摘要目的：探讨脑蛋白水解物注射剂对原发性青光眼患者血清金属蛋白酶2组织抑制因子(tissue inhibitor of metalloproteinase 2，TIMP-2)和视神经功能的影响。方法：选取广州市番禺区何贤纪念医院2014年1月—2015年1月收治的原发性青光眼患者120例(120只眼)，按随机数字表法分为2组各60例，观察组患者术后3 d给予脑蛋白水解物注射剂治疗；对照组患者术后3 d给予鼠神经生长因子治疗。比较2组患者治疗前、后血清TIMP-2水平和视神经功能指标的差异。结果：观察组血清TIMP-2水平由治疗前的(329.25±21.42) μg/L降低为治疗后的(285.14±12.35) μg/L，对照组则由治疗前的(331.25±31.54) μg/L降低为治疗后的(296.54±13.19) μg/L，均较同组治疗前明显降低，且观察组降低幅度大于对照组，差异有统计学意义(P<0.05)。观察组患者视力由治疗前的(0.38±0.05)上升为治疗后的(0.53±0.07)，眼压由治疗前的(13.58±3.52) mmHg(1 mmHg=0.133 kPa)降低为治疗后的(12.98±3.21) mmHg，MS由治疗前的(17.16±3.54) dB上升为治疗后的(21.34±4.01) dB，MD由治疗前的(16.75±5.26) dB降低为治疗后的(12.15±5.42) dB，潜伏期由治疗前的(121.91±13.21) ms降低为治疗后的(98.24±11.05) ms，振幅由治疗前的(5.91±1.21) μV上升为治疗后的(7.82±2.01) μV;对照组按上述观察组的顺序依次为(0.39±0.05)、(0.48±0.06)，(13.71±3.49)、(13.02±3.15) mmHg，(16.98±3.49)、(18.12±4.08) dB，(16.69±5.19)、(16.22±5.14) dB，(123.01±12.02)、(115.61±10.54) ms，(5.93±1.22)、(6.52±2.14) μV，均较同组治疗前明显降低，且观察组降低幅度大于对照组，差异有统计学意义(P<0.05)。结论：脑蛋白水解物注射剂可能通过降低血清TIMP-2水平，从而改善原发性青光眼患者视神经功能，值得临床推广应用。

关键词脑蛋白水解物注射剂； 原发性青光眼； 血清TIMP-2； 视神经功能

Effects of Brain Protein Hydrolysate Injection on Serum TIMP-2 and Optic Nerve Function in Patients with Primary Glaucoma

YANG Yubin(Dept.of Ophthalmology, Guangzhou Panyu District Hexian Memorial Hospital, Guangdong Guangzhou 511400, China)

ABSTRACTOBJECTIVE：To investigate the effects of brain protein hydrolysate injection on serum tissue inhibitor of metalloproteinase 2 (TIMP-2) and optic nerve function in patients with primary glaucoma. METHODS: 120 cases (120 eyes) of primary glaucoma admitted into Guangzhou Panyu District Hexian Memorial Hospital from Jan. 2014 to Feb. 2015 were selected to be divided into two groups via the ramdon number table, with 60 cases in each. The observation group were treated with brain protein hydrolysate injection in 3 d after operation; while the control group received mouse nerve growth factors therapy in 3 d after operation. The difference of serum TIMP-2 level and optic nerve function index before and after treatment were compared between two groups. RESULTS: The serum TIMP-2 levelin observation group decreased from (329.25±21.42) μg/L before treatment to (285.14±12.35) μg/L after treatment, and as for the control group, it decreased from (331.25±31.54) μg/L to (296.54±13.19) μg/L; after treatment, the data for the same group were significantly lower than before treatment; and the decline in observation group was obviously greater than that in the control group, with statistically significant difference (P<0.05). In observation group, the patients’ eyesight increased from (0.38±0.05) before treatment to (0.53±0.07) after treatment, the intraocular pressure decreased from (13.58±3.52) mmHg (1 mmHg=0.133 kPa) to (12.98±3.21) mmHg, the MS value increased from (17.16±3.54) dB to (21.34±4.01) dB, The MD value decreased from (16.75±5.26) dB to (12.15±5.42) dB, the incubation decreased from (121.91±13.21) ms to(98.24±11.05) ms, and the amplitude increased from (5.91±1.21) μV to (7.82±2.01) μV; meanwhile, according to the above sequence, these data in control group were respectively [(0.39±0.05) (0.48±0.06)], [(13.71±3.49) (13.02±3.15) mmHg], [(16.98±3.49) (18.12±4.08) dB], [(16.69±5.19) (16.22±5.14) dB]，[(123.01±12.02) (115.61±10.54) ms], [(5.93±1.22) (6.52±2.14) μV], the data for the same group were significantly lower than before treatment; and the decline in observation group was obviously greater than that in the control group, with statistically significant difference (P<0.05). CONCLUSIONS: Brain protein hydrolysate injection can improve optic nerve function for patients with primary glaucoma by reducing serum TIMP-2 level, it is worthy of clinical popularization and application.

KEYWORDSBrain protein hydrolysate injection; Primary glaucoma; Serum TIMP-2; Optic nerve function

青光眼是眼压增高或低血流灌注导致眼盲的不可逆病变，其中视神经功能受损是导致眼盲的重要原因。尽管临床上手术联合药物治疗用于降低眼压有一定效果，但大部分患者在眼压控制于正常值的情况下，视神经功能受损仍在继续[1]。相关研究结果表明，高眼压导致的视神经萎缩进展并未因眼压的降低而停止[2]。因此，视神经保护在原发性青光眼的治疗中具有重要的意义。本研究观察了脑蛋白水解物注射剂对原发性青光眼患者血清金属蛋白酶2组织抑制因子(Tissue inhibitor of metalloproteinase 2，TIMP-2)和视神经功能的影响，现报告如下。……