常丽

[摘要] 目的 探讨拉坦前列腺素与溴莫尼定治疗开角型青光眼的疗效对比分析。 方法 将2016年10月～2017年10月在我院眼科治疗的90例开角型青光眼患者随机分为两组，对照组采用溴莫尼定治疗，观察组采用拉坦前列腺素治疗，比较两组患者的眼压、视力、眼血流动力学指标、治疗效果、安全性。 结果 观察组治疗12周后眼压明显低于对照组，而视力明显高于对照组（P<0.05）；观察组治疗12周后CRA和PCA的PSV、EDV明显较对照组提高，RI明显降低（P<0.05）；观察组治疗有效率为93.33%，明显高于对照组的75.56%，差异有统计学意义（P<0.05）；观察组充血、流泪、眼睑水肿、烧灼感等不良反应发生率明显低于对照组（P<0.05）。 结论 拉坦前列腺素治疗开角型青光眼的疗效更佳，有利于降低眼压，促进视力提高，改善眼部血流动力学，降低眼部组织的缺血性损害，且治疗安全性高，具有积极的临床意义。

[关键词] 开角型青光眼；拉坦前列腺素；溴莫尼定

[中图分类号] R775 [文献标识码] B [文章编号] 1673-9701（2018）25-0086-04

[Abstract] Objective To compare and analyze the efficacy of latanoprost and brimonidine in the treatment of open-angle glaucoma. Methods A total of 90 patients with open-angle glaucoma who were treated in the department of ophthalmology in our hospital from October 2016 to October 2017 were randomly divided into two groups. The control group was given brimonidine， and the observation group was given latanoprost. The intraocular pressure， visual acuity， ocular hemodynamic parameters， therapeutic effects， and safety were compared between the two groups of patients. Results In the observation group， the intraocular pressure was significantly lower than that in the control group 12 weeks after treatment， but the visual acuity was significantly higher than that in the control group. The difference was statistically significant（P<0.05）； after 12 weeks of treatment， the PSV and EDV of CRA and PCA of the observation group were significantly higher than those in the control group， and the RI was significantly decreased. The differences were statistically significant（P<0.05）； the effective rate in the observation group was 93.33%， which was significantly higher than that in the control group（75.56%）， the difference was statistically significant（P<0.05）. The incidence rate of adverse reactions such as congestion， tearing， eyelid edema， and burning sensation in the observation group was significantly lower than that in the control group， and the difference was statistically significant（P<0.05）. Conclusion Latanoprost has a better efficacy in the treatment of open-angle glaucoma， which is beneficial to lowering intraocular pressure， improving visual acuity， improving hemodynamics of the eye， reducing ischemic damage of the eye tissue， and the safety is high. It has a positive clinical significance.

[Key words] Open-angle glaucoma； Latanoprost； Brimonidine

開角型青光眼是一种常见的青光眼类型，表现为眼压升高和特异性视神经损害，主要由于房水排出通道发生病变，导致房水排出不畅，眼压逐渐升高[1]。本病早期易被忽视，经常没有任何症状，部分患者待就诊时已发生明显视力损害，甚至视力永久丧失，因此，早期治疗有重要的临床意义。药物治疗是一种较为安全的治疗方式，临床用药有胆碱能类似药、前列腺素类似物、高渗剂、β-肾上腺素能受体阻滞剂、碳酸酐酶抑制剂、α2-肾上腺素能受体激动剂等，通过眼部滴注治疗可有效降低眼压，抑制房水生成，增强房水流出，达到治疗的目的[2]。拉坦前列腺素与溴莫尼定均是临床常用的治疗药物，两药疗效孰优孰劣尚无定论。本研究主要对比分析拉坦前列腺素与溴莫尼定治疗开角型青光眼的疗效，现报道如下。

1 资料与方法

1.1 一般资料

将2016年10月～2017年10月在我院眼科治疗的90例开角型青光眼患者随机分为两组。观察组45例，男24例，女21例，年龄41～78岁，平均年龄（59.7±14.6）岁，平均眼压（25.4±2.0）mmHg，视力（0.32±0.13）；……