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[摘要]
目的:探讨地奥司明治疗非缺血型视网膜静脉阻塞(retinal vein occlusion, RVO)的临床疗效。
方法:将符合非缺血型RVO诊断的48例48眼随机分为治疗组和对照组。治疗组27例27眼,给予地奥司明0.9g, po, bid, 4wk为一疗程,连续三个疗程。对照组21例21眼,先给予丹香冠心注射液16mL加入5g/L葡萄糖注射液(或者9g/L氯化钠注射液)500mL中,iv, qd, 1wk后改为丹参片3片,po, tid, 连续服用11wk。观察治疗前后最佳矫正视力和眼底病变的动态改变、视网膜电流图的变化、黄斑水肿的发生率及黄斑水肿厚度变化。
结果:治疗后4,8,12wk治疗组最佳矫正视力提高均显著高于对照组(P<0.05)。治疗后4wk,治疗组渗出、出血吸收率为63%,高于对照组的33%(P<0.05)。治疗后12wk, 治疗组暗适应眼最大电反应的b波振幅(231±39)μV与治疗前(184±65)μV相比明显提高(P<0.05),且与对照组(207±49)μV相比有差异(P<0.05)。治疗组并发黄斑水肿17例,对照组14例,治疗组黄斑水肿的发生率与对照组相比没有明显差异(P>0.05)。治疗后12wk黄斑中心凹厚度,治疗组为298±54μm,低于对照组的369±76μm(P<0.05)。
结论:对于非缺血型RVO,地奥司明能够有效的减轻黄斑水肿,降低视网膜的功能损伤,从而改善视功能,效果优于丹参治疗。
[Key word]
[Abstract]
AIM: To evaluate the therapeutic efficacy of diosmin in treating non-ischemic retinal vein occlusion.
METHODS: Forty-eight eyes of 48 cases of non-ischemic retinal vein occlusion were randomly divided into two groups. Twenty-seven eyes of 27 cases were enrolled in treatment group, receiving diosmin, 0.9g, po, bid, 4 weeks as a course altogether for 12 weeks. Twenty-one eyes of 21 cases in control group receiving danxiang guanxin injection 16mL+5g/L glucose injection(or sodium chloride injection)500mL, iv, qd for 1 week followed Salvia miltiorrhiza tablets, 3 tablets, po, tid, for 11 weeks. The best-corrected visual acuity, variation of eye fundus, electroretinogram, incidence rate of macular edema, and the thickness of macular were observed before and 4, 8, 12 weeks after the treatment.
RESULTS: The improvement of best-corrected visual acuity in treatment group was much better than that in control group with statistical difference between two groups at the end of 4, 8, 12 weeks(P<0.05). At the end of 4 weeks after treatment, the absorbency of bleeding and exudation of treatment group was 63%, higher than that of control group(33%, P<0.05). In dark adaptation eyes, the maximum amplitude of b wave in treatment group were meliorated 12 weeks later(231±39μV versus 184±65μV, P<0.05), also showing more improvement than those in control group(207±49μV, P<0.05). There was no significant difference in incidence rate of macular edema between the two groups(17 in treatment group versus 14 in control group, P<0.05). The thickness of macular in treatment group was 298±54μm, which was much less than that in control group(369±76μm, P<0.05).
CONCLUSION: In non-ischemic retinal vein occlusion, diosmin is efficient in reducing macular edema, alleviating the retinal disfunction, improving visual function. Its therapeutic efficacy is better than Salvia miltiorrhiza.
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