摘要
目的 :评价 4种抗青光眼药物对新诊青光眼病人呼吸循环系统及眼内压的影响。方法 :收集新诊青光眼患者 1 41例 ,进行全面的眼科、心血管及呼吸系统检查 ,包括心电图及肺活量测定。每位病人应用 4种青光眼药物中的一种 ,连续观察 3个月 ,随机选择一眼记录 ,4组间行 χ2检验及变异数分析。结果 :无论是原发性开角型青光眼 ( primary open angle glaucoma,POAG)组还是慢性闭角型青光眼 ( chronic closed- angleglaucoma,CCAG)组 ,latanoprost都显示出最明显的降眼压作用 ,眼压分别降低 8.9mm Hg( P=0 .0 0 5 )和4.1 mm Hg( P=0 .33)。应用博利尼定 ( brimonidine)者 41 %发生全身性副作用 ;应用噻吗洛尔 ( timolol)者伴有心率减慢和肺活量降低 ;应用倍他洛尔 ( betaxolol)的病人 5 5 %以上自述有眼球刺激症状 ,2 8%的病人需改用其他治疗方法。结论 :拉他前列素 ( latanoprost)控制眼压的效果良好 ,且全身和局部副作用发生率低 ,可作为青光眼初始治疗的首选药物。鉴于老年青光眼患者有潜在的可逆性呼吸功能障碍 ,噻吗洛尔所致的呼吸储备降低应加以考虑。博利尼定的应用伴有大量的难以预料的全身副作用。倍他洛尔导致眼球刺激 ,控制眼压的效果较差。建议局部应用 β受体阻断药治疗青光眼时 。
Objective:To evaluate the short term effects of four antiglaucomatous drugs on cardiovascular and respiratory systems,and intraocular pressure(IOP) in newly diagnosed patients with glaucoma.Methods:One hundred and forty one newly diagnosed patients with glaucoma were collected and underwent a full ocular,cardiovascular,and respiratory examination,including electrocardiogram(ECG) and spirometry.They were prescribed one of four topical antiglaucomatous drugs and reviewed 3 months later.One eye of each patient was randomly chosen for analysis,performed using analysis of variance and the χ 2 test.Results:Latanoprost had the greatest mean IOP lowering effect in both the primary open angle glaucoma(POAG)( P =0 005) and the chronic closed angle glaucoma(CCAG)( P =0 33) groups,reducing the IOP by 8 9 mmHg ang 4 1 mmHg respectively.Timolol was associated with lowered pulse rates and reductions in the spirometry measurements.Forty one per cent of patients using brimonidine complained of systemic side effects and over 55% of patients using betaxolol complained of ocular irritation.Twenty eight per cent of patients required an alteration in their glaucoma management.Conclusion:Latanoprost appears to be a useful primaty treatment for patients with glaucoma in view of superior IOP control and a low incidence of local and systemic side effects.Timolol causes a reduction in measurements of respiratory function,a concem in view of the potential subclinical reversible airway diseases in the elderly glaucoma population.Brimonidine is associated with substantial,unpredictable systemic side effects and betaxolol causes ocular irritation and weak IOP control.Spirometry is advised in all patients receiving topical β blocker therapy to control their glaucoma.
出处
《滨州医学院学报》
2002年第4期241-244,共4页
Journal of Binzhou Medical University
