摘要
目的研究高三尖杉酯碱（ｈｏｍｏｈａｒｉｎｇｔｏｎｉｎｅ）在青光眼滤过术中的抗增殖作用。方法采用随机对照的临床验证方法，施行同一标准的小梁切除术，将７８例（８８只眼）难治性青光眼分为用药组４２例（４６只眼）和对照组３６例（４２只眼）。用药组术中应用高三尖杉酯碱０４ｍｇ，术后再分次结膜下注射高三尖杉酯碱０６２±０２０ｍｇ（范围０５３～０７５ｍｇ）；对照组未用高三尖杉酯碱。术后随访观察１８～４８个月（平均３６个月）。采用寿命表分析法统计。结果手术成功率：用药组为８４５％，对照组为５０９％（Ｐ＜０．０５）。功能性滤过泡的累计百分率：用药组为８４２％，对照组为５２９％（Ｐ＜０．０５）。并发症：用药组的角膜上皮缺损和结膜伤口渗漏发生率分别为２３９％和６５％，对照组为７１％和２４％（Ｐ＜０．０５）。用药组的角膜内皮细胞数在用药前后差异无显著性（Ｐ＞０．０５）。结论高三尖杉酯碱是安全有效的抗增殖药物，可明显提高青光眼滤过术的成功率，至少可在术后３年内将眼压维持在正常水平。
Objective To study the antiproliferative effects of homoharringtonine (Hh) on glaucoma filtering surgery. Methods In a randomized control clinical trial,78 patients (88 eyes) with refractory glaucoma underwent trabeculectomy with and without Hh.In the Hhtreated eyes (n=46), the therapeutic dose of Hh was: intraoperative application of Hh 0.4 mg and postoperative subconjunctival injections of Hh 0.62±0.20 mg (ranged 0.53～0.75 mg).In the control eyes (n= 42), Hh was not used. The followup period was 18 to 48 months, and the data were analyzed by using the lifetable method of KaplanMeier.Results The cumulative success probability in Hh group was 84.5% and that in control group was 50.9%, the difference being significant (P<0.05).The cumulative percentage of functioning bleb in Hh group was 84.2% and that in control group was 52.9% (P<0.05).1The rates of corneal erosion were 23.9% and 7.1%, and the rates of conjunctival wound leak were 6.5% and 2.4% in Hh and control group respectively.There was no significant change in corneal endothelial density following the use of Hh (P>0.05).Conclusion The study indicates that Hh is a safe and effective antiproliferative agent for the use in glaucoma filtering surgery, it not only can increase the success probability considerably, but also maintain at least the postoperative IOP at relatively low normal level for 3 years.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
1998年第5期361-364,共4页
Chinese Journal of Ophthalmology
基金
卫生部科研基金
关键词
青光眼
滤过术
高三尖杉酯碱
Homoharringtonine Glaucoma Lifetable method Complications
