作者：钱晶晶，陆志荣，张黎明，管怀进 作者单位：南通大学附属医院眼科，南通 226001
【摘要】 目的：观察口服刺五加联合尼莫地平片对原发性闭角型青光眼视神经损害的临床疗效。方法：原发性闭角型青光眼术后眼压控制正常的患者25例（35眼）,随机分为观察组14例（21眼），口服刺五加联合尼莫地平治疗，对照组11例（14眼），仅口服肌苷片,治疗后3月两组进行闪光视网膜电图（F-ERG）及图形视诱发电位（P-VEP）的检查。结果：观察组F-ERG的b波振幅值、P-VEP的P100波潜伏时及振幅值改善明显高于对照组(P<0.05)。观察组F-ERG的b波潜伏时较对照组有所提前。结论：刺五加药片联合尼莫地平可改善原发性闭角型青光眼视功能损害。
【关键词】 青光眼；视功能；电生理；刺五加；尼莫地平
The effect of acanthopanax senticosus and nimodipine
on the electrophysiology test of primary angle-closed glaucoma
QIAN Jingjing, LU Zhirong, ZHANG Liming, et al (The Ophthalmic Center， Affiliated Hospital of Nantong University,Nantong 226001)
[Abstract] Objective: To study the effect of acanthopanax senticosus and nimodipine tablets on primary angle-closed glaucoma(PACG). Methods: The patients with primary angle-closed glaucoma who had normal intraocular pressure after operation were divided into two groups randomly,14 patients(21 eyes) treated with acanthopanax senticosus and nimodipine tablets for 3 months and 11 patients(14 eyes) with inosine tablets as control group. All patients were examined by flash electroretinography (F-ERG) and pattern visual evoked potential(P-VEP).Results: Compared with control group, there was a significant improvements in the amplitude of b wave in F-ERG, and in the amplitude and latent time of P100 wave in treated group(P<0.05), and also there was an improvements in the latent time of b wave .Conclusion: The use of acanthopanax senticosus and nimodipine tablets can improve the visual function in patients with PACG.
[Key words] Glaucoma; Visual function; Electrophysiology; Acanthopanax senticosus； Nimodipine青光眼是一种常见的致盲眼病，以进行性视力丧失为特征。治疗以降低眼压为主，但临床上很多病例在眼压降至正常水平后仍不能阻止视功能的进行性损害，可能原因为高眼压造成的继发性损伤持续存在所致。有证据显示微循环障碍和钙离子内流引起的氧化应激在视神经损伤中扮演了重要的角色，因此我们采用刺五加药片联合尼莫地平对原发性青光眼进行了尝试性治疗，通过观察其对电生理的影响，探讨这两种药物联合应用对视神经损伤的保护作用。
1 对象与方法
1．1 资料 25例(35眼)均为我院住院患者,其中9例(11眼)为急性闭角型青光眼,16例(24眼)为慢性闭角型青光眼,男14例，女11例，年龄47~70岁，平均57.9±0.2岁。均行小梁切除术控制眼压在≤21mmHg。两组患者均在术后用药前测眼压。对照组11眼眼压平均值为14.5 mmHg，治疗组21眼眼压平均值为14.3mmHg。
1．2 方法 25例随机分为2组，对照组11例(14眼)，观察组14例(21眼)。两组均使用0.1%氟美瞳、0.3%托百士局部抗炎治疗，必要时散瞳。其中治疗组给予刺五加药片口服，3片/次，bid及尼莫地平10 mg，口服，tid。对照组仅口服肌苷片0.4 g，tid，3个月后行F-ERG及P-VEP检查（Rolandconsult多焦电生理检查仪，RETL分析系统）。电生理检测由专人负责并记录。本实验均取得患者知情同意，每位患者均为服药满3个月无脱落的受试者。
1．3 统计学方法 计量资料以x±s表示，组间比较采用t检验。P<0.05示差异有统计学意义。
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