拉坦前列腺素联合马来酸噻吗洛尔对原发性开角型青光眼患者24h眼[摘要]目的探讨拉坦前列腺素联合马来酸噻吗洛尔（拉坦噻吗）对原发性开角型青光眼患者24h眼压及眼血流的影响并与拉坦前列腺素单用效果进行比较。方法选取符合纳入标准的原发性开角型青光眼患者50例作为研究对象，随机分为单用组和联合组各25例，单用组给予拉坦前列腺素滴眼液滴眼，联合组给予拉坦噻吗滴眼液滴眼，治疗前及治疗后4周测量24h眼压并测定视网膜中央动脉血流动力学数据。结果治疗后单用组除2：00各时段眼压及均值均显著降低（P<0.05），联合组各时段眼压均显著降低（P<0.05），两组24h眼压变化值较治疗前显著降低（P<0.05）。联合组各时段眼压、均值、24h变化值均显著低于单用组（P<0.05）。治疗后两组视网膜中央动脉EDV、PSV较治疗前显著升高，RI显著降低（P<0.05），联合组EDV、PSV显著高于单用组，RI显著低于单用组（P<0.05）。结论拉坦噻吗与拉坦前列腺素均能有效降低原发性开角型青光眼患者眼压，控制24h眼压曲线波动，改善眼血流，拉坦噻吗各时段眼压、眼压波动的控制效果及改善眼血流的效果均优于拉坦前列腺素。[关键词]原发性开角型青光眼；拉坦噻吗；拉坦前列腺素；马来酸噻吗洛尔；眼压；血流动力学[]R775[文献标识码]B[]1673-9701（2015）05-0074-04Effectoflatanoprost-timololmaleatecombinedof24hIOPandbloodflowinpatientswithopen-angleglaucomaSHENQimin1YAOKe2SHIXiaoqin31.DepartmentofOphthalmology，thePeople'sHospitalofYuyaoCityinZhe激angProvince，Yuyao315400，China；2.EyeCenter，theAffiliatedSecondHospitalofMedicalCollegeofZhe激angUniversity，Hangzhou310009，China[Abstract]ObjectiveToinvestigatetheeffectoflatanoprost-timololmaleatecombinedof24hIOPandbloodflowinpatientswithopen-angleglaucoma，andcontrastedtolatanoprost.MethodsAtotalof50casesofpatientswithprimaryopen-angleglaucomamettheinclusioncriteriaforthestudy，randomizeddivideintogroups，single-usegroupandcombinedgroupeachwith25cases，single-usegroupweregivenlatanoprosteyedrops，thecombinedgroupweregivenlatanoprost-timololeyedrops，beforetreatmentandafter4weeksoftreatmentweremeasured24hIOPandartercentralisretinaehemodynamicdata.ResultsAftertreatmentthetwogroupsvarioustimeintervalsandthemeanIOPweresignificantlydecreased（P<0.05），comparedwithbeforetreatmentvalues24hIOPoftwogroupsweresignificantlylower（P<0.05）.VarioustimeintervalsthecombinedgroupmeanIOP，24hchangevaluesweresignificantlylowerthansingle-usegroup（P<0.05）.Aftertreatment，thecentralarteryEDV，PSVoftwogroupsweresignificantlyhigherthanthebefore，RIweresignificantlylower（P<0.05），thecombinedgroupEDV，PSVweresignificantlyhigherthansingle-usegroup，RIweresignificantlylowerthansingle-usegroup（P<0.05）.ConclusionLatanoprost-timololmaleatecombinedandlatanoprostbothcouldeffectivelyreduceIOPinpatientswithopen-angleglaucoma，controllingintraocularpressurecurvefluctuations24himprovingocularbloodflow，effectofeachtimeIOP，IOPfluctuationcontrolandimprovingocularbloodflowoflatanoprost-timololmaleatecombinedarebetterthanlatanoprost.[Keywords]Primaryopen-angleglaucoma；Latanoprost-timololmaleatecombined；Latanoprost；Timololmaleate；IOP；Hemodynamic青光眼的高眼压使眼血流动力学的改变造成视神经损害是致盲的重要原因，药物干预控制眼压是开角型青光眼的主要治疗方式，目前认为控制眼压绝对值的同时应对眼压的波动进行干预。眼压昼夜波动具有一定规律，夜间是眼压升高的高危时段，而此时可能与生理性低血压重叠加剧对眼部循环不畅的状态，造成视神经损伤促进病情进展[1]。拉坦前列腺素作为前列腺素类药物具有良好的降眼压效果，而单一用药对眼压波动曲线控制效果并不确切。有研究显示，其对24h眼压曲线影响较小，眼压...