目的 探討血栓通注射液聯(lián)合鼠神經(jīng)生長因子治療非動脈炎性前部缺血性視神經(jīng)病變(AION)的療效觀察。方法 選取2013年6月—2015年6月沈陽市第四人民醫(yī)院眼科收治的非動脈炎性AION患者88例,按治療方案的差別將患者分為對照組和治療組,每組各44例。對照組肌肉注射注射用鼠神經(jīng)生長因子,18 μg/次加入到0.9%生理鹽水或滅菌注射用水2 mL中溶解,1次/d。治療組在對照組治療基礎(chǔ)上靜脈滴注血栓通注射液,5 mL加入到0.9%生理鹽水250 mL,1次/d。兩組患者均連續(xù)治療4周。觀察兩組的臨床療效,同時比較兩組視野缺損(MD)、P₁₀₀波潛伏期、視盤各象限視神經(jīng)纖維層厚度(ATRNFL)、視力提高行數(shù)。結(jié)果 治療后,對照組和治療組的總有效率分別為77.27%、93.18%,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組患者MD、P₁₀₀潛伏期較治療前顯著減小,同組治療前后差異具有統(tǒng)計學(xué)意義(P<0.05);且治療組的改善程度優(yōu)于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組ATRNFL均較治療前減小,但治療后治療組ATRNFL較對照組高,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05);并且治療后對照組ATRNFL較正常值低。治療組的視力提高行數(shù)高于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 血栓通注射液聯(lián)合鼠神經(jīng)生長因子治療非動脈炎性AION具有較好的臨床療效,可明顯改善視力,有效提高視野,具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of Xueshuantong Injection combined with mouse nerve growth factor in treatment of nonarteritic anterior ischemic optic neuropathy. Methods Patients (88 cases) with nonarteritic anterior ischemic optic neuropathy in Department of Ophthalmology from Shenyang the Fourth Hospital of People from June 2013 to June 2015 were enrolled in this study. According to the different treatment plan, patients were divided into treatment group (44 cases) and control group (44 cases). The patients in the control group were im administered with Mouse Nerve Growth Factor for injection, 18 μg/time added into 0.9% normal saline or sterilization injection water 2 mL, once daily. The patients in the treatment group were iv administered with Xueshuantong Injection on the basis of control group, 5 mL added into 0.9% normal saline 250 mL, once daily. The patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the MD, the incubation period of P₁₀₀ wave, ATRNFL of each quadrant optic, the line number of improve eyesight in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.27% and 93.18%, respectively, and there were differences between two groups (P < 0.05). After treatment, MD and the incubation period of P₁₀₀ wave in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, ATRNFL in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, ATRNFL in the treatment group was significantly higher than that in the control group, with significant difference between two groups (P < 0.05). After treatment, ATRNFL in the control group was lower than normal level. The line number of improve eyesight in the treatment group was higher than that in the control group, with significant difference between two groups (P < 0.05). Conclusion Xueshuantong Injection combined with mouse nerve growth factor has clinical curative effect in treatment of nonarteritic anterior ischemic optic neuropathy, and can obviously improve vision, also can improve the field of vision, which has a certain clinical application value.