非炎症性前部缺血性视神经病变患者经复方樟柳碱治疗前后血浆内皮素-1浓度的测定.DOCVIP

临床医学论文-非炎症性前部缺血性视神经病变患者经复方樟柳碱治疗前后血浆内皮素-1浓度的测定 【摘要】??目的??测定非动脉炎性前部缺血性视神经病变（NAION）患者在复方樟柳碱治疗前后血浆中内皮素-1（ET-1）浓度，探讨其变化规律。方法??NAION患者39例，给予复方樟柳碱2ml颞浅动脉旁注射，共治疗21天，所有患者按治疗效果分为3组（A组为治愈，B组为显效或有效，C组为无效），分别通过放射免疫法（RIA）测定治疗前后血浆ET-1浓度。结果??各组治疗前的血浆ET-1浓度，A、B组高于C组，其差异有显著性（tA，C=4.67，P0.05；tB，C=4.03，P0.05），而A、B组之间差异无显著性（tA，B=1.34，P0.1）。各组治疗后的血浆ET-1浓度，其分布规律同治疗前（tA，C=4.13，P0.05；tB，C=3.89，P0.05；tA，B=0.67，P0.1）。各组治疗后的血浆ET-1浓度较治疗前均有所下降，A组、B组其治疗前后的浓度差异有显著性（FA=4.78，P＜0.05；FB=4.23，P＜0.05），C组治疗前后的浓度差异无显著性（FC=0.78，P＞0.1）。结论??复方樟柳碱对NAION患者的治疗效果，可能与血浆ET-1水平有关。 ???? ????【关键词】??缺血性视神经病变；复方樟柳碱；内皮素-1 ???? ???? ????【Abstract】??Objective??To?measure?the?concentration?of?plasma?endothelin-1(ET-1)in?patients?with?nonarteritic?anterior?ischemic?optic?neuropathy?(NAION)?before?and?after?treatment?by?compound?anisodine?and?investigate?the?rule.Methods??39?patients?with?NAION?were?treated?by?compound?anisodine?which?was?injected?subcutaneously?around?superficial?temporal?artery?once?a?day?for?21days.All?the?patients?were?divided?into?three?groups?according?to?the?results?after?treatment:Groups?A:?cure；Group?B:?efficacy；Group?C:?no?efficacy.The?plasma?levels?of?ET-1?in?39?cases?before?and?after?treatment?were?measured?by?radioimmuoassay(RIA).Results??The?plasma?levels?of?ET-1?before?and?after?treatment?in?group?A?and?group?B?were?significantly?higher?than?those?in?group?C.There?was?no?significantly?difference?between?group?A?and?group?B.The?plasma?levels?of?ET-1?in?patients?after?treatment?were?obviously?lower?than?those?before?treatment.There?was?significantly?difference?in?group?A?and?group?B?but?not?in?group?C.Conclusion??The?efficiency?of?compound?anisodine?on?patients?with?NAION?may?result?in?the?plasma?levels?of?ET-1. ???? ???? ????缺血性视神经病变是一类比较常见的眼底疾病，临床上以前部缺血性视神经病变（anterior?ischemic?optic?neuropathy，AION）较常见，并且从其发病机制来看，非动脉炎性AION（NAION）在我国占绝大多数。由于病变引起的视神经纤维缺血甚至梗死，可导致严重后果，易致神经萎缩。已有研究表明，内皮素-1（ET-1）作为强力缩血管物质可能参与到NAION的发病机制中。本病治疗较为困难，常需综合治疗，其中复方樟柳碱是目前比较公认有效的药物。本文将从复方樟柳碱治疗前后NAION患者血浆ET-1浓度的变化入手，对本