神经生长因子治疗非动脉炎性前部缺血性视神经病变的临床效果

doi:10.3760/cma.j.cn115909-20191228-00353

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摘要目的：观察神经生长因子（NGF）治疗非动脉炎性前部缺血性视神经病变（NA-AION）的临床疗效。方法：前瞻性随机对照研究。选择2016年7月至2019年6月涟水县人民医院眼科收治的NA-AION患者58例（58眼），根据随机数字表法分为对照组和观察组，对照组29例（29眼）予以糖皮质激素+活血通络颗粒+复方樟柳碱治疗，观察组29例（29眼）在对照组基础上加NGF治疗。比较2组治疗的总有效率、治疗前后最佳矫正视力（BCVA）、30°范围视野检查平均缺损（MD）、视盘视网膜神经纤维层（RNFL）厚度。数据采用Fisher精确检验、t检验及非参数检验。结果：治疗后，观察组总有效率明显高于对照组（P=0.04），观察组BCVA小数视力0.1以上所占百分比明显高于对照组（P<0.001），但观察组的MD和RNFL厚度均明显低于对照组（t=2.59，P=0.01；t=4.86，P<0.001）。2组治疗后均无明显不良反应。结论：加用NGF治疗NA-AION可获得更好的疗效，能提高患者视力，改善视野，降低 RNFL厚度。

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关键词 ： , 神经生长因子, 非动脉炎性前部缺血性视神经病变, 最佳矫正视力, 平均缺损, 视网膜神经纤维层

Abstract： Objective: To observe the effects of nerve growth factor (NGF) in the treatment of non-arteritic anterior ischemic optic neuropathy (NA-AION). Methods: This was a prospective, randomized, controlled study. Fifty-eight NA-AION patients (58 eyes) admitted to Lianshui County People's Hospital from July 2016 to June 2019 were selected, and then were divided into a control group and an observation group based on the random numerical table method. The control group (29 patients with 29 eyes) were given glucocorticoid hormones, Huoxue Tongluo granules and an anisodine compound. While the observation group (29 patients with 29 eyes), were treated with NGF in addition to the treatment plan previously described. The total effective rate, best corrected visual acuity (BCVA), the 30-degree visual-field examination mean deviation (MD) and the disc retinal nerve fiber layer (RNFL) thickness of the two groups were compared. Data were analyzed by the Fisher's exact test, a t test and a non-parametric test. Results: After treatment, the total effective rate for the observation group was significantly higher than that for the control group (P=0.04), the percentage of BCVA above 0.1 in the observation group was significantly higher than that in the control group (P<0.001), and both the MD and RNFL thickness in the observation group were significantly lower than those in the control group (t=2.59, P=0.01; t=4.86, P<0.001). There were no obvious adverse reactions for either group after treatment. Conclusions: The treatment of NA-AION with NGF can obtain a better effective rate, improve the patient's vision, improve the visual field and reduce RNFL thickness.

Key words： nerve growth factor non-arteritic anterior ischemic optic neuropathy best corrected visual acuity mean deviation retinal nerve fiber layer

收稿日期: 2019-12-28

PACS:

基金资助:江苏省第五期333高层次人才培养工程[（2018）Ⅲ-1063号]

通讯作者: 周洪伟（ORCID：0000-0002-5320-3886），Email：leave0307@163.com

引用本文:

陈凯周洪伟. 神经生长因子治疗非动脉炎性前部缺血性视神经病变的临床效果[J]. 中华眼视光学与视觉科学杂志, 2020, 22(10): 781-785. Kai Chen, Hongwei Zhou. Effects of Nerve Growth Factor in the Treatment of Non-Arteritic Anterior Ischemic Optic Neuropathy. Chinese Journal of Optometry Ophthalmology and Visual science, 2020, 22(10): 781-785. DOI: 10.3760/cma.j.cn115909-20191228-00353

链接本文:

https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20191228-00353 或 https://www.cjoovs.com/CN/Y2020/V22/I10/781

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