Tsukamoto Hidetoshi, Larsson Lill-Inger
Department of Ophthalmology, Uppsala University Hospital, Uppsala, Sweden.
Arch Ophthalmol. 2004 Feb;122(2):190-3. doi: 10.1001/archopht.122.2.190.
To measure the effectiveness of topical 0.2% brimonidine tartrate as a suppressor of aqueous humor flow in the human eye compared with the effectiveness of 2% dorzolamide hydrochloride, and to measure the additivity of the effects of the 2 drugs.
A randomized, double-masked, placebo-controlled study was performed in 20 healthy human subjects. The topical drugs were instilled twice daily the day before and again in the morning on the day of the measurements. The rate of aqueous humor flow was measured from 8 AM to 4 PM by clearance of topically applied fluorescein using a fluorophotometer, after administration of doses of each drug singly and both drugs together. Intraocular pressure (IOP) was measured with applanation tonometry.
Compared with placebo, brimonidine reduced the aqueous humor flow by a mean +/- SD of 28.2% +/- 18.0% (P<.001), dorzolamide by 19.3% +/- 22.0% (P =.007), and the combination of brimonidine and dorzolamide by 37.2% +/- 20.6% (P<.001). The combination of both drugs statistically significantly suppressed aqueous humor flow compared with dorzolamide alone (P<.001) and brimonidine alone (P =.04). The IOP was reduced by a mean +/- SD of 11.6% +/- 10.1% (P<.001) by brimonidine, 8.5% +/- 14.1% (P =.02) by dorzolamide, and 17.9% +/- 16.5% (P<.001) by the combination. The combination of drugs reduced IOP better than dorzolamide (P<.001), but not more than brimonidine (P =.06).
The combination of brimonidine and dorzolamide caused a further reduction of aqueous humor flow compared with each drug applied alone. The IOP was further reduced by the combination compared with dorzolamide alone, but not compared with brimonidine alone.
与2%盐酸多佐胺的效果相比，测量0.2%酒石酸溴莫尼定作为人眼房水生成抑制剂的有效性，并测量两种药物效果的相加性。
对20名健康受试者进行了一项随机、双盲、安慰剂对照研究。在测量前一天，局部用药每天滴注两次，测量当天上午再次滴注。在单独给予每种药物以及同时给予两种药物后，使用荧光光度计通过局部应用荧光素的清除率，从上午8点至下午4点测量房水生成率。使用压平眼压计测量眼压。
与安慰剂相比，溴莫尼定使房水生成减少，平均±标准差为28.2%±18.0%（P<0.001），多佐胺使房水生成减少19.3%±22.0%（P = 0.007），溴莫尼定和多佐胺联合使用使房水生成减少37.2%±20.6%（P<0.001）。与单独使用多佐胺（P<0.001）和单独使用溴莫尼定（P = 0.04）相比，两种药物联合使用在统计学上显著抑制了房水生成。溴莫尼定使眼压降低，平均±标准差为11.6%±10.1%（P<0.001），多佐胺使眼压降低8.5%±14.1%（P = 0.02），联合使用使眼压降低17.9%±16.5%（P<0.001）。联合用药降低眼压的效果优于多佐胺（P<0.001），但不优于溴莫尼定（P = 0.06）。
与单独使用每种药物相比，溴莫尼定和多佐胺联合使用可进一步减少房水生成。与单独使用多佐胺相比，联合用药可进一步降低眼压，但与单独使用溴莫尼定相比则不然。
