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曲伏前列素滴眼液对眼压和搏动性眼血流的影响:与拉坦前列素滴眼液治疗开角型青光眼患者的180天随机双盲对照研究。

Effects of travoprost eye drops on intraocular pressure and pulsatile ocular blood flow: a 180-day, randomized, double-masked comparison with latanoprost eye drops in patients with open-angle glaucoma.

作者信息

Cardascia Nicola, Vetrugno Michele, Trabucco Tiziana, Cantatore Francesco, Sborgia Carlo

机构信息

Glaucoma Research Center, Department of Ophthalmology, Bari University, Policlinico di Bari, Bari, Italy.

出版信息

Curr Ther Res Clin Exp. 2003 Jul;64(7):389-400. doi: 10.1016/S0011-393X(03)00112-7.

Abstract

BACKGROUND

Because of the increasing realization of the importance of optic nerve head perfusion in the pathogenesis of glaucoma, the influence of new antiglaucomatous drugs on ocular hemodynamic properties should be investigated.

OBJECTIVE

The aim of this study was to compare the effects of 2 prostaglandin analogues, travoprost eye drops and latanoprost eye drops, on intraocular pressure (IOP) and pulsatile ocular blood flow (pOBF) in patients with primary open-angle glaucoma (POAG).

METHODS

Previously untreated patients aged 40 to 60 years with POAG and normal brachial blood pressure (BBP), heart rate, body mass index, and hemorheologic findings were eligible for this randomized, double-masked study. Two drops of travoprost (group T) or latanoprost (group L) were self-administered in both eyes at 9:00 pm. In all patients, IOP, pOBF, BBP, and heart rate were measured at baseline and on days 15, 30, 60, 90, and 180 of treatment.

RESULTS

Twenty-five consecutive patients with POAG were enrolled in this study conducted at the Glaucoma Research Center of the Department of Ophthalmology, Bari University, Policlinico di Bari (Bari, Italy). Of these, 7 were withdrawn because they did not return for the second appointment, leaving 18 patients (11 men, 7 women; mean [SD] age, 51.9 [5.5] years) to complete the study. In both groups, mean IOP values were significantly reduced at all time points compared with baseline (all P<0.01). Mean pOBF values increased ∼50% from baseline following treatment with either travoprost or latanoprost by day 15, were maintained at that level for 60 days, and then gradually decreased (group T: P = NS, NS, <0.01, <0.05, and <0.05 at days 15, 30, 60, 90, and 180, respectively, vs baseline; group L: P<0.01 at all time points vs baseline). All other parameters remained constant throughout the study. An early inverse correlation between IOP and pOBF was noted in group T but not in group L. No significant differences were found between groups in IOP or pOBF at any time point.

CONCLUSIONS

In this study population, pOBF was increased with travoprost and latanoprost in the short term, but this effect was kept constant only with travoprost. IOP was reduced with both drugs after short-term therapy, and this reduction was maintained in both groups. Travoprost may represent another option for the medical treatment of POAG.

摘要

背景

由于人们越来越意识到视神经乳头灌注在青光眼发病机制中的重要性,因此应研究新型抗青光眼药物对眼部血流动力学特性的影响。

目的

本研究旨在比较两种前列腺素类似物曲伏前列素滴眼液和拉坦前列素滴眼液对原发性开角型青光眼(POAG)患者眼压(IOP)和搏动性眼血流量(pOBF)的影响。

方法

年龄在40至60岁之间、未经治疗的POAG患者,若肱动脉血压(BBP)、心率、体重指数和血液流变学指标正常,则符合本随机、双盲研究的入选标准。晚上9点时,两组患者均自行在双眼各滴入两滴曲伏前列素(T组)或拉坦前列素(L组)。所有患者在基线时以及治疗的第15、30、60、90和180天测量眼压、pOBF、BBP和心率。

结果

在意大利巴里大学波利克利尼科迪巴里眼科系青光眼研究中心进行的这项研究中,连续纳入了25例POAG患者。其中7例因未返回进行第二次复诊而退出,剩余18例患者(11例男性,7例女性;平均[标准差]年龄为51.9[5.5]岁)完成了研究。与基线相比,两组在所有时间点的平均眼压值均显著降低(所有P<0.01)。使用曲伏前列素或拉坦前列素治疗后,到第15天时,平均pOBF值较基线增加了约50%,并在60天内维持在该水平,然后逐渐下降(T组在第15、30、60、90和180天与基线相比,P值分别为无统计学意义、无统计学意义、<0.01、<0.05和<0.05;L组在所有时间点与基线相比P<0.01)。在整个研究过程中,所有其他参数均保持不变。T组中眼压与pOBF之间早期存在负相关,而L组中未观察到这种相关性。在任何时间点,两组之间的眼压或pOBF均未发现显著差异。

结论

在本研究人群中,曲伏前列素和拉坦前列素在短期内均可使pOBF增加,但只有曲伏前列素能使这种作用持续稳定。两种药物在短期治疗后均可降低眼压,且两组的眼压降低情况均得以维持。曲伏前列素可能是POAG药物治疗的另一种选择。

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Travoprost--a new prostaglandin analogue for the treatment of glaucoma.
Expert Opin Pharmacother. 2002 Jul;3(7):965-77. doi: 10.1517/14656566.3.7.965.

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