强化体外反搏对非动脉炎性前部缺血性视神经病变患者的影响。
Effect of enhanced extracorporeal counterpulsation in patients with non-arteritic anterior ischaemic optic neuropathy.
作者信息
Zhu Wenhui, Liao Ruiduan, Chen Yongchong, Liu Li, Zhang Yan
机构信息
Department of Ophthalmology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China.
出版信息
Graefes Arch Clin Exp Ophthalmol. 2015 Jan;253(1):127-33. doi: 10.1007/s00417-014-2823-z. Epub 2014 Oct 10.
PURPOSE
The purpose is to study the effect of Enhanced Extracorporeal Counterpulsation (EECP) in patients with non-arteritic anterior ischaemic optic neuropathy (NAION).
METHODS
EECP is a noninvasive, mechanical, and circulatory support therapy. Sixteen patients with unilateral NAION were treated with EECP (twelve 1-h daily treatment sessions for each patient). Color Doppler imaging (CDI) was applied to measure the mean flow velocity (MFV), peak-systolic velocity (PSV), end-diastolic velocity (EDV) of the ophthalmic artery (OA) and central retinal artery (CRA). Intraocular pressure (IOP) was measured by Goldmann applanation tonometry. Measurements were collected before and immediately after the first and the last sessions of EECP in both eyes, and they were compared with the baseline measurement before EECP. The measurements were also compared between the NAION eyes and the normal fellow eyes. Visual acuity (VA) and visual field (VF) were assessed before EECP and after the last EECP.
RESULTS
EECP progressively increased blood flow velocities of the OA and CRA and progressively decreased IOP in both eyes (P < 0.05). After the first session of EECP, there was a 16 ± 5.3% increase in EDV and a 13.9 ± 9.5% increase in MFV of the OA, and a 17.1 ± 2.5% increase in PSV, a 21.2 ± 9.3% increase, in EDV and a 16.5 ± 3.3% increase in MFV of the CRA in NAION eyes. After the last EECP treatment, there was a 16.8 ± 6.7% increase in EDV and a 14.0 ± 5.1% increase in MFV of the OA, and a 17.7 ± 12.3 % increase in PSV, a 23.1 ± 6.3% increase in DSV, and a 21.1 ± 8.4% increase in MFV of the CRA in NAION eyes (P < 0.05). The change of the PSV, EDV, and MFV in the CRA were more significant in NAION eyes than that of their fellow eyes (P < 0.05). VA was improved and VF mean deviation was decreased in NAION eyes after the last EECP treatment (P = 0.003 and 0.049, respectively), and VA improvement was correlated positively with the blood flow parameter.
CONCLUSIONS
EECP could be a clinically effective and safe treatment for NAION.
目的
研究增强型体外反搏（EECP）对非动脉炎性前部缺血性视神经病变（NAION）患者的疗效。
方法
EECP是一种无创、机械性的循环支持疗法。16例单侧NAION患者接受了EECP治疗（每位患者每天治疗1小时，共12次）。应用彩色多普勒成像（CDI）测量眼动脉（OA）和视网膜中央动脉（CRA）的平均血流速度（MFV）、收缩期峰值速度（PSV）、舒张末期速度（EDV）。用Goldmann压平眼压计测量眼压。在EECP治疗的第一眼和最后一眼治疗前、治疗后即刻进行测量，并与EECP治疗前的基线测量值进行比较。还对NAION眼和对侧正常眼的测量值进行了比较。在EECP治疗前和最后一次EECP治疗后评估视力（VA）和视野（VF）。
结果
EECP使双眼OA和CRA的血流速度逐渐增加，眼压逐渐降低（P<0.05）。在EECP治疗的第一疗程后，NAION眼中OA的EDV增加了16±5.3%，MFV增加了13.9±9.5%，CRA的PSV增加了17.1±2.5%，EDV增加了21.2±9.3%，MFV增加了16.5±3.3%。在最后一次EECP治疗后，NAION眼中OA的EDV增加了16.8±6.7%，MFV增加了14.0±5.1%，CRA的PSV增加了17.7±12.3%，DSV增加了23.1±6.3%，MFV增加了21.1±8.4%（P<0.05）。NAION眼中CRA的PSV、EDV和MFV的变化比其对侧眼更显著（P<0.05）。在最后一次EECP治疗后，NAION眼的VA得到改善，VF平均偏差降低（分别为P=0.003和0.049），VA改善与血流参数呈正相关。
结论
EECP可能是一种治疗NAION安全有效的临床方法。
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