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口服他汀类药物对丝裂霉素 C 增强小梁切除术效果的影响。

Effect of oral statin use on mitomycin-C augmented trabeculectomy outcomes.

机构信息

Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.

出版信息

PLoS One. 2021 Jan 15;16(1):e0245429. doi: 10.1371/journal.pone.0245429. eCollection 2021.

Abstract

PURPOSE

The effect of statins on wound healing is controversial, and their effect on trabeculectomy outcomes remains unclear. This study aimed to examine the relationship between oral statin use and trabeculectomy outcomes.

METHODS

Medical records of patients who underwent primary mitomycin-C augmented trabeculectomy with 2 years of follow-up were reviewed. Pre- and postoperative intraocular pressures (IOP) and numbers of medications, subconjunctival 5-fluorouracil (5-FU) injections, and bleb-needling procedures were compared between statin users and nonusers. Failure was defined as an eye that failed to achieve a 20% lowering of IOP from baseline or had an IOP > 21 mm Hg, as well as an eye that required further surgical intervention, developed hypotony, or had no light perception visual acuity.

RESULTS

In total, 158 subjects were enrolled, with 47 eyes from statin users and 111 eyes from statin nonusers. The 24-month cumulative probability of failure was 78.7% for statin users and 60.4% for nonusers (P = .013). Cox proportional-hazards modeling showed a significantly higher hazard risk in statin users (adjusted hazard ratio 1.61, P = .026). There were no significant between-group differences in mean IOPs or number of medications (both P > .05) at 24 months. Multivariable Poisson regression analysis that statin use was associated with increased numbers of 5-FU injections (P = .014) and bleb-needling procedures (P = .031).

CONCLUSIONS

This study demonstrated that oral statin use was associated with higher rates of trabeculectomy failure and increased numbers of 5-FU injections and bleb-needling procedures.

摘要

目的

他汀类药物对伤口愈合的影响存在争议,其对小梁切除术结果的影响尚不清楚。本研究旨在探讨口服他汀类药物使用与小梁切除术结果之间的关系。

方法

回顾了接受丝裂霉素 C 增强性小梁切除术的患者的病历,随访时间为 2 年。比较了他汀类药物使用者和非使用者的术前和术后眼压(IOP)以及药物数量、结膜下 5-氟尿嘧啶(5-FU)注射和滤泡针刺次数。失败定义为眼压未从基线降低 20%或眼压>21mmHg,需要进一步手术干预、发生低眼压或无光感视力的眼睛。

结果

共纳入 158 例患者,其中 47 例为他汀类药物使用者,111 例为他汀类药物非使用者。他汀类药物使用者 24 个月累积失败概率为 78.7%,而非使用者为 60.4%(P=0.013)。Cox 比例风险模型显示,他汀类药物使用者的风险显著更高(调整后的风险比为 1.61,P=0.026)。24 个月时,两组间平均眼压或药物数量均无显著差异(均 P>0.05)。多变量泊松回归分析表明,他汀类药物使用与 5-FU 注射次数(P=0.014)和滤泡针刺次数(P=0.031)增加相关。

结论

本研究表明,口服他汀类药物使用与小梁切除术失败率升高以及 5-FU 注射和滤泡针刺次数增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad90/7810309/040b54b1b274/pone.0245429.g001.jpg

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