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目的 研究原发性开角型青光眼 (primary open- angle glaucoma,POAG)患者在寒冷刺激及服用钙离子通道阻滞剂后视盘血流的变化。 方法 用海德堡视网膜血流仪 (Heidelberg retinal flowmetry,HRF)分别测量 POAG患者与正常个体视盘筛板区微血管在基础状态下、手指冷激发试验后及含服硝苯吡啶后的血流情况。 结果 POAG患者在冷激发试验后视盘平均血管容积及平均血流量分别由 2 7.1与5 45 .4降至 2 2 .3与 45 2 .4(P<0 .0 5 ) ,在含服硝苯吡啶后平均血管容积及平均血流量分别升至 2 9.0与5 79.5 (P<0 .0 5 )。有手足发冷史的 POAG患者在冷激发条件下视盘血流平均下降值为 137.2 ,在含服硝苯吡啶后视盘血流平均增加值为 196 .4,与无手足发冷史的 POAG患者比较差异均有显著性意义 (P<0 .0 5 )。 结论 POAG患者视盘血流受冷刺激后明显下降。钙离子通道阻滞剂可提高部分 POAG患者即时视盘血流。手足发冷史与 POAG患者的血流变化有密切关系。
Objective To study the changes of optic disc blood flow in patients with primary open angle glaucoma (POAG) after cold stimulation and taking calcium channel blockers. Methods The Heidelberg retinal flowmetry (HRF) was used to measure the blood flow of capillaries in POAG patients and normal individuals under basal conditions, finger cold stimulation test and nifedipine-containing nifedipine respectively. Results The mean vessel volume and average blood flow of optic disc in POAG patients decreased from 21.1 and 545.4 to 22.3 and 45.2.4 respectively (P <0.05) The mean volume of mean vasoconstriction and mean blood flow increased to 29.5 and 5 79.5 (P <0.05) after treatment with pyridine. In POAG patients with a history of hand-foot episodes of cold episodes, the mean decrease in optic disc blood flow was 137.2 under cold-excitation conditions and an average increase of optic disc blood flow was 196.4 after co-nifedipine treatment compared with POAG patients with no history of hand-foot episodes The difference was significant (P <0. 05). Conclusion The optic disc blood flow in patients with POAG decreased significantly after cold stimulation. Calcium channel blockers can improve real-time optic disc blood flow in some POAG patients. Hand-foot chills history and POAG patients with changes in blood flow are closely related.