目的:对早晨与晚间应用固定联合制剂拉坦前列素/噻吗洛尔(适利加),1次/d治疗开角型青光眼和高眼压症疗效及其安全性的比较。方法:本研究为前瞻性、观察性的临床研究,患者入组前先进行全面的眼科检查,并进行24h眼压测定,早晨开始应用固定联合制剂拉坦前列素/噻吗洛尔,1次/d,1mo后随访,测量其24h眼压曲线,记录就诊的观察结果及副作用。停用1wk后嘱患者改为晚间应用固定联合制剂拉坦前列素/噻吗洛尔,1次/d,应用1mo后再测量24h眼压曲线,记录就诊的观察结果及副作用,比较两次随访中24h眼压及副作用的差别。结果:本研究共入组32例患者,早晨组平均眼压(17.3±3.1mmHg)和晚间组平均眼压(17.1±2.7mmHg)均较基线眼压(21.1±3.3mmHg)降低(P<0.01)。在6∶00相比较,晚间组的平均眼压(16.4±2.3mmHg)较早晨组的平均眼压(17.9±2.8mmHg)明显降低(P<0.05)。晚间组应用固定联合制剂拉坦前列素/噻吗洛尔可以维持较低的白天眼压,早晨组应用固定联合制剂拉坦前列素/噻吗洛尔可以维持较低的夜间眼压。晚间应用固定联合制剂拉坦前列素/噻吗洛尔平均24h眼压波动(3.6±1.6mmHg),较早晨组(4.4±1.6mmHg)低(P<0.05)。两组副作用均无统计学差异(P>0.05)。结论:本研究显示早晨应用固定联合制剂拉坦前列素/噻吗洛尔与晚间应用固定联合制剂拉坦前列素/噻吗洛尔1次/d均能有效的降低24h眼压,患者的耐受性好,副作用少,但晚间应用固定联合制剂拉坦前列素/噻吗洛尔更能有效的维持24h眼压的稳定。

AIM:To evaluate the effect and safety of morning vs evening once daily of fixed combinations latanoprost/timolol maleate therapy in primary open angle glaucoma or in ocular hypertensive patients. METHODS:This study was prospective, observational clinial research. All ophthalmology examinations and 24 hours IOP testing were performed at the beginning of the study of latanoprost /timolol maleate.At 1 month follow-up, 24 hours IOP was tested and recorded the results and side effects. One week after stopping treatment, this was then changed to evening dosing once daily with fixed combinations of latanoprost/timolol maleate. After 1 month follow-up, 24 hours IOP was tested, the results and side effects were recorded. The IOP and side effects in two groups were then compared. RESULTS:Thirty-two patients completed this study. There was a significant reduction at each time point in the 24-hour diurnal curve of both morning (17.3±3.1mmHg) and evening (17.1±2.7mmHg) dosed patients, compared to the baseline IOP (21.1±3.3mmHg) (P<0.01). When the morning and evening dosing groups were compared directly, the 6∶00 time point was statistically lower with evening dosing (16.4±2.3mmHg) vs morning dosing (17.9±2.8mmHg) (P<0.05). A trend was observed, which indicated greater daytime reduction with night-time dosing, whereas morning dosing tended to give lower night-time pressure. There was a significantly lower mean range of diurnal pressure with evening (3.6±1.6mmHg) vs morning (4.4±1.6mmHg) dosing (P<0.05). There was no significant difference between two groups of side effects (P>0.05). CONCLUSION:This study suggests that fixed combinations latanoprost/timolol maleate both given once daily in the morning and evening can effectively reduce the IOP for the 24-hour diurnal curve and are well tolerated with few side effects. There is a significantly stable 24 hour IOP lowering in evening dosed fixed combinations of latanoprost /timolol maleate..

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