方法：将我院2012-01/2014-06急性视神经炎住院患者70例70眼随机分组，观察组35例给予前列地尔10μg入10mL生理盐水缓慢静推，1次/d，7d为一疗程； 对照组35例给予10mL生理盐水缓慢静推。此外，两组均给予甲基强的松龙20mg患眼球旁注射，每3d注射1次，共3次； 甲基强的松龙800～1000mg静滴3d，1次/d； 3d后改为醋酸泼尼松口服，1mg/(kg·d)，1wk后每周减量5mg至停药； 口服盐酸雷尼替丁胶囊、碳酸钙D₃片等支持治疗。观察两组患者治疗后的疗效差异。

结果：观察组中，显效25例(71.4%)，有效7例(20.0%)，无效3例(8.6%)，总有效率91.4%。对照组中，显效15例(42.9%)，有效14例(40.0%)，无效6例(17.1%)，总有效率82.9%。观察组与对照组的总有效率差异无统计学意义(P=0.477)，但观察组显效率高于对照组，差异有统计学意义(χ²=5.833，P=0.016)。

结论：前列地尔联合糖皮质激素治疗急性视神经炎临床疗效显著，值得推广。

METHODS: Seventy patients(70 eyes)with AON from January, 2012 to June, 2014 were randomly divided into two groups. 35 patients in observation group were used 10ug alprostadil with 10mL normal saline(NS)by intravenous injection, once/d for 7d/one treatment course, and 10mL NS was used by intravenous injection in 35 patients of control group. Besides, the two groups were treated with the combined therapy as follows: 20mg methylprednisolone was injected periglomerularly beside the eyeballs, once /3d for 3 times; 800～1 000mg of methylprednisolone through intravenous drip for 3d, once/d; after 3d, oral administration of prednisone acetate for 1wk, 1mg/(kg·d); after 1wk, the dose decreased to 5mg/wk until withdraw. Simultaneously, oral administration of ranitidine capsules, calcium carbonate and vitamin D₃ tablets were combined in the supportive treament. The differences of curative effect between two groups were comparatively analyzed.

RESULTS: In the observation group, 25 eyes(71.4%)were markedly effective, 7 eyes(20.0%)were valid and 3 eyes(8.6%)were invalid, and the total effective rate was 91.4%. In the control group, 15 eyes(42.9%)were markedly effective, 14 eyes(40.0%)were valid and 6 eyes(17.1%)were invalid, and the total effective rate was 82.9%. The difference of total effective rate between the two groups was not statistically significant(P=0.477), but there was a significant difference in markedly effective rate between the two groups(χ²=5.833, P=0.016).

CONCLUSION: Alprostadil combined with glucocorticoids is effective for AON, and it is worth of advocation.