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目的:比较4％毛果芸香碱凝胶(pilocarpine gel,PG)和1％毛果芸香碱溶液(pilocarpine solution,PS)的降眼压效果及安全性。方法:20例(40只眼)高眼压症及早期原发性开角型青光眼患者,采用自身对照,分别比较PG(每晚一次)和PS(每天4次)对日间多次眼压的降眼压效应,分别比较二者连续4周用药对某一时点(10AM)的眼压、瞳孔及屈光度的影响,以及眼部副作用。结果:4％PG每晚1次用药,其有效降眼压时间可持续20小时,降眼压幅度达9.3％～13.8％,连续4周用药的10AM各时点的降眼压幅度为11.3％～17.6％;1％PS每天用药4次降眼压幅度达12.4％～16.2％,连续用药4周的10AM各时点降眼压幅度为17.4％～19.7％;二者差异无显著性意义。连续四周用药的10AM各时点的瞳孔缩小及近视屈光度增加,4％PG明显小于1％PS,应用4％PG亦很少主诉有视物模糊。结论:在降眼压效果方面,PG与PS相似;从用药方便性、患者依从性、对瞳孔及近视度的影响,PG较PS优越,值得推广作为临床替代PS多次用药的一种长效缓释药物剂型。眼科学报2000;16:77-80。
OBJECTIVE: To compare the IOP lowering effect and safety of 4% pilocarpine gel (PG) and 1% pilocarpine solution (PS). Methods: Twenty patients (40 eyes) with ocular hypertension and early primary open-angle glaucoma were compared with PG (once a night) and PS (4 times daily) IOP, IOP, IOP, pupil and diopter, and ocular side effects were compared between the two groups for 4 weeks. Results: 4% PG was administered once a night. The effective time of intraocular pressure reduction was 20 hours and the intraocular pressure was 9.3% ~ 13.8%. The intraocular pressure reduction of 10AM for 4 weeks was 11.3% ~ 17.6%. The intraocular pressure (IOP) ranged from 12.4% to 16.2% with 1% PS 4 times per day. The IOP decreased from 17.4% to 19.7% at 10 AM for 4 weeks. The difference was insignificant. 4:00 PG was significantly less than 1% PS, the application of 4% PG rarely complained of blurred vision. CONCLUSIONS: PG is similar to PS in terms of intraocular pressure reduction. PG is superior to PS in terms of ease of administration, patient compliance, pupil and myopia, and is worthy of promotion as a long-term clinical alternative to PS Release drug formulations. Ophthalmology 2000; 16: 77-80.