山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (4): 5-10.doi: 10.6040/j.issn.1673-3770.1.2020.048

• 眼缺血综合征多学科精准诊疗 专家笔谈 • 上一篇    下一篇

溶栓治疗在视网膜动脉阻塞中的应用进展

杨明综述魏文斌审校   

  1. 杨明 综述 魏文斌 审校 首都医科大学附属北京同仁医院/北京同仁眼科中心/眼内肿瘤诊治研究北京市重点实验室/北京市眼科学与视觉科学重点实验室/医学人工智能研究与验证工信部重点实验室, 北京 100730
  • 收稿日期:2019-05-26 出版日期:2020-07-20 发布日期:2020-08-28
  • 基金资助:
    国家自然科学基金(81570891);北京市自然科学基金(7151003);北京市医院管理局“登峰”人才培养计划(DFL20150201);北京市卫生系统高层次卫生技术人才培养计划(2014-2-003);首都卫生发展科研专项(首发2016-1-2051);北京市医院管理局临床医学发展专项经费资助(扬帆计划)(ZYLX201307);北京市科委科技计划项目(Z181100001818003,Z151100001615052)

Application progress of thrombolysis in retinal artery occlusionYANG Ming Overview WEI Wenbin Guidance Beijing Tongren Hospital, Capital Medical University / Beijing Tongren Eye Center / Beijing key Laboratory of Intraocular Tumor Diagnosis and Treatment / Beijing Ophthalmology&Visual Sciences Key Lab / Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing 100730, ChinaAbstract:

Central retinal artery occlusion(CRAO)is the most common cause of acute vision loss. Thrombolysis is a more radical treatment than conservative treatment, including arterial thrombolysis and intravenous thrombolysis, as well as the combination therapy of thrombolysis and other therapies. Thrombolysis treatment can improve the visual acuity of CRAO patients, but because of its lack of randomized controlled trials, further clinical studies are needed to determine their efficacy and safety. Our review summarized the application progress of thrombolysis in recent ten years, further evaluated its safety and effectiveness, and provided an evidence for clinical application.   

  1. Key words: Thrombolysis;
    Retinal artery occlusion/therapy;
    Arterial thrombolysis;
    Intravenous thrombolysis视网膜动脉阻塞是类似于脑卒中的临床眼科急症, 其发病原因可能是栓子栓塞、血栓形成、动脉痉挛及受压等, 每年发病率约1/100 000［1］, 临床表现为突发单眼无痛的视觉丧失, 如果不及时进行临床干预, 约80%的患者进展到视力为20/400或更低［2］, RAO最常见的原因是栓子栓塞视网膜动脉, 溶栓治疗即激发纤溶系统, 将包裹于原发性栓子的血性栓塞物及单纯性血栓溶解而使栓子变小甚至消失, 最大减少缺血受损范围［3］, 既往的研究表明, 视力恢复的程度往往与发生视网膜缺血的总时间相关。Hayreh等［4］报道, 当视网膜缺血时间超过4 h, 视网膜组织RGC细胞会发生不可逆的形态学变化, 随着缺血时间增加, 视功能及神经组织的损害更严重。
  • Received:2019-05-26 Online:2020-07-20 Published:2020-08-28

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摘要： 视网膜动脉阻塞是引起急性视力下降的眼科常见疾病, 溶栓治疗属于相对于保守治疗外较激进的治疗方法, 包括动脉溶栓和静脉溶栓, 以及溶栓与其他疗法的联合治疗, 溶栓治疗虽能提高患者视力, 但是因为其并存的风险以及缺少大样本前瞻随机对照研究而一直不能为临床提供有力的证据, 综述近十年国内外关于溶栓治疗的研究进展, 进一步评估其安全性和有效性, 为临床应用提供理论依据。

关键词: 溶栓治疗, 视网膜动脉阻塞, 动脉溶栓, 静脉溶栓

Abstract: Central retinal artery occlusion(CRAO)is the most common cause of acute vision loss. Thrombolysis is a more radical treatment than conservative treatment, including arterial thrombolysis and intravenous thrombolysis, as well as the combination therapy of thrombolysis and other therapies. Thrombolysis treatment can improve the visual acuity of CRAO patients, but because of its lack of randomized controlled trials, further clinical studies are needed to determine their efficacy and safety. Our review summarized the application progress of thrombolysis in recent ten years, further evaluated its safety and effectiveness, and provided an evidence for clinical application.

Key words: Thrombolysis, Retinal artery occlusion/therapy, Arterial thrombolysis, Intravenous thrombolysis

中图分类号: 

  • R765.21
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