ACCELERATED REPERFUSION OF POORLY PERFUSED RETINAL AREAS IN CENTRAL RETINAL ARTERY OCCLUSION AND BRANCH RETINAL ARTERY OCCLUSION AFTER A SHORT TREATMENT WITH ENHANCED EXTERNAL COUNTERPULSATION
ACCELERATED REPERFUSION OF POORLY PERFUSED RETINAL AREAS IN CENTRAL RETINAL ARTERY OCCLUSION AND BRANCH RETINAL ARTERY OCCLUSION AFTER A SHORT TREATMENT WITH ENHANCED EXTERNAL COUNTERPULSATION
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DOI：
10.1097/00006982-200408000-00006
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发表时间：
2004-08
期刊：
影响因子：
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通讯作者：
D. Werner;F. Michalk;J. Harazny;C. Hugo;W. Daniel;G. Michelson
中科院分区：
文献类型：
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作者：
D. Werner;F. Michalk;J. Harazny;C. Hugo;W. Daniel;G. Michelson
背景：迄今为止，急性视网膜中央动脉闭塞（CRAO）或视网膜分支动脉闭塞（BRAO）患者没有令人满意的治疗方法。增强体外反搏（EECP）是一种新的无创手术，可以增加内脏器官的灌注。在目前的研究中，作者测量了EECP对缺血视网膜组织再灌注的影响。方法：在一项前瞻性随机研究中，纳入20例CRAO或BRAO患者。10例患者给予血液稀释治疗和2小时EECP， 10例患者仅给予常规血液稀释治疗。采用扫描激光多普勒血流仪（任意单位）定量观察视网膜灌注变化。结果：体外反搏增强无明显不良反应。EECP后视网膜缺血区域的灌注立即显著增加（57±19个任意单位对99±14个任意单位）。相比之下，未接受EECP治疗的组无变化（83±19任意单位对89±44任意单位）。48h后，两组缺血视网膜灌注均明显增加，两组间灌注无明显差异。结论：目前的研究表明，EECP可能是一种临床有效且安全的治疗CRAO或BRAO患者的方法，可以加速视网膜缺血区域的灌注恢复。
Background: To date, no satisfactory therapy has become available for patients with acute central retinal artery occlusion (CRAO) or branch retinal artery occlusion (BRAO). Enhanced external counterpulsation (EECP) is a new noninvasive procedure that increases perfusion of inner organs. In the current study, the authors measured the impact of EECP on reperfusion in ischemic retinal tissue. Methods: In a prospective, randomized study, 20 patients with CRAO or BRAO were included. Ten patients were given hemodilution therapy and 2 hours of EECP, and 10 patients were given regular hemodilution therapy only. Quantification of changes in retinal perfusion was carried out by means of scanning laser Doppler flowmetry (in arbitrary units). Results: Enhanced external counterpulsation caused no observable adverse events. A significant increase in perfusion occurred immediately after EECP in the ischemic retinal areas (57 ± 19 arbitrary units versus 99 ± 14 arbitrary units). In contrast, no change was measured in the group not treated with EECP (83 ± 19 arbitrary units versus 89 ± 44 arbitrary units). Forty-eight hours later, a significant increase in perfusion could be shown in the ischemic retina of both groups, and no significant difference of perfusion was found between the two groups any longer. Conclusion: The current study suggests that EECP could be a clinically useful and safe procedure in patients with CRAO or BRAO to accelerate recovery of perfusion in ischemic retinal areas.