目的：观察长春胺缓释胶囊治疗非动脉炎性前部缺血性视神经病变的临床疗效及安全性。

方法：将2015-01/09来我院就诊的急性期发病的单眼非动脉炎性前部缺血性视神经病变(non-arteritic ischemic optic neuropathy， NAION)患者42例42眼，随机分为对照组(15例15眼)、治疗组(27例27眼)，所有患者均给予大剂量激素(甲基强的松龙500～1 000mg)、维生素B1、甲钴胺片营养神经治疗的同时，治疗组给予长春胺缓释胶囊口服治疗，30mg/次，每天2次，疗程为3mo。观察比较两组患眼治疗前后最佳矫正视力(best corrected visual acuity， BCVA)、平均视野缺损(mean deviation， MD)、平均盘周神经纤维层厚度(retinal nerve fiber layer， RNFL)、视网膜神经节细胞复合体厚度(ganglion cell complex， GCC)、图形视觉诱发电位(pattern visual evoked potential， PVEP)P100波潜伏期及振幅等变化。

结果：治疗后，治疗组患眼视力治疗有效率较对照组高； 治疗组与对照组患眼MD均较治疗前降低，差异有统计学意义(t=2.342、2.692，P=0.027、0.041)。治疗后，治疗组与对照组PVEP振幅较治疗前均未见明显变化，差异无统计学意义(t=1.952、1.840，P=0.062、0.089)； 治疗组与对照组PVEP潜时值与治疗前比较无统计学差异(t=2.018、1.301，P=0.054、0.216)； 治疗组与对照组盘周神经纤维层厚度、神经节细胞复合体厚度都比治疗前变薄，差异均有统计学意义(P<0.001)，对照组萎缩程度更严重。两组治疗均有效，治疗组效果优于对照组。尚未发现与长春胺缓释胶囊的口服治疗相关的不良事件发生。

结论：长春胺缓释胶囊治疗NAION具有较好的临床疗效及安全性，能够起到辅助治疗、减少视神经损伤的作用。

METHODS:Patients who were diagnosed with monocular onset NAION in acute stage from January to September 2015 were divided into two groups. Routine treatment such as steroid pulse therapy and neurotrophic treatment were given to all the patients. Vincamine was added to the treatment group patients with 30mg twice a day for 3mo. The best corrected visual acuity(BCVA), mean deviation(MD)of visual field, retinal nerve fiber layer(RNFL), ganglion cell complex(GCC), pattern visual evoked potential(PVEP)and OCT results were analyzed before and after the treatment.

RESULTS: Totally 42 eyes of 42 patients were enrolled in our study. There were 27 patients in the treatment group, aged from 33 to 79 years old, the average value was 55.55±11.83 years old. The control group has 15 patients, aged from 40 to 70 years old, the average value was 55.71±10.06 years old. There were no statistical differences between the two groups in the baseline. After 3mo of the treatment, MD value of the two groups were lower compared with the baseline, the difference was statistically significant in the treatment and control group respectively(t=2.342, 2.692; P=0.027, 0.041). The difference of PVEP amplitude and potential of the two groups before and after the treatment were not statistically significant. The thickness of retinal nerve fiber layer and the ganglion cell complex were all lower than the baseline, and the difference was statistically significant(P<0.001). The treatment of the two groups were both effective, the treatment group has better treatment effect than the control group. Adverse events related to the treatment of vincamine had not been found.

CONCLUSION: Vincamine is helpful in the treatment of non-arteritic anterior ischemic optic neuropathy.