摘要
目的评价不同体积分数自体血清局部应用治疗单纯疱疹病毒性角膜炎(herpes simplex keratitis,HSK)恢复期干眼的疗效。方法纳入2015年7月至2017年6月就诊的HSK进入恢复期合并干眼的患者69例69眼,随机分为3组:低浓度治疗组给予体积分数20%自体血清,高浓度治疗组给予体积分数50%自体血清,对照组给予重组人表皮生长因子眼液滴眼,均为每天4次。观察治疗前及治疗后7 d、14 d、28 d的眼表疾病指数(ocular surface disease index,OSDI)评分、泪液分泌试验(Schirmer’s I test,SIT)、泪膜破裂时间(break-up time,BUT)、角膜荧光素(fluorescence,FL)染色评分、角膜知觉、中央角膜厚度和角膜混浊度。结果两治疗组治疗后OSDI评分降低,患眼SIT值增加、BUT延长、FL染色评分降低(均为P<0.05),对照组患眼仅BUT延长(P<0.05),但程度明显低于两治疗组。两治疗组治疗后患眼角膜知觉逐渐恢复,至28 d时分别为治疗前的1.21倍和1.23倍,对照组为治疗前的1.08倍。两治疗组患眼角膜水肿减退、中央角膜厚度降低并在14~28 d恢复至正常值范围;对照组患眼中央角膜厚度也较治疗前降低(P<0.05),但降低程度明显低于两治疗组;两治疗组患眼角膜混浊度减轻(均为P<0.05),而对照组则无明显变化(P>0.05);两治疗组间各项指标差异均无统计学意义(均为P>0.05)。各组患者在治疗前健眼SIT、BUT、FL染色评分、角膜知觉、中央角膜厚度差异均无统计学意义(均为P>0.05),且均无角膜混浊,治疗后仅观察到两治疗组健眼SIT值增加、BUT延长(均为P<0.05),其余指标均无显著改变(均为P>0.05)。结论局部应用体积分数20%和体积分数50%自体血清均能有效缓解HSK恢复期干眼症状且疗效无明显差异。
Objective To evaluate the effect of different volume fractions of autologous serum （AS） on the dry eyes of convalescent herpes simplex keratitis （HSK）.Methods Totally 69 patients （69 dry eyes） of convalescent HSK in our hospital from July 2015 to June 2017 were enrolled and randomly divided into three groups.Patients were treated with 20% AS in low concentration therapy group,50% AS in high concentration therapy group,recombinant human epidermal growth factor eyedrops in control group and different eyedrops were administrated four times per day,respectively.Ocular surface disease index （OSDI）,Schirmer’s I test （SIT） value,tear break-up time（BUT）,fluorescence（FL） score,cornea perception,central cornea thickness （CCT）,degree of cornea opacity were observed before and 7 d,14 d,28 d after therapy.Results OSDI decreased in the two therapy groups.In the HSK eyes,SIT values were increased,BUT were prolonged,FL scores were decreased in two therapy groups （all P〈0.05）,while only BUT improvement was observed in control group（P〈0.05） and the range of improvement was lower.Cornea perception was recovered gradually after therapy and the values were 1.21-folds and 1.23-folds in therapy groups compared with the beginning of the study,however,the value was only 1.08-folds in control group.Corneal edema was relieved and CCT was reduced to normal range during 14 d to 28 d in therapy groups,the similar alternations were observed in control group（P〈0.05） and the extent was much lower.Cornea opacities were obviously improved in therapy groups （all P〈0.05） while there was little alternation in control group（P〉0.05）.All the indexes in HSK eyes indicated no significant difference between the two therapy groups （all P〉0.05）.Meanwhile,there were no difference of SIT values,BUT,FL scores,cornea perception,CCT in unaffected eyes in each group（all P〉0.05）.There’s no obvious cornea opacity in all unaffected eyes and only increasing SIT values and prolonging BUT were observed after therapy （all P〈0.05） and no significant alternations in other indexes（all P〉0.05）.Conclusion Both 20% AS and 50% AS can relieve the dry eyes of convalescent HSK with equivalent therapeutic effects.
作者
江丹
刘新泉
张殷建
阮雯洁
JIANG Dan;LIU Xin-Quan;ZHANG Yin-Jian;RUAN Wen-Jie
出处
《眼科新进展》
CAS
北大核心
2018年第8期746-750,共5页
Recent Advances in Ophthalmology
基金
国家自然科学基金项目(编号:81574028)
龙医学者项目(编号:LYTD-50)~~
