贝复舒滴眼液联合玻璃酸钠滴眼液治疗白内障术后角膜水肿的临床效果
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摘要
目的观察贝复舒滴眼液联合玻璃酸钠滴眼液治疗白内障术后角膜水肿的临床效果。方法 2014年1月—2016年1月选择在北京市顺义区妇幼保健院诊治的白内障术后角膜水肿患者78例,根据随机信封抽签原则分为观察组与对照组各39例,对照组给予玻璃酸钠滴眼液治疗,观察组给予贝复舒滴眼液联合玻璃酸钠滴眼液治疗,两组都连续治疗观察4周。比较两组临床疗效、治疗前后视力状况、并发症情况及炎症因子白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平。结果治疗后观察组的有效率(98.7%)明显高于对照组(88.5%),差异有统计学意义(P<0.05)。治疗后观察组与对照组的视力明显好于治疗前,同组治疗前后比较差异有统计学意义(P<0.05);同时观察组治疗后的视力明显好于对照组,差异有统计学意义(P<0.05)。观察组治疗期间的新生血管性青光眼、瞳孔区模性渗出、玻璃体积血等并发症发生率为7.7%,对照组为9.0%,两组对比无明显差异。治疗后观察组的泪液IL-6和TNF-α含量明显低于治疗前,同组治疗前后比较差异有统计学意义(P<0.05);同时治疗后观察组的泪液IL-6和TNF-α含量明显低于对照组,差异有统计学意义(P<0.05)。结论贝复舒滴眼液联合玻璃酸钠滴眼液治疗白内障术后角膜水肿能抑制泪液中炎症因子的表达,具有很好的安全性,从而提高治疗疗效与改善视力。
Objective To observe the clinical efficacy of sodium hyaluronate drops combined with Bei Fu Shu drops in the treatment of corneal edema after cataract surgery.Methods From January 2014 to January 2016,78 patients with corneal edema after cataract surgery in our hospital for treatment were selected as the research object,all the patients were divided into observation group and control group with 39 cases in each group accorded to the random draw envelope principle.The control group was given sodium hyaluronate drops treatment,the observation group was given Bei Fu Shu drops based in the treatment of the control group,all the patients were treated for 4 weeks.Results After treatment,the effective rate of the observation group and the control group were 98.7% and 88.5% respectively,and the effective rate of the observation group was significantly higher than that of the control group(P < 0.05).After treatment,the visual acuity of the observation group and the control group were significantly better than that before treatment(P < 0.05),and the visual acuity in the observation group after treatment was better than that of the control group(P< 0.05).The complication rate of neovascular glaucoma,pupillary zone effusion and vitreous hemorrhage in the observation group during treatment was 7.7%,so that was 9% in the control group.After treatment,the IL-6 and TNF-α contents of tear in the two groups were significantly lower than that before treatment(P < 0.05),and the IL-6 and IL-6 and TNF-α contents of tear after treatment in the observation group was significantly lower than the control group(P < 0.05).Conclusion Sodium hyaluronate drops combined with Bei Fu Shu drops in the treatment of corneal edema after cataract surgery can inhibit the expression of inflammatory factors in tears and has good safety,which can improve the therapeutic effect and improve the visual acuity.
Objective To observe the clinical efficacy of sodium hyaluronate drops combined with Bei Fu Shu drops in the treatment of corneal edema after cataract surgery.Methods From January 2014 to January 2016,78 patients with corneal edema after cataract surgery in our hospital for treatment were selected as the research object,all the patients were divided into observation group and control group with 39 cases in each group accorded to the random draw envelope principle.The control group was given sodium hyaluronate drops treatment,the observation group was given Bei Fu Shu drops based in the treatment of the control group,all the patients were treated for 4 weeks.Results After treatment,the effective rate of the observation group and the control group were 98.7% and 88.5% respectively,and the effective rate of the observation group was significantly higher than that of the control group(P < 0.05).After treatment,the visual acuity of the observation group and the control group were significantly better than that before treatment(P < 0.05),and the visual acuity in the observation group after treatment was better than that of the control group(P< 0.05).The complication rate of neovascular glaucoma,pupillary zone effusion and vitreous hemorrhage in the observation group during treatment was 7.7%,so that was 9% in the control group.After treatment,the IL-6 and TNF-α contents of tear in the two groups were significantly lower than that before treatment(P < 0.05),and the IL-6 and IL-6 and TNF-α contents of tear after treatment in the observation group was significantly lower than the control group(P < 0.05).Conclusion Sodium hyaluronate drops combined with Bei Fu Shu drops in the treatment of corneal edema after cataract surgery can inhibit the expression of inflammatory factors in tears and has good safety,which can improve the therapeutic effect and improve the visual acuity.
引文
[1]孙晓楠,肖格格,冯云,等.角膜移植术后病毒性角膜内皮炎与内皮型排斥反应的临床特征[J].中华实验眼科杂志,2016,34(11):1002-1007.
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[4]彭艳阳,吴伟,曾丽娜,等.重组人表皮生长因子和碱性成纤维生长因子促进人角膜上皮细胞的增殖[J].中国组织工程研究,2014,7(11):1045-1050.
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[7]王涛.贝复舒滴眼液联合典必殊滴眼液治疗白内障超声乳化术后角膜水肿的临床效果观察[J].浙江创伤外科,2016,21(01):51-53.
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[9]Bao X,Hou M,Peng R,et al.Expression of dominant negative K6W-ubiquitin in the lens epithelium via an adenoviral vector delays posterior capsule opacification in a rabbit model[J].Curr Mol Med,2017,5(31):670-677.
[10]吴丝雨,廖桂仪,黄心瑜,等.自制阿昔洛韦地塞米松混合滴眼液治疗61例病毒性角膜基质炎的疗效分析[J].上海医药,2016,37(21):3-5,9.
[11]闫韬.白内障超声乳化术后重度角膜水肿疗效对比分析[J].基层医学论坛,2016,20(30):4330-4331.
[12]Benoist D'azy C,Benoist D'azy C,Gabison E,et al.Descemet's membrane endothelial keratoplasty(DMEK):Analysis of a variation in Descemet's endothelial graft preparation[J].J Fr Ophtalmol,2017,12(17):30134-30141.
[13]Sitoula R P,Sarkar I,Nayak D,et al.Lens induced glaucoma:An experience in tertiary eye care center in eastern Nepal[J].Nepal J Ophthalmol,2016,8(16):161-166.
[14]林少斌,洪永州,罗燕珊,等.晶状体囊张力环在超声乳化白内障吸除术治疗晶状体半脱位中的临床效果研究[J].中华眼科医学杂志(电子版),2015,13(01):14-17.
[15]Mikkelsen L H,Hamoudi H,Gül C A,et al.Corneal Toxicity Following Exposure to Asclepias Tuberosa[J].Open Ophthalmol J,2017,31(11):1-4.
[16]Iovieno A,Neri A,Soldani A M,et al.Descemetorhexis Without Graft Placement for the Treatment of Fuchs Endothelial Dystrophy:Preliminary Results and Review of the Literature[J].Cornea,2017,36(6):637-641.
[17]邵玉妹,杨建,吴兵.高渗葡萄糖在白内障术后角膜水肿的疗效分析[J].国际眼科杂志,2015,8(02):329-330.
[18]Chou S F,Lee C H,Lai J Y.Bioengineered keratocyte spheroids fabricated on chitosan coatings enhance tissue repair in a rabbit corneal stromal defect model[J].J Tissue Eng Regen Med,2017,5(9):2456-2461.
[19]Kymionis G,Oikonomakis K,Petrelli M,et al.Treatment of anterior corneal scarring,following DSAEK graft failure,with combined graft exchange and phototherapeutic keratectomy[J].Eye Vis(Lond),2017,4(4):12.
[20]叶兴桥.糖皮质激素治疗角膜异物剔除术后角膜水肿的疗效及安全性观察[J].临床眼科杂志,2015,13(04):339-340.
[21]Malaisse J,Bourguignon V,De Vuyst E,et al.Hyaluronan metabolism in human keratinocytes and atopic dermatitis skin is driven by a balance of hyaluronan synthases 1 and3[J].J Invest Dermatol,2014,134(8):2174-2182.
[2]Fayed AAE.Ultrasound biomicroscopy value in evaluation of restoration of ciliary muscles contractility after cataract extraction[J].Clin Ophthalmol,2017,4(11):855-859.
[3]Shajari M,Rafiezadeh P,Pavlovic I,et al.Management of Interface Fluid Syndrome After LASIK by Descemet Membrane Endothelial Keratoplasty in a Patient With Fuchs'Corneal Endothelial Dystrophy[J].J Refract Surg,2017,33(5):347-350.
[4]彭艳阳,吴伟,曾丽娜,等.重组人表皮生长因子和碱性成纤维生长因子促进人角膜上皮细胞的增殖[J].中国组织工程研究,2014,7(11):1045-1050.
[5]Moloney G,Petsoglou C,Ball M,et al.Descemetorhexis Without Grafting for Fuchs Endothelial DystrophySupplementation With Topical Ripasudil[J].Cornea,2017,36(6):642-648.
[6]Tryland M,Romano J S,Marcin N,et al.Cervid herpesvirus 2 and not Moraxella bovoculi caused keratoconjunctivitis in experimentally inoculated semi-domesticated Eurasian tundra reindeer[J].Acta Vet Scand,2017,59(1):23.
[7]王涛.贝复舒滴眼液联合典必殊滴眼液治疗白内障超声乳化术后角膜水肿的临床效果观察[J].浙江创伤外科,2016,21(01):51-53.
[8]López-García J S,García-Lozano I,Rivas L,et al.Autologous serum eye drops diluted with sodium hyaluronate:clinical and experimental comparative study[J].Acta Ophthalmol,2014,92(1):22-29.
[9]Bao X,Hou M,Peng R,et al.Expression of dominant negative K6W-ubiquitin in the lens epithelium via an adenoviral vector delays posterior capsule opacification in a rabbit model[J].Curr Mol Med,2017,5(31):670-677.
[10]吴丝雨,廖桂仪,黄心瑜,等.自制阿昔洛韦地塞米松混合滴眼液治疗61例病毒性角膜基质炎的疗效分析[J].上海医药,2016,37(21):3-5,9.
[11]闫韬.白内障超声乳化术后重度角膜水肿疗效对比分析[J].基层医学论坛,2016,20(30):4330-4331.
[12]Benoist D'azy C,Benoist D'azy C,Gabison E,et al.Descemet's membrane endothelial keratoplasty(DMEK):Analysis of a variation in Descemet's endothelial graft preparation[J].J Fr Ophtalmol,2017,12(17):30134-30141.
[13]Sitoula R P,Sarkar I,Nayak D,et al.Lens induced glaucoma:An experience in tertiary eye care center in eastern Nepal[J].Nepal J Ophthalmol,2016,8(16):161-166.
[14]林少斌,洪永州,罗燕珊,等.晶状体囊张力环在超声乳化白内障吸除术治疗晶状体半脱位中的临床效果研究[J].中华眼科医学杂志(电子版),2015,13(01):14-17.
[15]Mikkelsen L H,Hamoudi H,Gül C A,et al.Corneal Toxicity Following Exposure to Asclepias Tuberosa[J].Open Ophthalmol J,2017,31(11):1-4.
[16]Iovieno A,Neri A,Soldani A M,et al.Descemetorhexis Without Graft Placement for the Treatment of Fuchs Endothelial Dystrophy:Preliminary Results and Review of the Literature[J].Cornea,2017,36(6):637-641.
[17]邵玉妹,杨建,吴兵.高渗葡萄糖在白内障术后角膜水肿的疗效分析[J].国际眼科杂志,2015,8(02):329-330.
[18]Chou S F,Lee C H,Lai J Y.Bioengineered keratocyte spheroids fabricated on chitosan coatings enhance tissue repair in a rabbit corneal stromal defect model[J].J Tissue Eng Regen Med,2017,5(9):2456-2461.
[19]Kymionis G,Oikonomakis K,Petrelli M,et al.Treatment of anterior corneal scarring,following DSAEK graft failure,with combined graft exchange and phototherapeutic keratectomy[J].Eye Vis(Lond),2017,4(4):12.
[20]叶兴桥.糖皮质激素治疗角膜异物剔除术后角膜水肿的疗效及安全性观察[J].临床眼科杂志,2015,13(04):339-340.
[21]Malaisse J,Bourguignon V,De Vuyst E,et al.Hyaluronan metabolism in human keratinocytes and atopic dermatitis skin is driven by a balance of hyaluronan synthases 1 and3[J].J Invest Dermatol,2014,134(8):2174-2182.