摘要
目的观察羟糖甘滴眼液联合维生素A棕榈酸酯凝胶治疗视网膜脱离术后干眼症的疗效。方法选取2017年3月至2019年12月海南医学院第二附属医院收治的82例(125眼)视网膜脱离术后干眼症患者进行前瞻性研究,按照简单随机化方法将患者分对照组(n=41,61眼)和观察组(n=41,64眼),对照组患者给予羟糖甘滴眼液,观察组患者在此基础上给予维生素A棕榈酸酯凝胶。比较两组患者的临床疗效、基础泪液分泌试验(SIt)、泪膜破裂时间(BUT)、角膜荧光素染色(FL)、眼表疾病指数量表评分(OSDI)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、Toll样受体4(TLR4)、过氧化脂质(LPO)、超氧化物歧化酶(SOD)、总抗氧化能力(TAC)、丙二醛(MDA)水平,采用Spearman相关性分析评价以上各指标与临床疗效的相关性。结果治疗后,观察组患者的总有效率、SIt、BUT、SOD、TAC分别为95.31%、(8.16±0.67) mm、(9.72±1.35) s、(0.16±0.04) mmol/L、(10.36±1.44) kU/L,高于对照组的80.33%、(6.95±0.73) mm、(7.08±1.12) s、(0.12±0.03) mmol/L、(7.25±1.12) kU/L,FL、OSDI评分、IL-1β、TNF-α、TLR4、LPO、MDA分别为(1.18±0.39) s、(6.59±1.12)分、(22.68±9.55) ng/L、(28.19±7.41) ng/L、(0.78±0.19)ng/L、(1.05±0.25)μmol/L、(1.69±0.32) U/L,低于对照组的(3.07±0.42) s、(12.88±2.67)分、(50.74±13.29) ng/L、(56.08±10.52) ng/L、(1.68±0.25) ng/L、(1.49±0.30)μmol/L、(3.72±0.58) U/L,差异均具有统计学意义(P<0.05);IL-1β(r=-0.382)、TNF-α(r=-0.497)、TLR4(r=-0.611)、LPO(r=-0.536)、MDA(r=-0.477)均与疗效呈负相关,SOD(r=0.515)、TAC(r=0.602)均与疗效呈正相关(P<0.05)。结论羟糖甘滴眼液联合维生素A棕榈酸酯凝胶治疗视网膜脱离术后干眼症,能有效缓解患者临床症状,提高泪膜稳定性,改善炎症反应和氧化应激,疗效显著。
Objective To observe the efficacy of Hydroxyglycan eye drops combined with Vitamin A palmitate gel in the treatment of dry eye after retinal detachment surgery.Methods A prospective study was conducted on 82 patients(125 eyes) with dry eye after retinal detachment who were admitted to the Second Affiliated Hospital of Hainan Medical College from March 2017 to December 2019,and they were randomly divided into the control group(n = 41,61 eyes) and the observation group(n = 41,64 eyes),The control group was given Hydroxyglycan eye drops,and the observation group was given Vitamin A palmitate gel on this basis.The clinical efficacy,Schirmer’s I-test(SIt),tear break up time(BUT),corneal fluorescein staining(FL),ocular surface disease index(OSDI) questionnaire,interleukin-1β(IL-β),tumor necrosis factor-α(TNF-α),Toll-like receptor 4(TLR4),lipid peroxide(LPO),superoxide dismutase(SOD),total antioxidant capacity(TAC),and malondialdehyde(MDA) levels of the two groups were compared,Spearman was used to analyze the correlation between the above indicators and efficacy.Results After treatment,the total effective rate,SIt,BUT,SOD,and TAC of the observation group were 95.31%,(8.16 ± 0.67) mm,(9.72 ± 1.35) s,(0.16 ± 0.04) mmol/L,(10.36 ± 1.44) KU/L,higher than those of the control group [80.33%,(6.95 ± 0.73)mm,(7.08 ± 1.12) s,(0.12 ± 0.03) mmol/L,(7.25 ± 1.12) k U/L],and FL,OSDI score,IL-1β,TNF-α,TLR4,LPO,and MDA were(1.18 ± 0.39) s,(6.59 ± 1.12) points,(22.68 ± 9.55) ng/L,(28.19 ± 7.41) ng/L,(0.78 ± 0.19) ng/L,(1.05 ± 0.25) μmol/L,(1.69 ±0.32) U/L,lower than those of the control group [(3.07 ±0.42) s,(12.88 ±2.67) points,(50.74 ±13.29) ng/L,(56.08 ±10.52) ng/L,(1.68 ± 0.25) ng/L,(1.49 ± 0.30) μmol/L,(3.72 ± 0.58) U/L],the differences were statistically significant(P< 0.05);IL-1β(r =-0.382),TNF-α(r =-0.497),TLR4(r =-0.611),LPO(r =-0.536),MDA(r =-0.477) were all negatively correlated with efficacy,SOD(r = 0.515) and TAC(r = 0.602) were positively correlated with efficacy(P< 0.05).Conclusion Hydroxyglycan eye drops combined with Vitamin A palmitate gel for the treatment of dry eyes after retinal detachment surgery can effectively alleviate clinical symptoms,improve tear film stability,improve inflammatory response and oxidative stress,and have significant effects.
作者
张虹
陈颖平
陈圣文
吴子东
ZHANG Hong;CHEN Ying-ping;CHEN Sheng-wen(Department of Ophthalmology,the Second Affiliated Hospital of Hainan Medical University,Haikou Hainan 570311,China)
出处
《临床和实验医学杂志》
2020年第15期1613-1617,共5页
Journal of Clinical and Experimental Medicine
基金
海南省卫生计生行业科研项目(编号:18A200169)。
关键词
干眼症
视网膜脱离术后
羟糖甘滴眼液
维生素A棕榈酸酯凝胶
炎症因子
氧化应激
Dry eye
After retinal detachment surgery
Hydroxyglycan eye drops
Vitamin A palmitate gel
Inflammatory factors
Oxidative stress
