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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

36

期数:

2019年6

页码:

525-528

栏目:

临床研究

出版日期:

2019-06-05

文章信息/Info

Title:

Effect of recombinant human epidermal growth factor combined with carbomer eye gel in treatment of dry eye after phacoemulsification

作者:

陈伽俐; 窦晓燕; 李　林

（深圳市第二人民医院眼科，广东　深圳　518000）

Author(s):

CHEN Jia-li; DOU Xiao-yan; LI Lin

（Department of Ophthalmology，the Second People′s Hospital of Shenzhen，Shenzhen 518000，Guangdong Province，China）

关键词:

重组人表皮生长因子; 卡波姆凝胶; 超声乳化白内障吸除术; 干眼症

Keywords:

recombinant human epidermal growth factor; carbomer eye gel; phacoemulsification; dry eye

分类号:

R988.1

DOI:

10.7683/xxyxyxb.2019.06.006

文献标志码:

A

摘要:

目的　探讨重组人表皮生长因子（rhEGF）联合卡波姆凝胶治疗超声乳化白内障吸除术后干眼症的临床效果及其对泪液中肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平的影响。方法　选择2017年6月至2017年12月深圳市第二人民医院收治的超声乳化白内障吸除术后干眼症患者100例，根据治疗方法将患者分为观察组和对照组，每组50例。对照组患者均给予玻璃酸钠滴眼液，每次1滴，每日5次；并给予卡波姆凝胶，每次1滴，每日4次；观察组患者在对照组治疗的基础上给予rhEGF滴眼液，将rhEGF滴眼液滴入眼结膜囊内，每次1～2滴，每日4次；2组患者均连续治疗4周。2组患者分别于治疗前、后测定基础泪液分泌（SIT）、角膜荧光素染色（FLS）评分、泪膜破裂时间（BUT）和泪液中TNF-α、IL-6水平，分别于治疗前和治疗后2、4周进行干眼症状评分，于治疗后4周比较2组患者的临床疗效。结果　治疗前2组患者的SIT、FLS评分及BUT比较差异均无统计学意义（P>0.05）；与治疗前比较，2组患者治疗后SIT、BUT显著升高，FLS评分显著降低（P<0.01）；治疗后，观察组患者SIT、BUT显著高于对照组，FLS评分显著低于对照组（P<0.01）。治疗前2组患者干眼症状评分比较差异无统计学意义（P>0.05），2组患者治疗后2、4周干眼症状评分均显著低于治疗前（P<0.01），2组患者治疗后4周干眼症状评分显著低于治疗后2周（P<0.01）；治疗后2、4周，观察组患者干眼症状评分均显著低于对照组（P<0.01）。观察组和对照组患者治疗总有效率分别为94.0%（47/50）、78.0%（39/50），观察组患者治疗总有效率显著高于对照组（χ²=4.070，P<0.05）。治疗前2组患者泪液中TNF-α和IL-6水平比较差异无统计学意义（P>0.05），2组患者治疗后泪液中TNF-α和IL-6水平显著低于治疗前（P<0.01）；治疗后，观察组患者泪液中TNF-α和IL-6水平显著低于对照组（P<0.01）。结论　rhEGF联合卡波姆凝胶治疗超声乳化白内障吸除术后干眼症的效果显著，可能是通过降低患者体内TNF-α和IL-6水平而发挥治疗作用。

Abstract:

Objective　To investigate the effect of recombinant human epidermal growth factor （rhEGF） combined with carbomer eye gel in treatment of dry eye after phacoemulsification and its effect on the levels of tumor necrosis factor-α（TNF-α） and interleukin-6（IL-6） in tear.Methods　One hundred patients with dry eyes after phacoemulsification in the Second People′s Hospital of Shenzhen from June 2017 to December 2017 were selected and divided into control group and observation group according to the treatment method，with 50 patients in each group.All patients in the control group were given sodium hyaluronate eye drops，one drop each time，5 times a day and carbomer gel，one drop each time，4 times a day.Based on the treatment of the control group,the patients in the observation group were given rhEGF eye drops.The rhEGF eye drops were injected into the conjunctival sac，4 times a day，1-2 drops each time.All patients were treated for 4 weeks.The schirmerⅠtest （SIT），fluorescein vital staining （FLS） score，tear film rupture time （BUT） and the levels of TNF-α and IL-6 in tear were detected before and after treatment.The dry eye symptom scores of patients were compared between the two groups before treatment and 2，4 weeks after treatment；the clinical effect were compared between the two groups at four weeks after treatment.Results　There was no statistic difference in the SIT，FLS score and BUT between the two groups before treatment （P>0.05）.Compared with that before treatment，the SIT and BUT were significantly increased and FLS score was significantly decreased in the two groups after treatment （P< 0.01）.After treatment，the SIT and BUT of patients in the observation group were significantly higher than those in the control group，and the FLS score was significantly lower than that in the control group （P< 0.01）.There was no significant difference in the dry eye symptom score between the two groups before treatment （P>0.05）；the dry eye symptom scores of patients in the two groups at 2，4 weeks after treatment were significantly lower than those before treatment （P<0.01）；the dry eye symptom scores of patients at 4 weeks after treatment was significantly lower than those at 2 weeks after treatment （P<0.01）；at 2，4 weeks after treatment，the dry eye symptom score of patients in the observation group was significantly lower than that in the control group （P<0.01）.The total effective rate of patients in the observation group and control group was 94.0%(47/50) and 78.0%(39/50) respectively；the total effective rate of patients in the observation group was significantly higher than that in the control group（χ²=4.070，P<0.05）.There was no significant difference in the levels of TNF-α and IL-6 in tears between the two groups before treatment（P>0.05）；the levels of TNF-α and IL-6 in tears of patients in the two groups after treatment were significantly lower than those before treatment （P<0.01）；after treatment，the levels of TNF-α and IL-6 in tears of patients in the observation group were significantly lower than those in the control group （P<0.01）.Conclusion　rhEGF combined with carbomer eye gel is effective in treating dry eye after phacoemulsification cataract extraction.It may play a therapeutic role by decreasing the levels of TNF- and IL-6 in patients.

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更新日期/Last Update: 2019-06-05