无环鸟苷联合干扰素，双氯芬酸钠治疗单纯疱疹病毒性角膜炎

目的：观察无环鸟苷联合干扰素,双氯芬酸钠治疗单纯疱疹病毒性角膜炎的效果。方法：对160例（186眼）患者随机分为治疗组80例（97眼）和对照组80例（89例）治疗组患者滴0．1％无环鸟苷滴眼液,重组干扰素α1b滴眼液（10μg/ml）、0．1％双氯芬酸钠滴眼液,对照组滴用0．1％无环鸟苷滴眼液,结果：治疗组治愈率（91．75％）,对照治愈率（75．28％）经统计学处理,差异有显著意义（P＜0．01）;治疗组有效率（96．90％,对照组有效率（88．75％）,差异有显著意义（P＜0．05）,结论：无环鸟苷联合干扰素,双氯芬酸钠治疗单纯疱疹病毒性角膜炎疗效肯定,治愈率高,是合理安全的用药方法。     

无环鸟苷和单克隆抗体治疗实验性单疱病毒性角膜炎

以ＢＡＬＢ／Ｃ小鼠ＨＳＫ为动物模型，应用地环鸟环苷（ＡＣＶ）和单克隆抗体在接种病毒后不同时间开始点眼治疗，观察对角膜炎的疗效。各治疗组与对照组相比较有显著疗效，接种病毒后同一时间开始治疗，ＡＣＶ与ＭｃＡｂ对角膜病变的疗效相似，１小时开始治疗组上皮病变明显轻于２４小时开始治疗组，此外，ＡＣＶ治疗组角膜新生血管减少。     

无环鸟苷抑制小鼠单纯疱疹性角膜炎潜伏病毒激活作用的研究

目的 证实无环鸟苷能够作用于潜伏单郊病毒的激活阶段,抑制病毒活化。方法 以Ｂａｌｂ／ｃ小鼠作为潜伏感染模型,以紫外线Ｂ照射为激活条件,治疗组给予无环鸟苷口服,停药后１天处死动物检测活化病毒。结果 治疗组３０例中无１例,而对照组３０例中有１２例检测出活化病毒（Ｐ〈０．０１）;治疗至照射后２天的１０只鼠无１例,而相应对照组１０只中６例检出活化病毒（Ｐ〈０．０１）。结论 预防性应用ＡＶＣ特异作用于病毒激活期,有效的抑制病毒活化。     

无环鸟苷及滴宁联合治疗单纯疱疹性角膜炎

单纯疱疹性角膜炎是由单纯疱疹病毒感染引起的眼科常见疾病，是一种严重的致盲性眼病，其发病率和致盲率均占角膜病首位。我院2001年2月～2004年10月以来，采用无环鸟苷及滴宁(重组人干扰素α1b滴眼液)联合治疗单纯疱疹性角膜炎，效果满意，现报告如下。     

抗疱疹病毒药物的联合应用

研究了五个抗疱疹病毒药物联合应用对HSV-1的作用,并用图表法和FIC指数进行评价。结果表明:ACV/CC,DHPG/CC联合呈现协同作用;TDA/CC,PFA/CC,DHPG/TDA,ACV/TDA,ACV/PFA,ACV/DHPG联合应用呈现不同程度的相加作用;无任一联合表现拮抗或干扰作用。     

目炎灵滴眼剂治疗实验性单纯疱疹病毒性角膜炎

用中药目炎灵眼药水滴眼治疗兔实验性单纯疱疹病毒性角膜炎。结果“治疗６天角膜病变保护率达４６．５％。治疗１０天保护率与无环鸟苷相同达９６％。该药对角膜炎有一定治疗作用，对深层角膜炎疗效更明显，而且无刺激性，无毒副作用。     

丹参、无环鸟苷联合治疗急性视网膜坏死

目的：为了探讨急性视网膜坏死（ａｃｕｔｅ ｒｅｔｉｎａｌ ｎｅｃｒｏｓｉｓ,ＡＲＮ）的有效疗法。方法：对６例（８只眼）ＡＲＮ患者采用丹参、无环鸟苷（ａｃｙｃｌｏｖｉｒ,ＡＣＶ）联合治疗。结果：随访６￣１８个月,７只眼视力有不同程度提高,视力提高达８８．８％。结论：丹参、ＡＣＶ联合应用是治疗ＡＲＮ的一和中有效方法。     

更昔洛韦对比阿昔洛韦治疗单纯疱疹病毒性角膜炎的系统评价

目的：评价更昔洛韦治疗单纯疱疹性角膜炎的疗效和安全性。

方法：计算机检索Cochrane Library、EMbase、PubMed、中国生物医学数据库、中国期刊全文数据库、维普数据库和万方数据库,收集所有更昔洛韦对比阿昔洛韦治疗单纯疱疹病毒性角膜炎的随机对照试验,由两名评价员独立筛选合格文献并提取相关信息进行分析。根据Cochrane协作网推荐的工具进行偏倚风险评估,用Revman 5.0软件进行统计学分析。

结果：最终纳入14个随机对照试验,共4 820例单纯疱疹病毒性角膜炎患者。按以患者人数为观察对象和以患眼数为观察对象分组分析,并对纳入研究根据随访时间进行亚组分析。更昔洛韦组在有效率、复发率等方面优于阿昔洛韦组,差异具有统计学意义\〖RR=1.22, 95%CI(1.10～1.36); OR=4.50, 95%CI(2.02～ 10.04); RR=0.23, 95%CI(0.10～0.52)\〗。更昔洛韦组不良反应发生率比阿昔洛韦组少,差异具有统计学意义\〖RR=0.12,95%CI(0.03～ 0.46)\〗。两组的不良反应均可自行缓解。

结论：目前证据表明,更昔洛韦相比阿昔洛韦治疗单纯疱疹病毒性角膜炎疗效好、安全性高。     

Clinical efficacy of oral and topical acyclovir in herpes simplex virus stromal necrotizing keratitis

Purpose:To evaluate the efficacy of systemic and topical antiviral therapy in the treatment of active herpes simplex virus (HSV) necrotizing stromal keratitis (NSK).Design:Prospective interventional case series.Methodology:Patients with a diagnosis of HSV NSK based on history and clinical findings were enrolled in the study. A standard protocol was used for microbiologic investigations. Ten weeks regime of systemic acyclovir and 2 weeks of topical acyclovir was given. Complete ophthalmic examination was performed at every visit. Outcome measures were a reduction in the area of infiltration and improvement in visual acuity.Results:Fifteen patients were enrolled in the study. The mean age of presentation was 51.53 years. The duration of symptoms at presentation ranged from 2 to 8 weeks. HSV1 DNA polymerase chain reaction was positive in 70% cases of those tested. Area of infiltration at trial entry and at the end of 2 weeks of antiviral treatment reduced significantly (P = 0.007). All patients showed a complete resolution of keratitis at the end of study.Conclusion:Topical and systemic acyclovir for treatment of NSK facilitates healing of ulceration. Topical steroids after initial antiviral therapy are safe and decreases inflammation and improve visual recovery. Early initiation of therapy has better outcomes as compared to late presentations.     

Evaluation of the effects of acyclovir and/or human amniotic membrane on herpes virus culture and quantitative virus inactivity by real-time polymerase chain reaction

AIM: To investigate the permeability of amniotic membrane in herpes virus cell culture to acyclovir with real time polymerase chain reaction (RT-PCR).METHODS: Madin-Darby Bovine Kidney (MDBK) cell culture and Bovine Herpes Virus (BHV1) type 1 were used in the study. Cell cultures were grouped into two on the basis of herpes virus inoculation. Each group was sub-grouped into three. Amniotic membrane (V-HAM), acyclovir (V-A), and amniotic membrane and acyclovir (V-HAM-A) were applied to these subgroup cultures, respectively. After the application of the membrane and the drug, the cultures were evaluated at 24 and 48h for cytopathic effect positive (CPE+) with a tissue culture microscope. In the CPE (+) samples, the DNA was extracted for viral DNA analysis by RT-PCR.RESULTS: In control cultures without herpes virus CPE was not detected. Besides, amniotic membrane and acyclovir did not have cytotoxic effect on cell cultures. CPE were detected in Bovine Herpesvirus type-1 inoculated cell cultures after amniotic membrane and/or acyclovir application. DNA analysis with RT-PCR indicated that Cycle threshold (Ct) values were lower in the BHV1 and membrane applied group (amniotic membrane group< acyclovir group< membrane and acyclovir group). This showed that membrane did not have antiviral effect. The membrane and acyclovir cell culture groups with high Ct values indicated that membrane was permeable and had a low barrier effect to drug,CONCLUSION: In our in-vitro study, we found that amniotic membrane, which can be used in the treatment of corneal diseases, did not have antiviral effect. Besides, we detected that amniotic membrane was permeable to acyclovir in BHV-1 inoculated MDBK cell culture. However, more studies are necessary to investigate the quantitative effects of amniotic membrane and acyclovir.     

鱼腥草联合干扰素滴眼治疗单纯疱疹病毒性角膜炎的疗效评价

目的 评价鱼腥草联合干扰素（滴宁）滴眼液治疗单纯疱疹病毒性角膜炎（HSK）的临床疗效。方法 治疗组60例67眼HSK患者联合滴用鱼腥草滴眼液和干扰索滴眼液，并观察静脉滴注鱼腥草注射液的临床疗效，与对照组38例43眼HSK患者用阿昔洛韦滴眼液及静脉滴病毒唑注射液进行对比，比较其治愈率、有效率、疗程及复发率。结果 治疗组治愈59眼，治愈率为88．06％，有效6眼，有效率8．96％，无效2眼（深层型），治疗天数平均19天，随访1年54眼中复发5眼，复发率9．26％；对照组治愈25眼，治愈率58．14％，有效12眼，有效率27．91％，无效6眼，治疗平均天数31天，随访1年23眼复发7眼，复发率30．43％；两者比较治疗组疗程和疗效均优于对照组（P〈0．01），治愈患者随访1年，治疗组复发率比对照组明显低。结论 临床应用鱼腥草联合干扰素（滴宁）滴眼液治疗单纯疱疹病毒性角膜炎能提高疗效，缩短病程，降低复发率，具有较好的治疗和抗复发效果，从而降低致盲率。     

单纯疱疹病毒性角膜炎的研究新进展

单纯疱疹病毒性角膜炎是一种重要的致盲性眼病。它的致盲性和治疗上的困难性在于它的反复发作,从而引起角膜混浊,最终导致视力的丧失。随着分子生物学的发展,目前对于单纯疱疹病毒性角膜炎的诊断有着突飞猛进的发展,然而对于治疗复发性单纯疱疹病毒性角膜炎却没有有效药物,这将有待于分子生物学、病毒学、传统中医与现代西医的共同努力。     

球结膜下注射干扰素治疗单疱病毒性角膜炎36例

目的 探讨干扰素治疗单疱病毒性角膜炎的疗效。方法 明确诊断单疱病毒性角膜炎36例42眼,随机分为观察组和对照组,观察组21眼应用干扰素球结膜下注射治疗,对照组21眼应用普通药物治疗,3个疗程后观察结果。结果 观察组患者的视力恢复明显高于对照组,有效率达95％。结论 与其它治疗方法相比,应用干扰素球结膜下注射治疗单疱病毒性角膜炎有显著疗效。     

Geldanamycin is effective in the treatment of herpes simplex virus epithelial keratitis in a rabbit model

Background: To evaluate the efficacy of geldanamycin eye drops against herpes simplex virus epithelial keratitis in a rabbit model. Methods: New Zealand white rabbits were randomized into four groups and infected with herpes simplex virus type 1; geldanamycin topical eye drops was initiated 24 h after the infection and maintained for 12 consecutive days. Four groups of rabbits received 5 µg/mL geldanamycin, 10 µg/mL geldanamycin, 0.1% acyclovir and escipient (a kind of artificial tears), respectively. The severity of herpes simplex virus type 1 epithelial keratitis was measured by slit‐lamp and scored for statistics analysis. The virus shedding in eye swabs was isolated, and tissue culture infective dose (TCID₅₀) was determined. Results: Geldanamycin (10 µg/mL) treatment reduced significantly the severity of herpes simplex virus type 1 epithelial keratitis than the other three groups. Geldanamycin (5 µg/mL) was as effective as acyclovir (0.1%) treatment. The effect of geldanamycin against herpes simplex virus type 1 epithelial keratitis correlated with accelerated clearance of virus of the rabbits. Conclusion: Geldanamycin is a promising treatment option against herpes simplex virus type 1 epithelial keratitis. Geldanamycin (10 µg/mL) is better than acyclovir and geldanamycin (5 µg/mL) in the rabbit model. The optimal concentration of this drug in human is still to be determined.     

Cyclaradine的抗单纯疱疹病毒作用:在体和离体实验研究

目的 探讨(十)—Cyclaradine在体外及动物模型中抗HSV—1及其耐药株的作用。方法 应用VER0细胞培养和实验性单纯疱疹病毒性角膜炎动物模型，观察(十)—Cyclaradine对HSV—1KOS株、F株、HFTC株、dPyK株、7—2667ACVr株和LeBleu株的抑制效果，并与无环鸟苷(acyclovir，ACV)和三氟胸苷(trif1uorothymidine，TFT)作比较。结果 (十)—Cyclaradine在体外及动物模型中有确切的抗HSV—1作用，而且对ACV和TFT的耐药株也同样有效。结论 (十)—Cyclaradine是一种值得进一步研究的治疗单纯疱疹病毒性角膜灸的药物。     

基质金属蛋白酶在实验性单纯疱疹性角膜炎中的分布表达

目的 明确角膜感染Ⅰ型单纯疱疹病毒(HSV—1)后基质金属蛋白酶(MMPs)及其组织抑制剂(TIMPs)在角膜中的分布。方法 HSV—1(KOS株)接种于BALB／c小鼠角膜上。分别收集正常眼球及感染后第2、7、14及28d的感染眼球行石蜡包埋，并应用抗MMP—2、—8、—9及TIMP—1、—2的抗体免疫染色角膜切片。结果 感染后第2d，MMP—2、—9及TIMP—1、—2的表达比未感染眼增加且表达主要位于浅表基质层及上皮下的炎性细胞中。感染后第14d及28d可见坏死性角膜炎及角膜溃疡形成，角膜基质中及浸润的炎性细胞中尤其是溃疡处可见MMP—2、—9及TIMP—1、—2表达显著增加。溃疡区域可见大量MMP—8阳性染色的中性粒细胞。结论 HSV—1角膜感染后由角膜细胞及浸润的炎性细胞分泌产生的MMPs对于上皮性角膜炎及溃疡形成过程可能起重要作用。