新生儿急性细菌性结膜炎10年致病菌变迁

对1998～2007年临床确诊的新生儿急性细菌性结膜炎的细菌培养结果进行分析,探讨其致病菌10年的变迁,为临床治疗、合理用药提供依据.方法 对325例(466只眼)经临床诊断为新生儿急性细菌性结膜炎患儿的结膜囊分泌物标本进行细菌培养,同时对培养阳性的菌株进行鉴定分析.结果 新生儿急性细菌性结膜炎的细菌平均检出率为80%.不同年分的细菌检出率变化无明显差异(x2=0.83,P＞0.05).10年来,新生儿急性细菌性结膜炎的致病菌中革兰阳性细菌有逐渐减少、革兰阴性细菌有逐渐增加的趋势.在革兰阳性细菌中,条件致病菌(表皮葡萄球菌和腐生匍萄球菌)所占的百分比有逐年增加的趋势,金黄色葡萄球菌和溶血性链球菌所占的百分比则有逐年减少的趋势.在革兰阴性菌中,淋球菌为主要致病菌.10年来,表皮葡萄球菌、腐生葡萄球菌和淋球菌在新生儿急性细菌性结膜炎的致病菌中有逐渐增加的趋势.结论 对新生儿急性细菌性结膜炎患儿的结膜囊分泌物标本进行细菌培养、药物敏感试验既助于提高临床治疗,又可防止临床滥用抗生素、造成耐药菌株的增加.对于严重的新生儿急性细菌性结膜炎,早期可慎片喹诺酮类抗生素滴眼液治疗,待细菌培养和药物敏感试验结果报告后再结合治疗情况修改治疗方案.

Abstract：

Objective To study the results of bacterial culture from the inferior palpebral conjunctival surface of neonate with acute bacterial conjunctivitis and research the transition of bacterial pathogens in recent 10 years for sensitive antibiotics for its treatment,and to provide the basis for rational drug use for clinical treatment.Methods Secretion specimens were taken from 466 eyes of 325 cases with clinically diagnosed acute bacterial neonatal conjunctivitis for bacterial culture,and drug sensitivity test was carried out for specimens with positive culture results.Results Bacterial positive rate was 80% with insignificant changes among the different years.The past 10 years,neonatal conjunctivitis of acute bacterial pathogens,Gram-positive bacteria had a gradual downward trend;Gram-negative bacteria had a gradual upward trend.In Gram-positive bacteria,the percentage of opportunistic pathogen (Staphylococcus epidermidis and Staphylococcus saprophytic) was a rising trend,the percentage of Staphylococcus anreus and hemolytic streptococcus was a decreasing trend.In the Gram-negative bacteria,the main pathogenic bacteria were Neisseria gonorrhoeae.Staphylococcus epidermidis,Staphylococcus saprophytic and Neisseria gonorrhoeae in neonatal pathogens of acute bacterial conjunctivitis had a gradual upward trend in recent 10 years.Conclusions Bacterial culture combined with drug sensitivity test of secretion specimens of the acute bacterial neonatal conjunctivitis are beneficial not only for clinical treatment,but also to guide clinical practice in preventing antibiotics misuse and causing an increase in resistant strains.For serious neonatal acute bacterial conjunctivitis,the early quinolone antibiotic eye drops can be used with caution.After the results of bacterial culture and drug sensitivity test,the treatment programs should be modified.     

加替沙星和左氧氟沙星治疗细菌性结膜炎的疗效对比研究

Objective To evaluate the different efficacy and safety to the treatment of baeterial conjunctivitis between the fluoroquinolone antibiotics gatifloxacin and levofloxacin.Methods A multicentre,random,double-blind and control trial was performed in six centers including Eye Ear Nose and Throar Hospital of Fudan University,Henan Eye Institute,Eye Hospital Affiliated to Wenzhou Medieal College,the First Affiliated Hospital Of Nanjing Medical University,Xijing Hospital Affiliated to the Fourth Military Medical University,the Second Affiliated Hospital of Xi'an Jiaotong University between August 2006 and October 2007. The levofloxacin was set as the efficient control. Two hundred and thirty-five patients (235 eyes ) that diagnosed as bacterial conjunctivitis were randomly divided into two groups by the method of randomized blocks, the test group (gatifloxacin) had 118 eyes and the control (levofloxacin) group had 117eyes. The drug delivery into conjunctival sac was performed at a 7-day period ( two drops per time, eight times per day at the first two days and two drops per time, four times per day at the following 5 days). All participants were given the conjunetival sac germ culture and drug sensitive test before and after the study.The combination score of signs and symptoms and evaluation of safety were conducted at the pre-dilivery day,the (4 ± 1 ) and (7 ± 1 ) dilivery day. The statistic analysis was conducted by CMH X2 test, Pearson X2 test and Fisher's exact probabilities test. Results The efficacy of the two groups was 94. 0% ( 110/117 eyes)in gatifloxacin group and 93.8% ( 106/113 eyes) in levofloxacin group with no significant difference( X2 =0.052,P = 0.8201 ). There was also no difference in the bacteria clearance between the two groups [ gatifloxacin versus levofloxacin, 94.1% (80/85 eyes) versus 92. 5% (74/80 eyes) ,P =0. 3470]. The decrease of combination score of signs and symptoms at the (4 ± 1 ) delivery day was 4. 436 +2. 310 in the gatifloxacin group and 3. 814 ± 1. 962 in the levofloxacin group, the difference of which was significant ( F =7.280,P = 0. 0075 ) . This trend was also proved at the ( 7 ± 1 ) delivery day ( gatifloxacin versus levofloxacin, 7. 487 ± 2. 821 versus 6. 912 ± 2. 911, F = 4. 060, P = 0. 0452 ). The visual acuity and the tolerance after local application of the eye drops between the two groups had no diffenrence ( the visual acuity F = 1.04, P = 0. 3080; the tolarence after local admission X2 = 0. 1372, P = 0. 7111 ). According to the result of the germ culture, the major pathogenic bacteria were Gram-positive bacteria ( totally 20 kinds of Grampositive bacteria and 8 kinds of Gram-negetive bacteria). The MIC and drug resistence of gatifloxacin to the Gram-positive bacteria was lower than that of the levofloxaxin ( Staphylococcus Epidermidis, Staphylococcus Aureus, coagulase negative Staphylococcus, α-hemolytic Streptococcus). Conclusions The gatifloxacin eye drop has a good therapeutic effect to the bacterial conjunctivitis, It can effectively clear the pathogen with fast and strong effect. Moreover, it has a low MIC in vitro, advance a prospect in drug resistance, safety and ocular tolerance.     

加替沙星和左氧氟沙星治疗细菌性结膜炎的疗效对比研究

Objective To evaluate the different efficacy and safety to the treatment of baeterial conjunctivitis between the fluoroquinolone antibiotics gatifloxacin and levofloxacin.Methods A multicentre,random,double-blind and control trial was performed in six centers including Eye Ear Nose and Throar Hospital of Fudan University,Henan Eye Institute,Eye Hospital Affiliated to Wenzhou Medieal College,the First Affiliated Hospital Of Nanjing Medical University,Xijing Hospital Affiliated to the Fourth Military Medical University,the Second Affiliated Hospital of Xi'an Jiaotong University between August 2006 and October 2007. The levofloxacin was set as the efficient control. Two hundred and thirty-five patients (235 eyes ) that diagnosed as bacterial conjunctivitis were randomly divided into two groups by the method of randomized blocks, the test group (gatifloxacin) had 118 eyes and the control (levofloxacin) group had 117eyes. The drug delivery into conjunctival sac was performed at a 7-day period ( two drops per time, eight times per day at the first two days and two drops per time, four times per day at the following 5 days). All participants were given the conjunetival sac germ culture and drug sensitive test before and after the study.The combination score of signs and symptoms and evaluation of safety were conducted at the pre-dilivery day,the (4 ± 1 ) and (7 ± 1 ) dilivery day. The statistic analysis was conducted by CMH X2 test, Pearson X2 test and Fisher's exact probabilities test. Results The efficacy of the two groups was 94. 0% ( 110/117 eyes)in gatifloxacin group and 93.8% ( 106/113 eyes) in levofloxacin group with no significant difference( X2 =0.052,P = 0.8201 ). There was also no difference in the bacteria clearance between the two groups [ gatifloxacin versus levofloxacin, 94.1% (80/85 eyes) versus 92. 5% (74/80 eyes) ,P =0. 3470]. The decrease of combination score of signs and symptoms at the (4 ± 1 ) delivery day was 4. 436 +2. 310 in the gatifloxacin group and 3. 814 ± 1. 962 in the levofloxacin group, the difference of which was significant ( F =7.280,P = 0. 0075 ) . This trend was also proved at the ( 7 ± 1 ) delivery day ( gatifloxacin versus levofloxacin, 7. 487 ± 2. 821 versus 6. 912 ± 2. 911, F = 4. 060, P = 0. 0452 ). The visual acuity and the tolerance after local application of the eye drops between the two groups had no diffenrence ( the visual acuity F = 1.04, P = 0. 3080; the tolarence after local admission X2 = 0. 1372, P = 0. 7111 ). According to the result of the germ culture, the major pathogenic bacteria were Gram-positive bacteria ( totally 20 kinds of Grampositive bacteria and 8 kinds of Gram-negetive bacteria). The MIC and drug resistence of gatifloxacin to the Gram-positive bacteria was lower than that of the levofloxaxin ( Staphylococcus Epidermidis, Staphylococcus Aureus, coagulase negative Staphylococcus, α-hemolytic Streptococcus). Conclusions The gatifloxacin eye drop has a good therapeutic effect to the bacterial conjunctivitis, It can effectively clear the pathogen with fast and strong effect. Moreover, it has a low MIC in vitro, advance a prospect in drug resistance, safety and ocular tolerance.     

Efficacy of Sodium Cromoglicate Eye Drops Combined with Yupingfeng Granules in the Treatment of Allergic Conjunc- tivitis

Purpose： To observe the clinical efficacy of sodium cro- moglicate eye drops combined with Yupingfeng granules in the treatment of allergic conjunctivitis. Methods： A total of 118 patients with allergic conjunctivitis were randomly divided into a combined sodium cromoglicate and YupingfengGranule （treatment） group （n=74） and a sodium cromoglicate （control） group （n=44）. Clinical effica- cy of the two treatments was evaluated by observing the changes in patients＇ symptoms and physical signs before and after their respective treatments. Results： Following treatment, the symptoms and physical signs related to allergic conjunctivitis were significantly allevi- ated in all 118 cases. The total efficacy of the combined sodi- um cromoglicate and Yupingfeng granule treatment was 91.9%, which was significantly higher than the value of 75.0% obtained with sodium cromoglicate alone （P〈0.05）. Conclusion： Combined therapy of sodium cromoglicate eye drops and Yupingfeng granules had a high efficacy and no significant adverse reactions. Therefore, this treatment deserves to be considered for wide application in clinical settings.     

前节OCT评估抗生素滴眼液对泪河的影响

目的 利用前节OCT探讨点用抗生素滴眼液后泪河的变化,以期指导临床合理用药.方法 使用前节光学相干断层扫描(OCT)测量点用左氧氟沙星和0.3%盐酸左氧氟沙星透明质酸钠(SA)滴眼液前后泪河的参数,比较其变化.结果 青年近视患者眼泪液截面积为平均为(0.038±0.029)mm2,泪河深度(TMD)平均为(193.70±62.35)μm,泪河高度(TMH)平均为(302.79±121.72)μm.点用左氧氟沙星后泪液截面积为平均为(0.023±0.011)mm2,泪河深度平均为(160.81±44.98)μm,泪河高度平均为(238.26±54.33)μm,均比点药前减少,差异有统计学意义(P＜0.01);点用0.3%盐酸左氧氟沙星透明质酸钠滴眼液后泪液截面积为平均为(0.025±0.014)mm2,泪河深度平均为(164.85±49.71)μm,泪河高度平均为(242.19±66.15)μm,均比点药前减少,差异有统计学意义(P＜0.05);点药前后双眼之间上述指标差异没有统计学意义(P＞0.05).结论 点用左氧氟沙星滴眼液和0.3%盐酸左氧氟沙星透明质酸钠滴眼液均会减少泪河截面积、高度和深度,提示临床抗生素滴眼液应合理使用,适时保护泪膜.

Abstract：

Objective To study the change of tear meniscus arer antibiotic eye drops with optical coherence tomography and to instruct clinical usage of antibiotic eye drops properly.Methods Optical coherence tomography was used to measure tear meniscus before and after drop levofloxacin or 0.3% levofloxacin hydrochloride sodium hyaluronate,and the changes were compared.Results The cross-section of the inferior tear meniscus in myopic eye of young people was 0.038±0.029 mm2,tear meniscus depth was(193.70±62.35)μ m and tear meniscus height was(302.79± 121.72)μ m.The inferior tear meniscus decreased after drop levofloxacin.The cross-section of the inferior tear meniscus was(0.023± 0.011)mm2,tear meniscus depth was(160.8 1± 44.98)μ m,tear meniscus height was(238.26± 54.33)μ m,and they all had statistical difference with no eye drops(P ＜0.01).The inferior tear meniscus decreased after drop 0.3% levofloxacin hydrochloride SA.The cross-section of the inferior tear meniscus was(0.025 ± 0.014)mm2,tear meniscus depth was (164.85± 49.71)μ m,tear meniscus height was(242.19± 66.15)μ m and there was statistical difference between the same eye before and after using the eye drops(P ＜0.05),and there was no statistical difference between both eyes pre and after using the eye drops(P ＞0.05).Conclusions The tear meniscus cross-section,depth and height decrease after using drop levofloxacin and 0.3% levofloxacin hydrochloride SA which suggests that antibiotic eye drops should be used rationally in order to care and protect tear film properly in clinic.     

Ocular flora in patients undergoing intravitreal injections: antibiotic resistance patterns and susceptibility to antiseptic picloxydine

AIM: To study antibiotic resistance patterns and susceptibility to eye antiseptic picloxydine of conjunctival flora in patients undergoing intravitreal injections(IVIs).METHODS: Conjunctival swabs were taken in 4 groups of patients, 20 patients in each group(n=80): without IVIs and ophthalmic operations in history(group N1;control group);with the first IVI and antibiotic eye drops Tobrex applied 3 d before IVI and 5 d after it(group N2);with 20 or more IVIs and repeated courses of antibiotic eye drops(group N3);with the first IVI and antiseptic eye drops Vitabact(picloxydine) applied 3 d before IVI and 5 d after it(group N4). In groups N2 and N4 swabs were taken at baseline and after the treatment. Efficacy of picloxydine in inhibition of growth of conjunctival isolates susceptible and resistant to antibiotic was studied in vitro. Minimal inhibition concentrations(MIC) were determined with microdilution test.RESULTS: Two of the three patients who had to undergo the IVI procedure showed conjunctiva bacterial contamination. Along with few Staphylococcus aureus and Gram-negative isolates susceptible to most antibiotics, the majority(71%-77%) of causative agents were coagulase-negative Staphylococci(Co NS), 40%-50% of which were multidrug resistant(MDR). Eye disinfection in the operating room and peri-injection courses of Tobrex or Vitabact resulted in total elimination of isolates found at baseline. However, in 10% and 20% of patients, respectively, recolonization of the conjunctiva with differing strains occurred. In patients with repeated IVI and Tobrex/Maxitrol treatment, the conjunctival flora showed high resistance rates: 90% of Co NS were MDR. In the in vitro study, picloxydine showed bactericidal effect against Staphylococci isolates both antibiotic resistant and susceptible with MIC≥13.56 μg/m L. Incubation of bacteria for 15 min in Vitabact eye drops, commercially available form of picloxydine, 434 μg/m L, showed total loss of colony forming units of all tested isolates including Pseudomonas aeruginosa. CONCLUSION: The confirmed efficacy of eye antiseptic picloxydine against conjunctival bacterial isolates and the presence of its commercial form, 0.05% eye drops, convenient for use by patients before and after injection, make this eye antiseptic promising for prophylaxis of IVIassociated infectious complications.     

Coagulase-negative Staphylococci in Conjunctivitis and Blepharitis

Coagulase-negative staphylococcus (C-NS) are regarded asnormal flora of the lids and conjunctiva.The ability of these organisms tocause conjunctivitis and blepharitis can be overlooked or disregarded.Toelucidate the role of individual C-NS species in these eye diseases wecompared Staphylococcus sp.isolated from the conjunctiva and lids of 50healthy volunteers with 248 strains of Staphylococcus isolated frompatients with staphylococcal conjunctivitis or blepharitis.S.epidermidiswas the most frequent species isolated from the conjunctiva and lids ofboth groups.S.aureus was isolated only from infected patients.Noindividual C-NS species was found to be significantly associated with eyedisease,but the colony count of C-NS after isolation was a useful indicatorof conjunctivitis and blepharitis.The ability of Staphylococcus to fermentmannitol or mannose was associated with isolates only from infectedpatients.Eye Science 1993:9:129-135.     

INTRAOCULAR PRESSURE CHANGES AFTER PHACOEMULSIFICATION OF THE EYES WITH PSEUDOEXFOLIATION SYNDROME

Aim: The aim of this study is to demonstrate the changes of the intraocular pressure (IOP) of the eyes with pseudoexfoliation syndrome after phacoemulsification surgery. Methods: The patients were separated into two groups. For the Group 1 the 17 eyes of the 14 patients the IOP was higher than 20 mmHg despite to use of antiglaucoma eye drops (1 to 3 eye drops). For the Group 2, 18 eyes of 15 patients the IOP was equal to 20 mmHg or lower and they were not taking any anti-glaucomatous treat-     

Comparison of the SchirmerⅠtest with and without topical anesthesia for diagnosing dry eye

AIM: To determine the value of Schirmer Ⅰtest (SⅠt) without anesthesia and with topical anesthesia for diagnosing dry eye (DE). METHODS: Totally 220 eyes in 110 patients, male (44) and female (66), (39.56±12.67) years old diagnosed with DE were examined. SⅠt without anesthesia was performed firstly, and 15 minutes later, it was applied again in the same person after topical anesthesia with 0.5% proparacaine hydrochloride eye drops. The wetting strips counted <10mm per 5 minutes were defined positive, while ≤5mm per 5 minutes were defined strong positive. RESULTS: The wetting length in SⅠt after topical anesthesia was significantly lower than that in SⅠt without anesthesia (P<0.001). The positive rate and strong positive rate of SⅠt after topical anesthesia were significantly higher than that of SⅠt without anesthesia (P<0.001). The positive rate and strong positive rate of SⅠt without anesthesia and the strong positive rate of SⅠt after topical anesthesia in patients with aqueous-deficiency dry eye (ADDE) were significantly higher than those in total patients whereas those in patients with evaporative dry eye (EDE) were significantly lower than those in total patients (P<0.001). CONCLUSION: SⅠt after topical anesthesia with 0.5% proparacaine hydrochloride eye drops is more objective and reliable than that without anesthesia in reflecting the status of DE, and its diagnostic value in patients with ADDE was even higher, making itself a meaningful evidence for the diagnosis and treatment of DE.     

In Vivo Observations and Electron Microscopy of Treatment of Experimental HSV Keratitis with Anti-HSV Monoclonal Antibodies

Purpose: To study the antiviral activity of monoclonal antibodies (McAb) in vivo and identify their effects on experimental herpetic keratitis.Methods: Topical use of anti-HSV monoclonal glycoprotein antibodies was carried out on acute herpetic keratitis of rabbits infected by HSV-1 SM44. The application of the eye drops in each group was five times per day for 14 days by double-blind method. In vivo observation and electron microscopy were performed during the whole procedure. The anti-HSV McAb's solution was mixed up of five monoclonal antibodies with high neutrilization titers and/or high ADCC activity. Results: Compared with placebo-treated eyes, anti-HSV McAb treatment made statistically significant reduction of herpetic corneal epithelial lesion on rabbits from day 3 to day 14 postinnoculation (P<0. 01). Punctate and short dendritic lesion were the main patterns. The area of involvement was also limited. Electron microscopic analysis showed ultrastructural changes of herpetic corneal infection. Th     

加替沙星和左氧氟沙星对急性细菌性结膜炎有效性与安全性的Meta分析

目的:运用Meta分析系统评价加替沙星滴眼液和左氧氟沙星滴眼液对急性细菌性结膜炎的临床疗效及安全性。方法:按Cochrane系统评价方法,以“加替沙星”“左氧氟沙星”“急性细菌性结膜炎”为关键词,检索Embase、Cochrane library、Pubmed、Medline、中国知网数据库、万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库,从建库开始时间检索至2021-03-01。纳入比较加替沙星滴眼液和左氧氟沙星滴眼液治疗急性细菌性结膜炎的随机对照研究。采用Cochrane偏倚风险评估工具对纳入研究进行质量评价,使用RevMan5.3统计软件进行Meta分析,运用Stata12中Egger检验分析发表性偏倚,并按照GRADE系统评估证据水平。结果:共纳入10项随机对照研究,合计1149例患者。对照组采用左氧氟沙星滴眼液治疗,试验组采用加替沙星滴眼液滴眼液治疗。Meta分析结果表明加替沙星滴眼液组对于急性细菌性结膜炎临床有效率优于左氧氟沙星滴眼液组(OR=3.75,95%CI:2.52~5.58,P<0.00001),Egger检验提示存在发表偏倚,且GRADE评价结果显示该证据水平为“很低”;加替沙星滴眼液组药物不良反应发生率低于左氧氟沙星滴眼液组(OR=0.37,95%CI:0.19~0.71,P=0.003);Egger检验提示不存在发表偏倚,且根据GRADE方法评价,该证据水平为“低”。结论:加替沙星滴眼液对于急性细菌性结膜炎的疗效优于左氧氟沙星滴眼液,且不良反应发生率较低;但由于纳入的研究证据水平较低,需要更多的多中心、随机双盲临床试验,从而提高加替沙星滴眼液治疗急性细菌性结膜炎临床疗效的证据强度。     

盐酸左氧氟沙星滴眼液治疗细菌性结膜炎及角膜炎随机双盲对照临床研究

目的　比较北京医工生物技术研究所研制的 15mg/5mL盐酸左氧氟沙星滴眼液和海伦滴眼液治疗细菌性结膜炎、角膜炎的疗效和安全性。方法　用随机、双盲、平行研究。共选择 60例患者分为试验组和对照组各 3 0例。疗程 3～ 14d ,主要疗效参数为治疗第 7、14d的临床疗效。结果　用药 7d细菌性结膜炎和角膜炎试验组总有效率为 72 %( 18/2 5 ) ;对照组总有效率为 84 62 % ( 2 2 /2 6)。用药 14d细菌性结膜炎和角膜炎试验组总有效率为 10 0 % ( 2 5 /2 5 ) ;对照组总有效率为 96 15 % ( 2 5 /2 6) ,两组间细菌性结膜炎和角膜炎总有效率无统计学差异。试验组和对照组对细菌性结膜炎和角膜炎的疗效相当。细菌性结膜炎和角膜炎试验组细菌清除率为 10 0 % ;对照组总清除率 98 0 4% ,两组间清除率比较无显著性差异 (P >0 0 5 )。试验组与对照组均有良好的耐受性 ,无明显不良反应发生。结论　盐酸左氧氟沙星滴眼液治疗细菌性结膜炎和细菌性角膜炎有效且安全。     

加替沙星和左氧氟沙星治疗细菌性结膜炎的疗效对比研究

目的 探讨氟喹诺酮类抗生素加替沙星和左氧氟沙星治疗细菌性结膜炎的临床疗效和安全性.方法 采用多中心、随机、双盲、对照试验.2006年8月至2007年10月,在复旦大学附属眼耳鼻喉科医院、河南省眼科研究所、温州医学院附属视光医院、南京医科大学第一附属医院、第四军医大学西京医院、西安交通大学医学院第二附属医院6所医院进行研究.以盐酸左氧氟沙星滴眼液为有效对照,将诊断为细菌性结膜炎的235例(235只眼)患者按随机区组法分入两组:试验组118只眼,对照组117只眼,试验组滴用加替沙星,对照组滴用左氧氟沙星,每组给药方法均为每次2滴,第1-2天,每2小时滴1次,8次/d;以后每4小时滴1次,4次/d,滴入结膜囊内,疗程为7 d.所有人组患者均在试验开始前及试验结束后行结膜囊细菌培养及药物敏感试验,并在用药前和用药后第3-5天、第6-8天分别对症状、体征观察进行综合评分以及评价其安全性.采用协方差分析方法、CMH X2方法、Pearson X2检验、Fisher检验对实验数据进行统计学分析.结果 加替沙星组和左氧氟沙星组的有效率分别为94.0%(110/117只眼)和93.8%(106/113只眼),差异无统计学意义(X2=0.052,P=0.8201).加替沙星组和左氧氟沙星组的细菌清除率分别为94.1%(80/85只眼)和92.5%(74/80只眼),两组比较差异无统计学意义(P=0.3470).用药后第3～5天症状体征综合评分下降幅度加替沙星组为(4.436±2.310)分,左氧氟沙星组为(3.814±1.962)分,差异有统计学意义(F=7.280,P=0.0075).用药后第6～8天症状体征综合评分下降幅度加替沙星组为(7.487 ±2.821)分,左氧氟沙星组为(6.912±2.911)分,差异有统计学意义(F=4.060,P=0.0452).视力及局部用药后耐受性评分在两组之间无显著差异(视力F=1.04,P=0.3080;局部用药后耐受性X2=0.1372,P=0.7111).根据全部患者细菌培养结果,细菌性结膜炎致病菌以革兰阳性菌为主(共检测出革兰阳性菌20种,革兰阴性菌8种),加替沙星对革兰阳性菌的最低抑菌浓度低于左氧氟沙星(表皮葡萄球菌、金黄色葡萄球菌、凝固酶阴性葡萄球菌、甲型溶血性链球菌等).结论 加替沙星滴眼液对细菌性结膜炎有良好的治疗作用,能够有效清除致病菌,起效快,作用强,且体外抗菌活性高,不易产生耐药性,具备良好的安全性和眼部耐受性.     

飞秒激光小切口透镜取出术围手术期加替沙星眼用凝胶细菌清除率研究 △

目的 探讨加替沙星眼用凝胶在飞秒激光小切口基质透镜取出术(SMILE)围手术期预防性使用的有效性与安全性。方法 选择行SMILE的患者181例(181眼),随机分为2组,A组90例,B组91例。A组和B组在术前分别滴用0.3%加替沙星眼用凝胶和0.5%左氧氟沙星滴眼液,用药前后进行结膜囊细菌培养及药敏试验。结果 SMILE前结膜囊细菌培养阳性率为11.60%,其中表皮葡萄球菌15例、微球菌2例、唾液链球菌1例、微小棒状杆菌2例、铜绿假单胞菌1例。A组和B组用药前结膜囊细菌培养阳性率分别为10.00%和13.19%(P>0.05), 用药后细菌清除率均为100%。所有患者均未发现明显的不良反应。结论 SMILE前滴用加替沙星眼用凝胶和左氧氟沙星滴眼液的细菌清除率效果相似。     

抗敏滋肝明目汤治疗过敏性结膜炎30例临床观察

目的观察抗敏滋肝明目汤口服联合色甘酸钠滴眼液治疗过敏性结膜炎的临床疗效。方法将60例（120眼）患者随机分为2组各30例。两组均用色甘酸钠滴眼液局部点眼每日4次,治疗组加用抗敏滋肝明目汤口服,每日2次,治疗14天并随访。结果治疗组治疗显效22例,有效5例,无效3例;对照组显效14例,有效8例,无效8例;两组综合疗效比较,差异有显著性意义;且治疗组主要症状体征缓解时间短于对照组（P〈0．05）。结论抗敏滋肝明目汤口服联合色甘酸钠滴眼液治疗季节性和常年性过敏性结膜炎的疗效优于单用色甘酸钠滴眼液。     

鱼腥草滴眼液联合吡嘧司特钾滴眼液治疗过敏性结膜炎的疗效观察

目的:研究比较鱼腥草滴眼液联合吡嘧司特钾滴眼液治疗过敏性结膜炎的临床疗效。方法:过敏性结膜炎患者63例,随机分为观察组和对照组。对照组31例采用吡嘧司特钾滴眼液,观察组32例采用鱼腥草滴眼液联合吡嘧司特钾滴眼液。治疗前后观察眨眼、眼痒、眼红、异物感等症状,结膜水肿、充血及上、下睑结膜乳头和滤泡等体征,评价治疗有效率。结果:观察组和对照组治疗前症状、体征评分分别为:9.38±0.71和9.41±0.56、10.21±1.03和10.68±0.99,两组差异无统计学意义;观察组和对照组治疗后症状和体征评分分别为:1.22±0.61和4.25±0.84,1.21±0.60和5.78±1.29,两组差异有统计学意义。观察组和对照组治疗后有效率分别为78.12%和32.25%,两组差异有统计学意义。结论:鱼腥草滴眼液联合吡嘧司特钾滴眼液可明显改善过敏性结膜炎患者的临床症状及体征,提高疗效。     

Treatment of acute neonatal bacterial conjunctivitis: a comparison of fucidic acid to chloramphenicol eye drops

PURPOSE: To compare the clinical and bacteriological effects of fucidic acid (Fucithalmic: 1.0%) and chloramphenicol (Minims(R): 0.5%) eye drops in neonates with a clinical diagnosis of acute conjunctivitis of suspected bacterial origin. METHODS: A TOTAL OF 456 N: ewborns with gestational age > 32 weeks with acute conjunctivitis of suspected bacterial origin acquired within the first 28 days of life were included in the study. They were randomly assigned to a 7-day treatment with eye drops using either fucidic acid (1.0%) (Fucithalmic) applied twice per day, or chloramphenicol (0.5%) (Minims Chloramphenicol) applied six times per day. The subjects were followed up with two visits (on days 1 and 8) and by telephone 2 weeks after the end of treatment. RESULTS: Eighty-nine per cent of the neonates treated with Fucithalmic were cured, compared to 87.9% of those treated with Minims Chloramphenicol (n.s). The drug was used as instructed in 90.7% of patients treated with Fucithalmic and in 78.0% of those treated with Minims Chloramphenicol (P < 0.001). CONCLUSION: Treating neonatal conjunctivitis with fucidic acid is easier than with chloramphenicol and is equally effective.     

A multicenter randomized study of fusidic acid ophthalmic gel and rifamycine eyedrops in acute conjunctivitis

A total of 163 patients with acute, presumably bacterial, conjunctivitis were included in a randomized trial, comparing: 1% fusidic acid viscous eye drops, a new ophthalmic formulation of fusidic acid instilled twice daily with rifamycin eye drops, four times daily. Both drugs were given 7 days long. Bacterial origin of the conjunctivitis, mainly staphylococcal, was proved in 75% of the cases. Overall, at the end of the treatment, a satisfactory response, on bacteriological and clinical grounds, was recorded for 87.3 and 89.5% of the patients in the Fucidin gel and rifamycin groups respectively. 9 and 12% of the patients in each group respectively, had a clinical recurrence 15 days after the treatment. No significant difference between the groups clinically and bacteriologically was noted. Side effects, mainly burning and smarting were noted by the investigators in 8 and 11 patients treated by fusilic acid and rifamycin respectively. Two patients were taken out of the study in the rifamycin group because of allergy. The difference between the groups is not significant. The use of fusidic acid viscous eye drops as compared to rifamycin eye drops was judged significantly easier by the patients (P less than 0.02), especially because of the reduced number of applications, the lack of color, and the lase of application.     

富马酸依美斯汀联合氟米龙滴眼液治疗过敏性结膜炎

目的：评价富马酸依美斯汀滴眼液联合氟米龙滴眼液治疗过敏性结膜炎的疗效。

方法：回顾性研究。选取2020-06/2022-08于我院就诊接受治疗的过敏性结膜炎患者115例230眼,在常规使用富马酸依美斯汀滴眼液治疗的同时根据是否联合使用氟米龙滴眼液分为观察组(56例112眼)和对照组(59例118眼)。分别于治疗前、治疗4 wk后评估两组患者的眼部临床症状和体征评分、泪膜破裂时间(BUT)、角膜荧光素染色评分,并记录治疗期间并发症发生情况。

结果：治疗后两组患者眼部症状和体征评分均降低,且观察组低于对照组(P<0.05); 两组患者BUT均长于治疗前,且观察组长于对照组(P<0.05); 两组患者角膜荧光素染色评分均降低,且观察组低于对照组(P<0.05)。两组患者治疗期间并发症总发生率(3.6% vs 5.1%)无明显差异(P>0.05)。

结论：富马酸依美斯汀滴眼液联合氟米龙滴眼液治疗过敏性结膜炎可明显减轻患者的眼部症状与体征,延长泪膜破裂时间,降低角膜荧光素染色评分,提高疗效,且不增加并发症发生风险,安全性和有效性较高。     

The antiallergic eye drops "polynadyme": development, experimental and clinical studies

The antiallergic eye drops "Polynadyme", proposed by the Helmgolz Moscow Research Institute of Eye Diseases, have been prepared by the "Sintez" PJSC (Kurgan). The drops exert a combination of antihistaminic and vasoconstrictive effects and, for better tolerability, contain a low-toxic preserving complex. The drops are polymer-based, which ensures a long action and an artificial tear effect. Preclinical rabbit trials have shown the safety of the "Polynadyme" eye drops, their specific activity in preventing an allergic reaction, and their antiallergic effect on a model of allergic conjunctivitis. Comparative clinical trials covering 150 patients have yielded excellent and good results in 93% of cases. In acute allergic reactions, hyperemia, itch, and burning diminished just 5 minutes after administration. The "Polynadyme" eye drops are effective in treating pollinous conjunctivitis, spring (vernal) keratoconjunctivitis, allergic reactions when wearing contact lenses, the dry eye syndrome, drug-induced and toxicoallergic conjunctivitis, and other ocular allergic reactions.