重组人表皮生长因子凝胶联合玻璃酸钠滴眼液治疗对白内障超声乳化术后干眼症患者泪膜稳定性、泪液基础分泌量的影响

目的分析重组人表皮生长因子(rhEGF)凝胶联合玻璃酸钠滴眼液治疗对白内障超声乳化术后干眼症患者泪膜稳定性、泪液基础分泌量的影响。方法选取82例白内障术后干眼症患者,根据术后治疗方式的差异分为联合组42例和单一组40例,联合组采用rhEGF凝胶联合玻璃酸钠滴眼液治疗,单一组采用玻璃酸钠滴眼液治疗。对比两组临床疗效,治疗前及治疗2、4周的干眼症状评分。两组均于治疗前及治疗1、3月后进行泪膜厚度测量、基础泪液分泌试验(SIt)、角膜荧光素染色评分(FL)及泪膜破裂时间(BUT)检测,根据检测结果评估两组内膜结构和稳定性,同时比较治疗前及治疗1、3月后白介素-6(IL-6)、IL-1β及肿瘤坏死因子-α(TNF-α)水平。结果治疗2、4周后两组干眼症状评分较治疗前降低,且联合组评分低于单一组(P<0.05)。治疗1、3月后两组泪膜厚度、SIt及BUT升高,FL降低,观察组泪膜厚度、SIt及BUT均高于对照组,FL低于对照组(P<0.05)。治疗1、3月后两组IL-6、IL-1β及TNF-α水平下降,联合组IL-6、IL-1β及TNF-α水平均低于单一组(P<0.05)。联合组临床总有效率高于单一组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论重组rhEFG凝胶联合玻璃酸钠滴眼液可以有效改善白内障超声乳化术后干眼症患者临床症状、泪膜稳定性及眼液基础分泌量,临床疗效较仅玻璃酸钠滴眼液治疗佳,安全性高,值得临床推广。

The effects of recombinant human epidermal growth factor gel combined with sodium hyaluronate eye drops on the stability of the tear film and the basal secretion of tears in patients with dry eye after phacoemulsification

Objective To analyze the effect of recombinant human epidermal growth factor(rhEGF)gel combined with sodium hyaluronate eye drops on tear film stability and tear secretion in dry eye patients after phacoemulsification.Methods Eighty-two patients with dry eyes after cataract surgery were selected and divided into combined group(n=42)and single group(n=40)according to the difference of postoperative treatment.The combined group was treated with rhEGF gel combined with sodium hyaluronate eye drops while the single group was treated with sodium hyaluronate eye drops only.The clinical efficacy and dry eye symptom scores before treatment and after 2 and 4 weeks of treatment were compared between the two groups.The tear film thickness,basic tear secretion test(SIT),corneal fluorescein staining score(FL)and tear film rupture time(BUT)were measured before treatment and after 1 and 3 months of treatment.The intimal structure and stability of the two groups were evaluated according to the test results,and the levels of interleukin-6(IL-6),IL-1βand tumor necrosis factor-α(TNF-α)were compared before and after 1 and 3 months of treatment.Results After 2 and 4 weeks of treatment,the dry eye symptom scores of the two groups were lower than those before treatment,and the scores of the combined group were lower than those of the single group(P<0.05).After 1 and 3 months of treatment,the tear film thickness,SIT and BUT of the two groups were increased while FL was decreased.The tear film thickness,SIT and BUT of the observation group were higher than those of the control group,and FL was lower than that of the control group(P<0.05).After 1 and 3 months of treatment,the levels of IL-6,IL-1βand TNF-αin the two groups were decreased,and the levels of IL-6,IL-1βand TNF-αin the combined group were lower than those in the single group(P<0.05).The total effective rate of the combined group was higher than that of the single group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion rhEFG gel combined with sodium hyaluronate eye drops can effectively improve the clinical symptoms,tear film stability and secretion of eye fluid in dry eye patients after phacoemulsification.The clinical efficacy is better than that of sodium hyaluronate eye drops alone.It is safe and worthy of clinical promotion.