人血浆纤维连结蛋白对顽固性角膜上皮缺损的修复作用

背景纤维连结蛋白(Fibronection,FN)在炎症中起修复作用,能否用于治疗顽固性角膜上皮缺损,尚无定论.目的观察人血浆纤维连结蛋白(FN)对顽固性角膜上皮缺损的修复作用.设计设立对照的实验研究.单位广州市红十字会医院、广州市第一人民医院、广州市儿童医院、广州市中医院、广州市第二人民医院.对象顽固性角膜上皮缺损病变383眼.其中治疗组309眼,对照组74眼.方法治疗组用人血浆纤维连结蛋白滴眼2 h 1次;对照组10 g/L甲基纤维素滴眼2 h1次.两组均口服维乐生2粒/次,3次/d,结合病情用抗菌或抗病毒治疗.用药后隔天或每天复查,并用10 g/L荧光素钠染色观察角膜变化.主要观察指标两组患者症状,荧光素钠染色结果,角膜上皮愈合情况.结果根据患者症状,荧光素钠染色结果,角膜上皮愈合情况评定结果,治疗组随访观察309眼,治愈率为69.9%.平均治疗天数6.5 d.对照组治愈率58.1%,平均治疗天数为8.7 d.两组治疗效果比较差异有非常显著性意义(P＜0.01).结论纤维连结蛋白滴眼治疗顽固性角膜上皮缺损比常规治疗效果显著.

Role of human plasma fibronectin in the repair of the refractory corneal epithelial defect

BACKGROUND: Fibronectin(FN) plays the role of repair in the inflammation. There is no confirmed conclusion whether it can be applied to the refractory corneal epithelial defect.OBJECTIVE: To observe the repair effect of the human plasma FN for the refractory corneal epithelial defect.DESIGN: A controlled experimental study.SETTING: Guangzhou Red Cross Hospital, Guangzhou First People's Hospital, Guangzhou Children's Hospital, Guangzhou Hospital of Traditional Chinese Medicine and Guangzhou Second People's Hos pital.PARTICIPANTS: Totally 383 eyes with the refractory corneal epithelial defect were chosen, of which 309 were in the therapy group, and 74 in the control group.METHODS: The therapy group: Human plasma FN was administered by dropping it into the eyes once every two hours. The controlgroup: 10 g/L celacol M was administered by its dribbling into the eyes once every two hours. Weilesheng was taken orally in both groups, two pills once, three times per day. According to the state of illness, both groups received anti-bacterial or anti-viral treatment and reexamination was given every day or every other day after administration. 10 g/L fluorescein sodium was used to observe the changes of cornea.MAIN OUTCOSE MEASURES: The symptoms, results of staining using fluorescein sodium as well as the corneal epithelial healing of both groups.RESULTS: The symptoms, the results from staining using the fluorescein sodium and the corneal epithelial healing were used for the evaluation. In the therapy group, 309 eyes were followed up and the cure rate was 69.9%. The average therapeutic period was 6.5 days, while those of the control group were 58.1% and 8.7 days respectively. The difference in the curative effect between the two groups was significantly different( P＜0.01 ).CONCLUSION: The application of FN for the refractory corneal epithelial defect displays a more significant effect than conventional treatment.