玻璃酸钠联合氯替泼诺滴眼液与单纯玻璃酸钠滴眼液治疗儿童干眼的疗效比较

目的：探讨玻璃酸钠联合氯替泼诺滴眼液对比单纯玻璃酸钠滴眼液在临床治疗干眼患儿时的作用和安全性。

方法：选取2014-08/2016-08于本院接受人工泪液治疗的水液缺乏型干眼儿童共128例256眼，依据随机数字表法，将两组患儿随机分为联合组和对照组各64例128眼，联合组给予玻璃酸钠联合氯替泼诺滴眼液治疗，对照组给予单纯的玻璃酸钠滴眼液治疗。于治疗前和治疗后2、6wk行眼表综合分析系统(Keratograph 5M)检查，测定泪膜破裂时间(tear break-up time，BUT)、泪河高度、睑板腺红外线照相，裂隙灯下观察角膜荧光素染色，对各项观察指标进行统计学处理。

结果：治疗2wk后两组患儿的泪河高度和BUT水平均高于治疗前，睑板腺评分和角膜荧光素染色评分均低于治疗前，差异有统计学意义(P<0.05)； 治疗6wk后，两组患儿的泪河高度和BUT水平均高于治疗前和治疗2wk后，睑板腺评分和角膜荧光素染色评分均低于治疗前和治疗2wk后，差异有统计学意义(P<0.05)； 治疗2、6wk后，联合组患儿的泪河高度和BUT水平均高于同时期对照组，而睑板腺评分和角膜荧光素染色评分均低于同时期对照组，差异有统计学意义(P<0.05)； 两组患儿用药前后眼压对比差异均无统计学意义(P>0.05)。

结论：玻璃酸钠联合氯替泼诺滴眼液较单纯使用玻璃酸钠滴眼液在临床治疗干眼儿童时取得了更好的治疗效果，同时安全性和耐受性较好。

Study on the effect of sodium hyaluronate combined with loteprednol eye drops on the treatment of dry eye in children

AIM:To study the effect and safety of sodium hyaluronate combined with loteprednol eye drops compared to pure sodium hyaluronate eye drops in the clinical treatment of dry eye in children.

METHODS: From August 2014 to August 2016, 128 children(256 eyes)with water deficient dry eye treated with artificial tears in our hospital were randomly divided into two groups, 64 cases(128 eyes)in each, the combined group and the control group, according to the random number table method. The combined group was given sodium hyaluronate combined with loteprednol treatment; the control group was given simple treatment of sodium hyaluronate eye drops. Before and after treatment for 2 and 6wk for ocular surface analysis system(Keratograph 5M)examination, determination of tear break-up time(BUT), tear meniscus height(TMH), meibomian gland infrared photography, slit lamp observation of corneal fluorescein staining, the observation indexes were statistically analyzed.

RESULTS: After 2wk of treatment, the TMH and BUT level of the two groups were all higher than those before treatment(P<0.05). The scores of meibomian gland score and corneal fluorescein staining were lower than those before treatment, and the difference was statistically significant(P<0.05). After 6wk of treatment, the TMH and BUT level of the two groups were all higher than those before treatment and 2wk after treatment; The meibomian gland score and scores of corneal fluorescein staining were lower than those before treatment and 2wk after treatment, the difference was statistically significant(P<0.05). After 2wk and 6wk of treatment, TMH and BUT level combined groups were higher than those in the control group, while the score of meibomian gland and corneal fluorescein staining scores were lower than those in the control group, the difference was statistically significant(P<0.05). Intraocular pressure between the two groups before and after treatment was not significantly different(P>0.05).

CONCLUSION: Sodium hyaluronate combined with loteprednol eye drops is more effective in the clinical treatment of dry eye children than the use of sodium hyaluronate eye drops, while the safety and tolerance are better.