对比两种给药方案治疗急性视网膜坏死综合征患者的效果

目的：探讨阿昔洛韦+醋酸泼尼松片、丙氧鸟苷+醋酸泼尼松片+阿司匹林两种给药方案治疗急性视网膜坏死综合征的临床疗效。
　　方法：采用随机数字表法将我院急性视网膜坏死综合征患者30例40眼分为 A、B 两组,其中 A 组采用阿昔洛韦+醋酸泼尼松片的给药方案,B 组采用丙氧鸟苷+醋酸泼尼松片+阿司匹林的给药方案,观察并比较两组患者治疗后的临床效果。
　　结果：经过治疗后,B 组总有效率(90%)明显高于 A 组(70%),两种给药方案均有效,差异无统计学意义( P>0.05)；两组患者在治疗前视力情况差异无统计学意义(P>0.05)；经不同给药方案治疗后,A 组视力≥0.5者9眼,视力0.1~<0.5者3眼,视力0.02~<0.1者6眼,无感光者2眼,B 组视力≥0.5者12眼,视力0.1~<0.5者4眼,视力0.02~<0.1者3眼,无感光者1眼, B 组患者视力恢复情况优于 A 组,差异有统计学意义(P<0.05)；B组患者视网膜裂孔、疱疹、口腔溃疡、水痘、病毒性脑炎及中枢神经病变等并发症的发生率(10%)明显低于 A 组(35%),差异有统计学意义(P<0.05)。
　　结论：阿昔洛韦+醋酸泼尼松片、丙氧鸟苷+醋酸泼尼松片+阿司匹林两种给药方案都具有较为肯定的治疗效果,但后者对患者视力的恢复及并发症发生率的降低具有更好的优势。

Comparison of two different drug therapies for acute retinal necrosis syndrome

AIM: To investigate clinical efficacy of two drug therapies ( acyclovir with prednisone acetate tablets, ganciclovir with prednisone acetate tablets and aspirin) for acute retinal necrosis syndrome.
METHODS: Thirty patients (40 eyes) with acute retinal necrosis syndrome in our hospital were randomly divided into group A and B. Group A was treated with acyclovir with prednisone acetate tablets, and group B was given ganciclovir with prednisone acetate tablets and aspirin. Clinical effects in the two groups were observed and compared.
RESULTS: After treatment, the overall response rate in group B (90%) was obviously higher than that in group A (70%), both of two regimens were effective, without significant difference (P>0. 05). There was no significant difference on the pre - treatment visual acuity between the two groups (P>0. 05). After different treatments, the visual acuity in group B was ≥0. 5 in 12 eyes, 0. 1≤and<0. 5 in 4 eyes, 0. 02 ≤ and < 0. 1 in 3 eyes, and no photosensitive in 1 eye. The visual acuity in group A was≥0. 5 in 9 eyes, 0. 1≤and<0. 5 in 3 eyes, 0. 02≤and<0. 1 in 6 eyes, and no photosensitive in 2 eyes. The recovery of visual acuity in group B was obviously better than that in A group ( P < 0. 05). The incidence of complications such as retinal tear, herpes, mouth ulcers, chickenpox, viral encephalitis and central nervous system diseases in group B (10%) was significantly lower than that in A group (35%,P<0. 05).
CONCLUSION: Two drug therapies ( acyclovir with prednisone acetate tablets, ganciclovir with prednisone acetate tablets and aspirin ) both have positive therapeutic effect, but the latter can better restore visual acuity and decrease the complications.