膦甲酸钠滴眼液治疗上皮型单纯疱疹病毒性角膜炎

目的：探讨膦甲酸钠滴眼液治疗上皮型单纯疱疹病毒性角膜炎（herpes simplex keratitis,HSK）的近中期疗效。方法：选取2008-03/2009-12在钟祥市人民医院眼科门诊确诊的60例60眼上皮型HSK患者，将其随机分为对照组和试验组两组。对照组采用更昔洛韦滴眼液，8次/d；试验组采用膦甲酸钠滴眼液，6次/d，用药时间均为14d。观察治疗后3，7，10，14d的角膜溃疡面积、眼部症状体征评分，统计治愈率。随访2a，统计随访期间上皮型HSK的复发率。结果:两组患者治疗前的一般情况、症状体征评分无显著差异（P>0.05）。与治疗前相比，治疗后两组患者的角膜溃疡面积、眼部症状体征评分均明显下降（P<0.05），但两组之间的角膜溃疡面积、眼部症状体征评分和治愈率均无明显差异（P>0.05）。随访2a期间，试验组和对照组患者的复发率分别是13%,27%，差异有显著性（P<0.05）。结论:膦甲酸钠滴眼液在治疗上皮型HSK的近期疗效与更昔洛韦滴眼液相同，但中期复发率低于更昔洛韦滴眼液。

Clinical investigation of foscarnet sodium eye drops for the treatment of epithelial herpes simplex keratitis

AIM: To investigate clinical effect of epithelial herpes simplex keratitis (HSK) treated by foscarnet sodium eye drops in the early and middle term. METHODS:Totally 60 cases (60 eyes) with HSK at Zhongxiang People’s Hospital from March 2008 to December 2009 were enrolled. All the patients were divided into control group and experimental group randomly. Control group patients were treated by ganciclovir eye drops, 8 times per day, while experimental group patients were treated by foscarnet sodium eye drops, 6 times per day. All patients were treated for 14 days and were followed up for 2 years. The medication outcome and recurrence rate were investigated. RESULTS:There were no significant differences between control and experimental group in clinical characteristics of patients including age, gender, mean score of symptoms and signs before treatment (P>0.05). After therapy, both the corneal ulcer area and the score of symptoms and signs in control group patients and experimental group patients decreased significantly than those before treatment(P<0.05). But between two groups after treatment, the differences were not remarkable (P>0.05). In the 2 years’ follow-up, the recurrence rate in experimental group was significantly reduced compared with that in control group (P<0.05). CONCLUSION: Foscarnet sodium eye drops play a similar role in therapy of HSK with ganciclovir eyedrops in early stage, while may decrease the recurrence rate of HSK in the middle term.