更昔洛韦眼用凝胶治疗上皮型单纯疱疹病毒性角膜炎的疗效观察  

Observation of efficacy of ganciclovir gel in treatment of epithelial herpes simplex keratitis

作　　者：黄挺[1] 高娜[1] 王玉娟[1] 

机构地区：[1]中山大学中山眼科中心,广东省广州市510060

出　　处：《眼科新进展》2008年第4期297-299,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨局部使用更昔洛韦眼用凝胶治疗上皮型单纯疱疹病毒性角膜炎(herpes simplex keretitis,HSK)的疗效和安全性。方法采用前瞻性随机双盲试验,45例HSK患者分3组:A组16例,用1.5g.L-1更昔洛韦凝胶滴眼;B组14例,用1g.L-1更昔洛韦滴眼液滴眼;C组15例,用1g.L-1阿昔洛韦滴眼液滴眼;均每天4次。用药前和用药后3d、7d、10d、14d、21d检查,记录患者症状(包括眼痛、畏光、流泪)和体征(包括睫状充血、角膜浸润溃疡和角膜水肿)的变化。结果3组用药后,所有树枝状HSK患者均痊愈。但A、B2组治愈时间[(7.7±1.8)d、(10.0±2.3)d]均较C组[(15.8±2.7)d]短(P值分别为0.015、0.027)。A组用药后症状改善的时间(3.7d)较B、C2组短(5.6d、5.8d)(P值分别为0.025、0.031)。3组均未发现明显不良反应。结论更昔洛韦凝胶治疗HSK是安全有效的,并且可以较早改善患者的症状和缩短病程。Objective To discuss the efficacy and safety of topical application of ganciclovir gel in treatment of epithelial herpes simplex keratitis （HSK）. Methods A randomised double blind prospective clinical trial on the treatment of 45 cases （45 eyes） of epithelial HSK was carried out. All the cases were divided into three groups. Group A （ 16 eyes） were treated by 1.5 g · L^-1 ganciclovir gel, group B （ 14 eyes） were treated by 1 g · L^-1 ganciclovir drop,and group C （15 eyes ） were treated by 1 g · L^-1 aciclovir drop, each usage was four times a day. The symptoms （ including ophthalmalgia, photophobia, lacrimation） and physical signs （including ciliary congestion, corneal infiltration or corneal ulcer,corneal edema） pre-therapy and on 3 days,7 days,10 days,14 days,21 days posttherapy were observed. Results Each cases of dendritic HSK treated with gel or drop used in this study were cured. But the difference of cure time was significant. Both of the cure time of group A [ （7.7 ± 1. 8 ） d ] and group B [ （ 10.0 ± 2.3 ） d] were shorter than group C[ （ 15.8 ± 2.7 ） d ] （ P = 0.015,0. 027, respectively）. And the time for the symptom improvement was also significant. The time for symptom improvement of group A （3.7 d） was shorter than group B （5.6 d） or group C （5.8 d） （ P = 0. 025,0. 031, respectively）. No obviously adverse drug reaction was found in all of three agents. Conclusion Ganciclovir gel is effective and safe ophthalmic solution to treat HSK, and can improve symptom early and shorten the cure time of HSK.

关 键 词：单纯疱疹病毒性角膜炎 更昔洛韦 阿昔洛韦 

分 类 号：R772.21[医药卫生—眼科]