表皮生长因子在白内障超声乳化术后眼表损伤修复过程中的作用  

The effects of recombinant human epithelial growth factor on ocular surface injury after phacomulsification

作　　者：张珍珍[1] 张辉[2] 吴星伟[1] 唐于荣 

机构地区：[1]上海交通大学附属第一人民医院眼科,200080 [2]吉林大学附属第二医院眼科医院,长春130041 [3]南京明基医院眼科,210000

出　　处：《中华实验眼科杂志》2012年第6期553-556,共4页Chinese Journal Of Experimental Ophthalmology

基　　金：上海市卫生局中医药重大课题基金项目（2006ZD01）

摘　　要：背景随着白内障超声乳化联合后房型人工晶状体（IOL）植入术治疗年龄相关性白内障的广泛应用，部分患者术后感到明显的烧灼感、异物感，该手术对患者眼表的损伤及影响多有报道。目的观察重组人表皮生长因子（rhEGF）对年龄相关性白内障患者行白内障超声乳化联合IOL植入术后眼表损伤的修复作用。方法采用前瞻性研究方法。选择确诊为年龄相关性白内障并行白内障超声乳化联合IOL植入术的患者89例120眼，依据术后第1天给予滴眼液的不同分为rhEGF组、玻璃酸钠组和空白对照组，每组40眼。各组间术前角膜荧光素染色、泪膜破裂时间（BUT）及泪液分泌（Schirmer Ⅰ）试验结果差异均无统计学意义（均P〉0．05）。各组基础用药为质量分数0．3％氧氟沙星眼膏和妥布霉素地塞米松滴眼液，持续2周。术后第1天rhEGF组和玻璃酸钠组分别给予rhEGF滴眼液、玻璃酸钠滴眼液点眼，每日4次，持续4周。患者分别于术前1d及术后1d、1周、2周和1个月时行角膜荧光素染色、BUT及Schirmer Ⅰ试验检测，并进行比较分析。结果3个组间人口基线特征差异均无统计学意义（F年龄=3．740，Х性别^2=0．615，P〉0．05），术前1d眼表检查差异亦无统计学意义（角膜荧光素染色评分：F=0．247，P〉0．05；BUT：F=0．579，P〉0．05；Schirmer Ⅰ试验：F=0．475，P〉0．05）。随着术后时间的延长，各组内角膜荧光素染色评分、Schirmer Ⅰ试验结果均出现先升高后下降的趋势，BUT出现先缩短后延长的趋势，3个组术前1d，术后1d、1周、2周、1个月时角膜荧光素染色评分值、BUT、Schirmer Ⅰ试验结果各时间点间差异均有统计学意义（FN目=6．754、6．233、6．079，P〈0．01）；3个组间差异亦有统计学意义（F＊。=4．953、4．071、4．511，P〈0．05）。rhEGF组术后2周和术后1个月角膜荧光素染色评分明显低�Background With the widely application of phacoemulsication for cataract, dry eye-associated symptoms, such as foreign body sensation and burning frequently occur after cataract surgery in some patients. Objective This study was to evaluate the repair effects of recombinant human epithelial growth factor （rhEGF） on ocular surface injuriy after phaeomulsifieation. Methods This was a prospective study, and informed consent was obtained from eaeh subjeet before the experiment. One hundreds and twenty eyes of 89 consecutive patients after phacomulsification for age-related cataract were collected and randomized into rhEGF group,hyaluronic acid group and control group and 40 eyes for eaeh. RhEGF drops and hyaluronie aeid drops were topieally administered 4 times per day for consecutive 4 weeks after surgery in corresponding group, and no drops mentioned above was used in the control group. The 0.3% ofloxacin eye ointment and tobramyein＋dexamethasone drops were used as the element drops in all patients of each group. Corneal fluoreseein staining score, tear film break-up time （BUT） , Schirmer Ⅰ test without topical anesthesia were performed 1 day before surgery and 1 day, 1 week,2 weeks and 1 month after surgery. Results The demography and the relevant surface examinational outcomes were no significantly different among the rhEGF group,hyaluronie acid group and control group in preoperation （age： F = 3.74; gender：Х^2= 0. 615; corneal fluorescein staining： F=0. 247 ; BUT： F = 0. 579 ; Schirmer Ⅰ test： F = 0. 475 ; all P〉0.05 ）. With the prolong of the time,the corneal fluorescein staining scores and Schirmer Ⅰ test values appeared a early ascent and latterly decline, and the BUT value showed a early shorten and latterly restore,with a statistically significant differences among various time points （ F时间 = 6. 754,6. 079,6. 233, P 〈 0.01 ）. Meanwhile, statistically significant differences were found in the corneal fluorescein staining scores, Schirmer Ⅰ test values and BUT amon

关 键 词：重组人表皮生长因子 白内障 超声乳化 玻璃酸钠 干眼 

分 类 号：R779.66[医药卫生—眼科]