更昔洛韦胶囊治疗病毒性角膜内皮炎的疗效观察  

Curative effect assessment of oral ganciclovir capsules on the treatment of cortical endotheliitis

作　　者：孙昱昭[1,2] 陈亢[1,2] 

机构地区：[1]中国医科大学附属第一医院眼科 [2]中国医科大学眼科中心,中国辽宁省沈阳市110004

出　　处：《国际眼科杂志》2013年第4期706-709,共4页International Eye Science

摘　　要：目的:探讨更昔洛韦胶囊治疗病毒性角膜内皮炎的临床疗效。方法:收集2011-10/2012-10在中国医科大学附属第一院眼科门诊确诊的病毒性角膜内皮炎患者14例14眼,排除高血压病史、白细胞、血小板减少及肝肾功异常后,予更昔洛韦胶囊1.0g,3次/d,口服,持续2～4wk后,改为0.5g,3次/d,口服,持续4wk后停药;同时联合眼部应用1.5g/L更昔洛韦凝胶及10g/L醋酸泼尼松龙滴眼液点眼;观察用药后眼痛、视物模糊、畏光、异物感、视力、结膜充血、角膜水肿、角膜后弹力层皱褶及角膜后沉着物(KP)等指标,评价治疗有效率与治愈率,并观察用药后复发情况。治疗前后评分比较采用秩和检验方法。结果:采用更昔洛韦胶囊口服治疗后眼部症状及眼部体征从第1wk开始逐渐好转,评分由治疗前的19.14±4.57逐渐下降为第1wk的11.43±3.86,第2wk的6.93±2.59,第4wk的0.29±0.87;至治疗后第8wk14例患者眼部症状及体征完全消失。第1,2,4,8wk有效率分别为71%,100%,100%,100%。与发病之前比较,14例患者中10例视力完全恢复,3例轻度下降,1例视力明显下降。14例患者随访观察中均未见复发。结论:更昔洛韦胶囊联合眼部用药治疗病毒性角膜内皮炎有效,并且可以预防复发。AIM： To evaluate the clinical values of oral ganciclovir on the treatment of corneal endotheliitis. METHODS： The data of 14 eyes of 14 patients with corneal endotheliitis diagnosed in China Medical University Eye Center from October 2011 to October 2012 were retrospectively analyzed. Oral ganciclovir was orally administered 1.0g 3 times per day for 2-4 weeks, and then by 0. 5g 3 times per day for 4 weeks; 1. 5g/L ganciclovir ophthalmic gel and 10g/L prednisolone acetate eye drops were adopted in eyes. The symptoms and signs, together with effective rate and cure rate were evaluated before and after the therapy 1 st week, 2nd week, 4th week and 8th week respectively. The recurrence was followed up. The score before and after the treatment by Rank-sum test was compared. RESULTS： One week after therapy of oral ganciclovir, the symptoms and signs bettered, the score changed from 19.14±4.57 to 11.43±3.86, then 6.93±2.59 for 2th week, and 0. 29± 0. 87 for 4th week. Till 8th week, the symptoms and signs of all the patients disappeared completely. The effective rate was 71%, 100%, 100%, 100% after the therapy 1st week, 2nd week, 4th week and 8th week respectively. Compared with the vision of before, 10 cases fully recovered, 3 cases declined mildly, and 1 case significantly reduced. None of the cases recurred during the follow-up time. CONCLUSION：Treating corneal endotheliitis by oral ganciclovir combined with eye drops is effective. Oral ganciclovir could prevent recurrence.

关 键 词：角膜内皮炎 更昔洛韦 胶囊 

分 类 号：R772.2[医药卫生—眼科]