糖皮质激素联合人工泪液治疗单纯疱疹病毒性角膜炎恢复期干眼症的效果  

Use of corticosteroid eyedrops combined with artificial tears in the treatment of dry eyes in the convalescent phase of herpes simplex keratitis

作　　者：刘淑英[1] 李志清[1] 陈露霞[1] 赵少贞[1] 

机构地区：[1]天津医科大学眼科医院,300384

出　　处：《眼科》2013年第2期101-104,共4页Ophthalmology in China

摘　　要：目的探讨糖皮质激素联合人工泪液在病毒性角膜炎恢复期中治疗干眼症的效果。设计回顾性病例系列。研究对象2008年6月至2011年8月就诊于天津医科大学眼科中心的43例(52眼)病毒性角膜炎经常规治疗恢复期被确诊为干眼症的患者。方法上述患者在停用抗病毒、抗生素眼药及各种人工泪液的基础上,用不含防腐剂的人工泪液(每日4次)联合糖皮质激素(每日3次)点眼,观察所有患者治疗前及治疗后7、14、21天泪膜破裂时间(BUT)、角膜荧光素染色(FL)、基础泪液分泌试验(SIT)的变化。主要指标BUT、FL评分、SIT。结果所有患者均完成治疗和随访。治疗后7、14、28天观察BUT、FL及SIT较治疗前均有不同程度改善,部分病例症状消失。从治疗前到治疗后28天,SIT从(6.40±2.31)mm增加到(14.58±2.81)mm(P=0.000)、FL评分由(7.52±2.78)分降低到(0.14±0.26)分(P=0.000)、BUT从(7.63±0.90)秒延长到(11.53±1.78)秒(P=0.000)。结论对于病毒性角膜炎恢复期干眼患者,在停用抗病毒及抗生素药物的基础上联合应用糖皮质激素及不含防腐剂的人工泪液治疗,治愈率高,效果确切。Objective To investigate the effect of a combination of corticosteroid eyedrops and artificial tears in the treatment of dry eyes in the convalescent viral keratitis. Design Retrospective case series. Participants This study involved 52 eyes of 43 consecu- tive patients with dry eyes who had recovered from viral keratitis after routine treatment between June 2008 and August 2011. The average age was 35.28±11.62 （17-59） years old. Method The patients were given artificial tears without preservative 4 times per-day and corticosteroid eyedrops 3 times per-day. For all patients, the tear film break-up time （BUT）, corneal fluorescein staining score （FL） and Schirmer I test （SIT） were evaluated before and 7,14, and 28 days after initiating the treatment. Main Outcome Measures BUT, FL and SIT. Results All patients completed the study until its end. The BUT, FL and SIT were improved at all time points. Symptoms completely resolved in some patients. During treatment, the SIT increased from 6.40±2.31 mm to 14.58±2.81 mm （P=0.000）, the FL score decreased from 7.52±2.78 to 0.14±0.26 （P=0.000） and the BUT increased from 7.63±0.90 s to 11.53±1.78 s （P=0.000）. Conclusion Corticosteroid eyedrops combined with artificial tears without preservative were helpful and effective in the treatment of dry eyes in the convalescence phase of virus keratitis.

关 键 词：病毒性角膜炎 干眼症 糖皮质激素 人工泪液 

分 类 号：R777[医药卫生—眼科]