鼠神经生长因子治疗外伤性瞳孔散大疗效观察  

Effect of mouse nerve growth factor in the treatment of traumatic mydriasis patients

作　　者：高瑞莹[1] 李仕永[1] 陈晖[1] 牛文哲 GAO Rui-ying;LI Shi-yong;CHEN Hui;NIU Wen-zhe(Department of Ophthalmology,Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University,Nanjing Ningyi Eye Center,Nanjing 210008,Jiangsu Province,China;Department of Ophthalmology,Taikang Xianlin Drum Tower Hospital Affiliated to Medical School of Nanjing University,Nanjing 210046,Jiangsu Province,China)

机构地区：[1]南京大学医学院附属鼓楼医院眼科宁益眼科中心,江苏南京210008 [2]南京大学医学院附属泰康仙林鼓楼医院眼科,江苏南京210046

出　　处：《新乡医学院学报》2019年第1期77-80,共4页Journal of Xinxiang Medical University

摘　　要：目的观察鼠神经生长因子治疗外伤性瞳孔散大的临床疗效。方法使用随机数字表法将2013年2月至2017年4月南京大学医学院附属鼓楼医院宁益眼科中心收治的89例外伤性瞳孔散大患者分为对照组44例和观察组45例。对照组患者给予小剂量醋酸泼尼松片、云南白药胶囊、维生素C及甲钴胺口服治疗,局部给予糖皮质激素眼液滴眼,眼压升高者给予降眼压治疗;观察组患者在对照组治疗基础上加用鼠神经生长因子肌肉注射治疗。治疗前及治疗3周后2组患者均行裂隙灯显微镜、眼前段照相、B超、电子计算机断层扫描及超声生物显微镜检查,观察双眼最佳矫正视力(BCVA)、瞳孔大小及对光反射情况。结果对照组患者治疗前及治疗3周后患眼与健眼瞳孔直径差值分别为(2. 91±0. 44)、(1. 82±0. 34) mm,观察组患者治疗前、治疗3周后患眼与健眼瞳孔直径差值分别为(2. 97±0. 47)、(1. 32±0. 31) mm。治疗前2组患者患眼与健眼瞳孔直径差值比较差异无统计学意义(t=0. 832,P>0. 05);治疗3周后,2组患者患眼与健眼瞳孔直径差值均显著小于治疗前(t=-3. 27、-4. 78,P <0. 05),观察组患者患眼与健眼瞳孔直径差值显著小于对照组(t=-2. 23,P <0. 05)。对照组患者治疗前和治疗3周后BCVA分别为0. 98±0. 25、0. 21±0. 03 (Log MAR视力),观察组患者治疗前和治疗3周后BCVA分别为1. 02±0. 31、0. 16±0. 04(Log MAR视力); 2组患者治疗前BCVA比较差异无统计学意义(Z=-0. 041,P> 0. 05),2组患者治疗3周后BCVA均小于治疗前(对照组:Z=-5. 696,P <0. 05;观察组:Z=-6. 183,P <0. 05),治疗3周后观察组患者BCVA显著小于对照组(Z=-2. 776,P <0. 05)。治疗3周后,对照组和观察组患者治疗总有效率分别为65. 91%(29/44)、77. 78%(35/45),观察组患者治疗总有效率高于对照组(Z=-3. 683,P <0. 05)。2组患者均未发生严重并发症及药物不良反应。结论鼠神经生长因子对外伤性瞳孔散大患�Objective To investigate the clinical effect of mouse nerve growth factor in the treatment of traumatic mydriasis.Methods A total of 89 patients with traumatic mydriasis in Ningyi Eye Center of Gulou Hospital Affiliated to Medical School of Nanjing University from February 2013 to April 2017 were selected as the study subjects.The patients were divided into control group (n=44) and observation group (n=45) by random number table.The patients in the control group were treated with low dose prednisone acetate tablets,Yunnan Baiyao capsules,vitamin C and Mecobalamin by oral and glucocorticoid eye drops.The patients in the observation group were treated with mouse nerve growth factor by intramscular injection on the basis of the treatment in the control group.The best corrected visual acuity (BCVA),pupillary size and light reflex of eyes were observed by slit lamp microscopy,anterior segment photography,B-mode ultrasonography,computed tomography and ultrasound biomicroscopy before and three weeks after treatment.Results The difference of pupil diameter between the affected eye and the healthy eye in the control group before and after treatment was (2.91±0.44) and (1.82±0.34) mm,respectively.The difference of pupil diameter between the affected eye and the healthy eye in the observation group before and after treatment was (2.97±0.47) and (1.32±0.31) mm,respectively.There was no significant difference in pupil diameter difference between the affected eyes and the healthy eyes between the two groups before treatment (t=0.832,P>0.05).The difference of pupil diameter between the affected and healthy eyes after three weeks of treatment was significantly smaller than that before treatment in the two group (t=-3.27,-4.78;P<0.05).The difference of pupil diameter between the affected and healthy eyes in the observation group was significantly smaller than that in the control group after three weeks of treatment (t=-2.23,P<0.05).The BCVA of the patients in the control group was 0.98±0.25 and 0.21±0.03(LogMAR visual acuit

关 键 词：鼠神经生长因子 外伤 瞳孔散大 最佳矫正视力 

分 类 号：R773.2[医药卫生—眼科]