地夸磷索钠滴眼液对中重度干眼患者眼表状况和视觉质量的影响  

Effect of Diquafosol Sodium on the Ocular Surface and the Visual Quality of Patients with Moderate to Severe Dry Eyes

作　　者：王杨[1] 黄钰清 杨燕宁[1] Yang Wang;Yuqing Huang;Yanning Yang(Department of Ophthalmology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院眼科中心,430060

出　　处：《中华眼视光学与视觉科学杂志》2021年第5期329-335,共7页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：国家自然科学基金(81770899)。

摘　　要：目的:评价3%地夸磷索钠滴眼液对中重度干眼患者眼表状况和视觉质量的改善效果。方法:前瞻性临床研究。收集2019年9月至2020年8月在武汉大学人民医院眼科门诊就诊的中重度干眼患者78例(78眼),将其按随机数字表法随机分为人工泪液组38例(38眼)和地夸磷索钠滴眼液组40例(40眼),人工泪液组使用人工泪液点眼3次/d,地夸磷索钠滴眼液组使用3%地夸磷索钠滴眼液点眼6次/d和人工泪液3次/d,治疗1个月后观察疗效。2组数据比较采用独立样本t检验,性别差异使用卡方检验,组内治疗前后指标评分比较采用配对样本t检验,多重比较采用Bonferroni检验。各项参数间相关性分析使用Spearman相关性分析。结果:点眼1个月后,2组患者眼表状况及视觉质量均有所改善,地夸磷索钠组的泪膜破裂时间(BUT)、泪河高度、泪液分泌试验、角膜荧光染色(FL)和泪膜客观散射指数(TF-OSI)较人工泪液组比较效果更优,差异均有统计学意义(t=2.613,P=0.029;t=8.498,P=0.001;t=4.082,P=0.015;t=15.06,P<0.001;t=5.021,P=0.007)。2组使用前后的TF-OSI与BUT、调制传递函数截止频率呈负相关(r=-0.298,P=0.045;r=-0.478,P=0.033;r=-0.478,P=0.004;r=-0.399,P=0.006),且地夸磷索钠组TF-OSI与干眼问卷调查得分、FL呈正相关(r=0.479,P=0.035;r=0.254,P=0.027)。结论:地夸磷索钠滴眼液联合人工泪液可以有效改善中重度干眼的临床症状及体征,并能明显提高患者的视觉质量,效果优于单用人工泪液。Objective:To evaluate changes in the ocular surface status and the visual quality in patients with moderate to severe dry eyes before and after treatment with 3%diquafosol sodium eye drops.Methods:In this prospective clinical study,a total of 78 patients(78 eyes)with moderate to severe dry eye were included from the ophthalmic outpatient department of Renmin Hospital of Wuhan University from September 2019 to August 2020.Patients were randomly divided into two groups based on the criteria.In the artificial tear group,38 patients(38 eyes)were treated with artificial tear drops for 3 s/d;in the diquafosol sodium group,40 patients(40 eyes)were treated with diquafosol sodium for 6 s/d and artificial tear for 3 s/d.The therapeutic effect was observed 1 month after treatment.The data were analyzed by sample t test,Chi-square and Spearman correlation.Results:After 1 month of treatment,the two groups of patients had improved,and the effect in the diquafosol sodium group was better than that in the artificial tears group for break-up time(BUT),tear meniscus height,SchirmerⅠtest,corneal fluorescein staining(FL)and the tear film objective scatter index(TF-OSI)(t=2.613,P=0.029;t=8.498,P=0.001;t=4.082,P=0.015;t=15.06,P<0.001;t=5.021,P=0.007).TF-OSI was negatively correlated with BUT and Modulation transfer function cut off before and after use in the two groups(r=-0.298,P=0.045;r=-0.478,P=0.033;r=-0.478,P=0.004;r=-0.399,P=0.006),and TF-OSI was positively correlated with the dry eye questionnaire score(OSDI)and FL in the diquafosol sodium group(r=0.479,P=0.035;r=0.254,P=0.027).Conclusions:Diquafosol sodium combined with artificial tears can effectively improve the clinical symptoms and signs of moderate to severe dry eyes,and can effectively improve the visual quality of patients.This improvement is better than treatment with artificial tears alone.

关 键 词：中重度干眼 P2Y2受体 泪膜 视觉质量 泪膜客观散射指数 

分 类 号：R777.34[医药卫生—眼科]