重度玫瑰痤疮眼型28例眼部损害临床治疗结局分析  

Analysis of clinical treatment outcomes of ocular lesions in 28 cases of severe ocular rosacea

作　　者：孙静[1] 徐英男[1] 林彤[2] 薛劲松[1] Sun Jing;Xu Yingnan;Lin Tong;Xue Jinsong(The Affiliated Eye Hospital of Nanjing Medical University,Nanjing 210029,China;Institute of Dermatology,Chinese Academy of Medical Sciences and Peking Union Medical College,Nanjing 210042,China)

机构地区：[1]南京医科大学附属眼科医院,南京210029 [2]中国医学科学院、北京协和医学院皮肤病研究所,南京210042

出　　处：《中华皮肤科杂志》2023年第2期142-145,共4页Chinese Journal of Dermatology

摘　　要：目的探讨重度玫瑰痤疮眼型眼部损害的临床治疗方案。方法选取2019年12月1日至2021年5月30日间在南京医科大学附属眼科医院门诊诊断为重度玫瑰痤疮眼型患者28例34眼,将患者按单纯随机抽样法分为A、B两组,A组13例16眼,局部联合使用0.3%玻璃酸钠滴眼液及0.5%左氧氟沙星滴眼液;B组15例18眼,局部仅使用0.3%玻璃酸钠滴眼液。两组患者前2周口服盐酸米诺环素100 mg/d,后6周口服盐酸米诺环素50 mg/d,均辅以睑板腺按摩、眼睑局部热敷及睑缘清洁等相同的物理治疗。记录治疗前及治疗8周后两组患者的LogMAR视力、泪膜破裂时间(BUT)、眼表疾病评分量表(OSDI)评分以及睑板腺功能评分。采用配对t检验和独立样本t检验分别比较两组患者治疗前后组内及治疗后组间差异。结果治疗8周后,与治疗前相比,A、B组视力均明显提高(t值分别为3.10、2.15,P值分别为0.007和0.046),泪膜破裂时间明显提高(t值分别为3.44、2.85,P值分别为0.003和0.011),OSDI评分均显著下降(t=7.12、9.33,均P<0.001),睑板腺功能评分亦显著下降(t=13.73、16.82,均P<0.001);治疗后两组间视力(P=0.721)、泪膜破裂时间(P=0.189)、OSDI评分(P=0.808)以及睑板腺功能评分(P=0.191)差异均无统计学意义。治疗期间均未见药物不良反应。患者最长随访时间8个月,眼部皮损均未见复发。结论不联合局部使用抗生素,口服盐酸米诺环素片联合局部使用玻璃酸钠滴眼液可有效治疗重度玫瑰痤疮眼型眼部损害,并能控制复发。Objective To investigate clinical treatment regimens for ocular lesions in patients with severe ocular rosacea.Methods A total of 28 patients(34 eyes)with severe rosacea complicated by blepharokeratoconjunctivitis were collected from outpatient department of the Affiliated Eye Hospital of Nanjing Medical University from December 1,2019 to May 30,2021.They were randomly divided into two groups:group A(13 cases,16 eyes)topically treated with sodium hyaluronate 0.3%eye drops and levofloxacin 0.5%eye drops,and group B(15 cases,18 eyes)topically treated with sodium hyaluronate 0.3%eye drops alone.Patients in both groups also received oral minocycline hydrochloride 100 mg every day for the first 2 weeks,and then 50 mg every day for the next 6 weeks.Meanwhile,all patients received same physical therapies such as meibomian gland massage,eyelid hot compresses and eyelid margin cleaning.LogMAR visual acuity,tear break-up time(BUT),ocular surface disease index(OSDI)score,and meibomian gland function grading examination results in the two groups were recorded before and 8 weeks after treatment.Paired t test was used to compare within-group differences in the parameters before and after treatment,and two-independent-sample t test to compare intergroup differences after treatment.Results After 8-week treatment,both group A and group B showed significantly increased LogMAR visual acuity(t=3.10,2.15,P=0.007,0.046,respectively),improved BUT(t=3.44,2.85,P=0.003,0.011,respectively),but significantly decreased OSDI scores(t=7.12,9.33,respectively,both P<0.001)and meibomian gland function scores(t=13.73,16.82,respectively,both P<0.001)compared with those before treatment.After treatment,no significant differences were observed in the LogMAR visual acuity(P=0.721),BUT(P=0.189),OSDI scores(P=0.808)and meibomian gland function scores(P=0.191)between the two groups.No adverse drug reactions occurred during the treatment.During the follow-up period(8 months or shorter),no recurrence of ocular lesions was observed.Conclusion Without topica

关 键 词：红斑痤疮 眼疾病 治疗结果 米诺环素 玫瑰痤疮眼型 左氧氟沙星滴眼液 玻璃酸钠滴眼液 

分 类 号：R771.3[医药卫生—眼科] R758.734[医药卫生—临床医学]