不同非甾体类抗炎药物对超声乳化白内障吸除联合IOL植入术后抗炎效果的随机对照研究  

A randomized controlled study of anti-inflammatory effects of different non-steroidal anti-inflammatory drugs in the postoperative stage of phacoemulsification combined with intraocular lens implantation surgery

作　　者：葛佳佳 刘晴 周金燕 单晓娜 黄钰森 Ge Jiajia;Liu Qing;Zhou Jinyan;Shan Xiaona;Huang Yusen(Eye Institute of Shandong First Medical University,Qingdao Eye Hospital of Shandong First Medical University,State Key Laboratory Cultivation Base,Shandong Provincial Key Laboratory of Ophthalmology,School of Ophthalmology,Shandong First Medical University,Qingdao 266000,China)

机构地区：[1]山东第一医科大学附属眼科研究所、山东第一医科大学附属青岛眼科医院、山东省眼科学重点实验室-省部共建国家重点实验室培育基地、山东第一医科大学眼科学院,青岛266000

出　　处：《中华实验眼科杂志》2024年第3期256-263,共8页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金面上项目(81970788)。

摘　　要：目的比较2种非甾体类抗炎药物对超声乳化白内障吸除联合人工晶状体(IOL)植入术后的抗炎疗效及安全性。方法采用随机双盲临床对照研究方法,选取2020年10月至2021年2月于山东第一医科大学附属青岛眼科医院就诊的年龄相关性白内障患者90例90眼。采用随机数字表法将患者分为双氯芬酸钠组和溴芬酸钠组,每组45例45眼,均行超声乳化白内障吸除联合IOL植入术,并在围手术期分别点用0.1%新型双氯芬酸钠滴眼液(不含防腐剂)4次/日和0.1%溴芬酸钠滴眼液2次/日,连续用药6周。于术前及术后1 d、1周、6周对患者的客观症状进行评估,采用基础泪液分泌试验检测泪液分泌量,采用干眼分析仪记录泪膜破裂时间,在裂隙灯显微镜钴蓝光照射下观察角膜荧光素染色情况,采用裂隙灯显微镜测定前房闪辉并分级,采用光学相干断层扫描仪测量黄斑中央区厚度并检查有无黄斑囊样水肿;同时对视力、眼压及药物安全性和不良反应进行检测和评价。结果所有受试者手术过程顺利,术中未发生并发症,均按要求完成治疗和随访。双氯芬酸钠组和溴芬酸钠组患者主观症状评分术前分别为(0.47±0.73)和(0.47±0.51)分,术后1 d分别为(0.56±0.62)和(0.75±0.61)分,术后1周分别为(0.33±0.48)和(0.64±0.65)分,术后6周分别为(0.51±0.66)和(0.78±0.77)分。不同时间点2个组患者主观症状评分比较差异均有统计学意义(F_(组别)=5.001,P=0.028;F_(时间)=2.920,P=0.035),双氯芬酸钠组术后主观症状评分较溴芬酸钠组明显降低,差异均有统计学意义(均P<0.05)。双氯芬酸钠组和溴芬酸钠组患眼术前泪液分泌量分别为(5.87±2.37)和(7.36±2.74)mm,组间比较差异有统计学意义(F=6.910,P=0.012),术后1周分别为(6.07±2.53)和(6.29±3.46)mm,术后6周分别为(6.29±0.25)和(5.80±2.76)mm,组间比较差异无统计学意义(F=1.121、0.772,P=0.729、0.384)。双氯芬酸钠组和溴芬酸钠组�Objective To explore the anti-inflammatory effect and safety of two non-steroidal anti-inflammatory drugs in the phacoemulsification combined with intraocular lens(IOL)implantation.Methods A randomized,double-blind,clinical trial was conducted.A total of 90 age-related cataract patients(90 eyes)who were diagnosed in Qingdao Eye Hospital Affiliated to Shandong First Medical University were enrolled from October 2020 to February 2021.The patients were randomized to diclofenac sodium group and bromofenac sodium group by random number table method,with 45 cases(45 eyes)in each group.All patients underwent phacoemulsification combined with IOL implantation,and 0.1%diclofenac sodium eye drops(preservative-free),4 times a day,and 0.1%pramiphene eye drops,2 times a day were applied in the perioperative period.The duration of continuous medication treatment and follow-up time were 6 weeks.The subjective symptoms of the patients were scored before and after surgery.The amount of tear fluid secretion was detected by Schirmer I test,and the tear film breakup time was recorded with the Oculus dry eye analyzer.Corneal fluorescein staining was observed under a slit lamp microscope with cobalt blue light.Anterior chamber flash was measured by slit-lamp biomicroscopy.The thickness of central macular area and the presence of macular cystoid edema was measured by optical coherence tomography.Visual acuity,noncontact intraocular pressure(IOP)and the drug safety were examined and evaluated.This study adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Qingdao Eye Hospital(No.[2020]60).All patients were informed about the surgery and postoperative medication and signed the informed consent form.Results All subjects had no intraoperative complications,and completed treatment and follow-up as required.The preoperative,1-day postoperative,1-week postoperative,6-week postoperative subjective symptom scores were(0.47±0.73),(0.56±0.62),(0.33±0.48),and(0.51±0.66)points in the diclofenac group,and(0.47±0.51

关 键 词：非甾体类抗炎药 超声乳化白内障吸除术 前房 炎症 干眼 黄斑水肿 

分 类 号：R779.66[医药卫生—眼科]