探究重组牛碱性成纤维细胞生长因子眼用凝胶对白内障超声乳化术术后干眼症患者泪膜稳定性、视觉功能的影响  

Effects of recombinant bovine basic fibroblast growth factor ophthalmic gel on tear film stability and visual function in patients with dry eye after phacoemulsification

作　　者：张洪勤 陈子林 范惠雅[2] 黄立嘉[2] 刘云超 ZAHNG Hong-qin;CHEN Zi-lin;FAN Hui-ya(First Clinical School of Guangdong Medical University,Zhanjiang Guangdong 524023,China;Department of Ophthalmology Center,Huizhou Central People's Hospital,Huizhou Guangdong 516001,China)

机构地区：[1]广东医科大学第一临床医学院,广东湛江524023 [2]惠州市中心人民医院眼科中心,广东惠州516001

出　　处：《临床和实验医学杂志》2024年第19期2069-2073,共5页Journal of Clinical and Experimental Medicine

基　　金：广东省医学科研基金资助项目(编号:A2013775);广东省惠州市科技研发计划项目(编号:221014146940830)。

摘　　要：目的研究重组牛碱性成纤维细胞生长因子(rb-bFGF)眼用凝胶对白内障超声乳化术(CUP)术后干眼症患者的泪膜稳定性和视觉功能的影响。方法前瞻性选取2020年4月至2023年10月惠州市中心人民医院收治的CUP术后并发干眼症患者90例作为研究对象。按照随机数字表法将其分为观察组和对照组,每组各45例。对照组采用妥布霉素地塞米松滴眼液治疗,观察组在其基础上联合rb-bFGF眼用凝胶治疗。比较两组治疗疗效。观察两组患者治疗前、治疗4周后的泪膜稳定性[泪膜破裂时间(BUT)、基础泪液分泌试验(SIT)、角膜荧光素染色(FL)评分],治疗前、治疗2周、治疗4周后的视觉功能情况,并观察两组患者治疗前、治疗4周后的炎症指标[白细胞介素(IL)-1β、IL-8]、应激指标[脂质过氧化物(LPO)、丙二醇]变化,并比较两组的安全性。结果治疗后,观察组治疗总有效率为95.56%,高于对照组(82.22%),差异有统计学意义(P<0.05)。观察组治疗4周后的BUT、SIT分别为(8.64±0.92)s、(10.26±0.47)mm/5 min,均高于对照组[(7.83±0.44)s、(8.63±1.87)mm/5 min],FT评分为(0.84±0.17)分,低于对照组[(1.31±0.25)分],差异均有统计学意义(P<0.05)。观察组治疗2、4周后的视力分别为0.64±0.11、0.81±0.05,均高于对照组(0.54±0.09、0.75±0.11),差异均有统计学意义(P<0.05)。观察组治疗4周后的血清IL-1β、IL-8、丙二醇、LPO水平分别为(38.22±3.59)ng/L、(64.87±8.46)ng/L、(2.75±0.55)U/L、(1.43±0.15)μmol/L,均低于对照组[(77.15±9.25)ng/L、(96.06±10.34)ng/L、(3.29±0.12)U/L、(1.92±0.22)μmol/L],差异均有统计学意义(P<0.05)。观察组与对照组的不良反应总发生率比较(6.67%vs.4.44%),差异无统计学意义(P>0.05)。结论在CUP术后干眼症患者的临床治疗中,使用rb-bFGF眼用凝胶辅助治疗可显著提高其泪膜稳定性,促进视觉功能的恢复。Objective To study the effect of recombinant bovine basic fibroblast growth factor(rb-bFGF)ophthalmic gel on tear film stability and visual function of dry eye syndrome patients after cataract phacoemulsification(CUP).Methods A total of 90 patients with xerophthalmia after CUP admitted to Huizhou Central People's Hospital from April 2020 to October 2023 were prospectively selected as the study subjects.According to the random number table method,they were divided into the observation group and the control group,with 45 cases in each group.The control group was treated with tobramycin and dexamethasone eye drops,while the observation group was treated with rb-bFGF eye gel on the basis of tobramycin and dexamethasone eye drops.The therapeutic effects of the two groups were compared.The tear film stability[tear film rupture time(BUT),basic tear secretion test(SIT),fluorescein staining(FL)score],visual function before treatment,2 weeks and 4 weeks after treatment were observed in the two groups.The changes of inflammatory indexes[interleukin(IL)-1β,IL-8]and stress indexes[lipid peroxide(LPO),propylene glycol]before treatment and 4 weeks after treatment were observed in the two groups,and the safety of the two groups was compared.Results After treatment,the total effective rate of the observation group was 95.56%,which was higher than that of the control group(82.22%),and the difference was statistically significant(P<0.05).After 4 weeks of treatment,the BUT and SIT of the observation group were(8.64±0.92)s and(10.26±0.47)mm/5 min respectively,which were higher than those of the control group[(7.83±0.44)s and(8.63±1.87)mm/5 min],and the FT score was(0.84±0.17)points,which was lower than that of the control group[(1.31±0.25)points],the differences were statistically significant(P<0.05).The visual acuity of the observation group after 2 and 4 weeks of treatment were 0.64±0.11 and 0.81±0.05,respectively,which were higher than those of the control group(0.54±0.09 and 0.75±0.11),and the differences were statisti

关 键 词：重组牛碱性成纤维细胞生长因子眼用凝胶 白内障超声乳化术后 干眼症 泪膜稳定性 视觉功能 

分 类 号：R779.6[医药卫生—眼科]