0.05%环孢素A滴眼液治疗中重度干眼安全性及对角膜上皮下神经的影响  

Safety of 0.05%Cyclosporine A Eye Drops in the Treatment of Patients with Moderate to Severe Dry Eye and Its Effect on Corneal Subepithelial Nerves

作　　者：练海东[1] 张思瑶 董星星 袁婷 万慧娟 LIAN Hai-dong;ZHANG Si-yao;DONG Xing-xing;YUAN Ting;WAN Hui-juan(The First Affiliated Hospital of Shihezi University,Xinjiang Shihezi,832008)

机构地区：[1]石河子大学第一附属医院,新疆石河子832008

出　　处：《农垦医学》2024年第6期488-491,497,共5页Journal of Nongken Medicine

摘　　要：目的:探究0.05%CsA滴眼液治疗中重度干眼症患者的安全性及对角膜上皮下神经(Subepithelial Nerve,SBN)数量及形态的影响。方法:选取2021年6月至2022年12月期间我院收治的80名中、重度干眼症患者,按随机数字表法,将80名患者分成2组。对照组采用羟丙甲纤维素滴眼液,观察组在此基础上加用0.05%CsA滴眼液;比较2组患者眼部检查指标、SBN数量及形态、泪液表皮生长因子(Epidermal Growth Factor,EGF)及转化生长因子β1(Transforming Growth Factor Beta1,TGF-β1)、不良反应。结果:治疗1个月,2组患者泪膜破裂时间(Break-Up Time,BUT)和泪液分泌试验结果均高于治疗前,观察组高于对照组(P<0.05);2组患者角膜荧光染色评分均低于治疗前,观察组低于对照组(P<0.05);治疗1个月,2组患者神经密度均比治疗前高,观察组高于对照组(P<0.05),2组患者神经弯曲度评分低于治疗前,观察组比对照组低(P<0.05)。治疗1个月,2组患者泪液中EGF和TGF-β1的水平高于治疗前,观察组水平高于对照组(P<0.05)。2组不良反应比较差异无统计学意义(P>0.05)。结论:0.05%CsA滴眼液能够在不增加不良反应的情况下,显著改善中重度干眼症患者的泪膜功能,延长其BUT,增加泪液分泌,改善SBN数量及形态、EGF及TGF-β1水平,效果优于单独使用羟丙甲纤维素滴眼液治疗。Objective:To explore the safety of 0.05%cyclosporine A(CsA)eye drops in the management of moderate to severe dry eye disease patients and its effect on the number and morphology of corneal subepithelial nerves(SBN).Methods:A total of 80 patients with moderate to severe dry eye disease who were accepted to our hospital from June 2021 to December 2022 were chosed and divided into two groups according to the random number table method,with 40 cases in each group.The control group was treated with hydroxypropyl methylcellulose eye drops,and the observation group was treated with 0.05%CsA eye drops on this basis.The ocular examination indexes,number and morphology of SBN,tear epidermal growth factor(EGF)and transforming growth factor-β1(TGF-β1),and adverse reactions were compared between the two groups.Results:After 1 month of treatment,the tear film rupture time(BUT)and tear secretion test results of the two groups were higher than those before treatment,and the observation group was apparently higher than the control group(P<0.05).The corneal fluorescence staining scores of the two groups were lower than those before treatment,and the observation group was lower than the control group(P<0.05).After 1 month of treatment,the nerve density of the two groups was higher than that before treatment,and the observation group was apparently higher than the control group(P<0.05).The nerve curvature scores of the two groups were lower than those before treatment,and the observation group was lower than the con-trol group(P<0.05).After 1 month of treatment,the levels of EGF and TGF-β1 in tears of the two groups were high-er than those before treatment,and the observation group was exactly higher than the control group(P<0.05).The two groups showed no significant difference in adverse reactions after 1 month of treatment(P>0.05).Conclusions:0.05%cyclosporine A(CsA)eye drops can improve tear film function,prolong BUT,increase tear secretion,improve the number and morphology of SBN,EGF and TGF-β1 levels in patients with modera

关 键 词：干眼症 环孢素A滴眼液 角膜上皮下神经 安全性 

分 类 号：R777.34[医药卫生—眼科]