小牛血去蛋白提取物治疗糖尿病性白内障合并干眼患者超声乳化术后干眼的随机对照研究  

A randomized controlled study of deproteinized calf blood extract in the treatment of diabetic cataract with dry eye after phacoemulsification

作　　者：李凤洁 赵灿 裴力 孙吉君 李晓凤 牛梦迪 田亚宾 贺晓珍 汪金琮 王婷 Li Fengjie;Zhao Can;Pei Li;Sun Jijun;Li Xiaofeng;Niu Mengdi;Tian Yabin;He Xiaozhen;Wang Jincong;Wang Ting(Eye Institute of Shandong First Medical University,Eye Hospital of Shandong First Medical University(Shandong Eye Hospital),State Key Laboratory Cultivation Base,Shandong Provincial Key Laboratory of Ophthalmology,School of Ophthalmology,Shandong First Medical University,Jinan 250021,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眼科医院(山东省眼科医院),山东省眼科学重点实验室-省部共建国家重点实验室培训基地,山东第一医科大学眼科学院,济南250021

出　　处：《中华实验眼科杂志》2025年第4期343-349,共7页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金(82271052、82201154);国家自然科学基金区域创新发展联合基金(U20A20386);泰山青年学者项目(tsqn201909188)。

摘　　要：目的比较小牛血去蛋白提取物(DCBE)滴眼液与0.3%玻璃酸钠滴眼液治疗糖尿病性白内障合并干眼患者超声乳化术后干眼的临床效果。方法采用随机对照研究,选取2022年1—9月在山东第一医科大学附属眼科医院行白内障超声乳化术的2型糖尿病合并白内障和干眼患者112例116眼,采用随机数字表法将患者分为DCBE组49例51眼和玻璃酸钠组63例65眼,术后分别给予DCBE滴眼液和0.3%玻璃酸钠滴眼液点眼。记录并比较术前和术后1周、1个月干眼症状评分、角膜水肿分级、泪膜破裂时间(TBUT)、角膜荧光素染色(CFS)评分和泪液分泌试验Ⅰ(SⅠt)结果。结果手术前后不同时间点干眼症状评分、TBUT和SⅠt总体比较差异均有统计学意义(F时间=323.202、102.771、151.876,均P<0.001),其中2个组术后1周和术后1个月干眼症状评分均较术前降低,SⅠt均较术前增加,差异均有统计学意义(均P<0.017);DCBE组术后1周和1个月TBUT均较术前延长,玻璃酸钠组术后1个月TBUT较术前延长,差异均有统计学意义(均P<0.017)。2个组手术前后不同时间点CFS评分总体比较差异均有统计学意义(F组别=5.391,P=0.022;F时间=142.402,P<0.001),其中2个组术后1周和1个月CFS评分均较术前降低,差异均有统计学意义(均P<0.017);术后1周和术后1个月,DCBE组CFS评分均低于玻璃酸钠组,差异均有统计学意义(均P<0.017)。术后1周,DCBE组角膜水肿患者占5.9%(3/51),明显低于玻璃酸钠组的20.0%(13/65),差异有统计学意义(χ2=4.790,P=0.029)。结论DCBE滴眼液在糖尿病性白内障术后早期即可促进角膜修复、稳定泪膜及改善干眼不适症状,其总体效应优于0.3%玻璃酸钠滴眼液。Objective To compare the clinical effect of deproteinized calf blood extract(DCBE)eye drops and 0.3%sodium hyaluronate eye drops in the treatment of diabetic cataract patients with dry eye after phacoemulsification.Methods A randomized controlled study was performed.A total of 112 patients(116 eyes)with typeⅡdiabetes combined with cataract and dry eye who underwent phacoemulsification in the Eye Hospital of Shandong First Medical University from January 2022 to September 2022 were selected.Patients were divided into DCBE group(49 cases,51 eyes)and sodium hyaluronate group(63 cases,65 eyes)by the random number table method.Patients received DCBE eye drops and 0.3%sodium hyaluronate eye drops after surgery according to grouping.Preoperative and postoperative 1 week,1 month subjective symptoms of dry eye,corneal edema grade,tear film breakup time(TBUT),corneal fluorescein staining(CFS)and SchirmerⅠtest(SⅠt)results were recorded and compared.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Eye Hospital of Shandong First Medical University(No.SDSYKYY202112-1).Written informed consent was obtained from each subject.Results There were significant differences in dry eye symptom score,TBUT and SⅠt at different time points between before and after surgery(F time=323.202,102.771,151.876;all P<0.001).Dry eye symptom score decreased and SⅠt increased in the two groups at 1 week and 1 month after surgery compared with before surgery,and the differences were statistically significant(all P<0.017).TBUT was longer at 1 week and 1 month after surgery compared with before surgery in the DCBE group,and TBUT at 1 month after surgery was longer than that before surgery in the sodium hyaluronate group,and the differences were statistically significant(all P<0.017).There were statistically significant differences in CFS scores between the two groups at different time points before and after surgery(F group=5.391,P=0.022;F time=142.402,P<0.001).The CFS scores of both g

关 键 词：干眼 糖尿病 白内障 小牛血去蛋白提取物滴眼液 玻璃酸钠滴眼液 超声乳化术后 

分 类 号：R779.6[医药卫生—眼科]