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    刘兰静, 陈云珍. 两种细胞生长因子联合玻璃酸钠治疗白内障术后干眼的疗效观察[J]. 徐州医科大学学报, 2023, 43(2): 142-147. DOI: 10.3969/j.issn.2096-3882.2023.02.013
    引用本文: 刘兰静, 陈云珍. 两种细胞生长因子联合玻璃酸钠治疗白内障术后干眼的疗效观察[J]. 徐州医科大学学报, 2023, 43(2): 142-147. DOI: 10.3969/j.issn.2096-3882.2023.02.013
    shu
    LIU Lanjing, CHEN Yunzhen. Effect of two cell growth factors combined with sodium hyaluronate in the treatment of dry eyes after cataract operation[J]. Journal of Xuzhou Medical University, 2023, 43(2): 142-147. DOI: 10.3969/j.issn.2096-3882.2023.02.013
    Citation: LIU Lanjing, CHEN Yunzhen. Effect of two cell growth factors combined with sodium hyaluronate in the treatment of dry eyes after cataract operation[J]. Journal of Xuzhou Medical University, 2023, 43(2): 142-147. DOI: 10.3969/j.issn.2096-3882.2023.02.013
    shu

    两种细胞生长因子联合玻璃酸钠治疗白内障术后干眼的疗效观察

    Effect of two cell growth factors combined with sodium hyaluronate in the treatment of dry eyes after cataract operation

      摘要
    • 摘要: 目的 观察重组牛碱性成纤维细胞生长因子(rbFGF)眼用凝胶与人表皮细胞生长因子(rhEGF)滴眼液、玻璃酸钠滴眼液治疗白内障术后干眼的临床效果。方法 将2020年10月—2021年9月首都医科大学大兴教学医院收治的135例白内障术后干眼症患者,按照随机数字表法分为观察Ⅰ组(rhEGF滴眼液联合玻璃酸钠滴眼液治疗)、观察Ⅱ组(rbFGF眼用凝胶联合rhEGF滴眼液、玻璃酸钠滴眼液治疗)、对照组(玻璃酸钠滴眼液治疗),每组45例,连续治疗8周。比较3组临床治疗的有效率、眼表功能角结膜染色评分(FL)、泪液分泌试验(SIT)、泪膜破裂时间(BUT)、视功能相关生命质量量表(NEI-VFQ-25)评分、眼表疾病指数(OSDI)问卷得分,监测泪液中炎症相关因子细胞间黏附相关因子-1(ICAM-1)、肿瘤坏死因子-α(TNF-α)、白细胞介素-33(IL-33)水平,记录不良反应。结果 对照组、观察Ⅰ组、观察Ⅱ组的治疗有效率分别为73.81%、90.24%、95.24%(P<0.05)。治疗8周后,观察Ⅱ组、观察Ⅰ组的FL评分均明显低于对照组,SIT、BUT均明显高于对照组(P<0.05),观察Ⅱ组的变化程度更明显(P<0.05)。治疗后,3组患者NEI-VFQ-25评分均随时间延长呈升高趋势,OSDI评分均随时间延长呈下降趋势。治疗4周、8周,观察Ⅰ组、观察Ⅱ组患者NEI-VFQ-25评分均明显高于对照组,OSDI评分均明显低于对照组,且观察Ⅱ组患者明显优于观察Ⅰ组(P<0.05)。治疗8周后,观察Ⅱ组、观察Ⅰ组的ICAM-1、TNF-α、IL-33水平均明显低于对照组(P<0.05),但以观察Ⅱ组的变化程度更明显(P<0.05)。3组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 局部应用rbFGF眼用凝胶联合rhEGF滴眼液、玻璃酸钠滴眼液更有利于缓解白内障术后干眼患者的临床症状,改善眼表功能,提高生活质量,减轻眼部炎症损伤,安全性良好,值得推广。

       

      Abstract: Objective To observe the clinical effect of recombinant bovine basic fibroblast growth factor(rbFGF) eye gel, human epidermal cell growth factor(rhEGF) eye drops and sodium hyaluronate eye drops in the treatment of dry eyes after cataract surgery.Methods A total of 135 patients with dry eyes after cataract surgery who were admitted to Daxing Teaching Hospital, Capital Medical University from October 2020 to September 2021 were enrolled. They were randomly divided into three groups(n=45): an observation group Ⅰ, who were treated with rhEGF eye drops combined with sodium hyaluronate eye drops; an observation group Ⅱ, who were treated with rbFGF eye gel combined with rhEGF eye drops and sodium hyaluronate eye drops and a control group, who were treated with sodium hyaluronate eye drops. The three groups were treated for consecutive eight weeks. Then, the three groups were compared for clinical effective rate, ocular surface function fluorescein stain test score(FL), Schirmer Ⅰ test(SIT), and break up time(BUT), 25-item National Eye Institute Visual Function Questionnaire(NEI-VFQ-25) scores, and Ocular Surface Disease Index(OSDI) Questionnaire scores. The levels of inflammatory related factors intercellular adhesion related factor-1(ICAM-1), tumor necrosis factor-α(TNF-α), and interleukin-33(IL-33) in tears were measured and adverse reactions were recorded.Results The effective rate of the control group, observation group Ⅰ and observation group Ⅱ was 73.81%,90.24% and 95.24% respectively(P<0.05). After eight weeks of treatment, the observation group Ⅱ and the observation group Ⅰ showed significantly lower FL scores, but higher SIT and BUT than the control group(P<0.05), where changes in FL, SIT and BUT were more obvious in the observation group Ⅱ(P<0.05). After treatment, the NEI-VFQ-25 scores in all three groups showed an increasing trend, while OSDI scores showed a decreasing trend. After four and eight weeks of treatment, the observation group Ⅰ and the observation group Ⅱ presented significantly higher NEI-VFQ-25 scores and lower OSDI scores than the control group, where increased NEI-VFQ-25 scores and decreased OSDI scores were found in the observation group Ⅱ, compared with those in the observation group Ⅰ(P<0.05). After eight weeks of treatment, the levels of ICAM-1, TNF-α and IL-33 in the observation group Ⅱ and observation group Ⅰ were significantly lower than those in the control group(P<0.05), but the changes in observation group Ⅱ were more obvious(P<0.05). There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusions Local application of rbFGF gel combined with rhEGF eye drops and sodium hyaluronate eye drops is more beneficial to relieve the clinical symptoms of patients with dry eyes after cataract surgery, improve ocular surface function, improve the quality of life, and reduce eye inflammation and injury, with good safety.

       

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