摘要
目的对比观察春季角结膜炎活动期患者睑板下注射曲安奈德后的眼表症状、泪膜及泪液蛋白的特点。方法收集2010年8月至2014年6月眼科门诊确诊为春季角结膜炎活动期患者20例(24眼),随机分为A、B两组(各12眼),A组行睑板下注射曲安奈德(每次20 mg,共注射1次),B组行妥布霉素地塞米松眼液滴眼,每天3次,连续1个月。分别对两组患者治疗前与治疗后2周、1个月眼表症状评分、泪膜四项检查及泪液各蛋白测定结果并进行对比。结果两组患者治疗前眼表症状评分、泪膜四项(泪膜破裂时间、基础泪液分泌试验、泪河高度降低及角膜荧光素染色)、泪液蛋白、乳铁蛋白、溶菌酶比较,差异均无统计学意义(均为P>0.05);治疗14 d后,A组患者干眼症状眼数增多,眼表指数增高、泪膜破裂时间减短、基础泪液分泌试验增高、泪河高度降低、角膜荧光素染色增强,总蛋白、乳铁蛋白、溶菌酶较B组均明显降低,且差异均有统计学意义(均为P<0.05)。治疗1个月后,A组患者眼表指数、泪膜破裂时间、基础泪液分泌、泪河高度均减少,角膜荧光素染色增强,而B组患者眼表指数、泪膜破裂时间、基础泪液分泌、泪河高度及角膜荧光素染色均降低,差异均有统计学意义(均为P<0.05),并且A组较B组眼表指数减少,泪膜破裂时间、基础泪液分泌、泪河高度、角膜荧光素染色均明显增加(P<0.05)。结论曲安奈德睑板下注射治疗能提高春季角结膜炎活动期患者泪膜稳定性,升高泪液蛋白含量。
Objective To observe the symptom of ocular surface,characteristics of tear film and tear protein alteration in active vernal keratoconjunctivitis patients accepted the treatment of triamcinolone injection under the meibomian.Methods Between August 2010 and March 2014,20 cases（24 eyes） of active vernal keratoconjunctivitis were collected in the first Affiliated Hospital of Nanchang University and Xiangya Hospital of Zhongnan University.They were divided into two groups randomly,12 eyes in each group.Group A treated with 20 mg triamcinolone injection under the meibomian one time only.Group B treated with tobramycin dexamethasone eye drops one month,3 times each day.The results of tear film,tear protein which studied with ocular surface disease index examination for tear film,tests for tear proteins between these two groups were compared at before treatment,2 weeks and 1 month after treatment.Results There was no difference in ocular surface disease index,break-up time（BUT）,Schirmer I test（SIT）,tears meniscus height（TMH）,fluorescein staining（FL）,tear proteins,lactoferrin,lysozyme between two groups（all P〉0.05）.At 14 days after treatment,more patients in group A presented symptom of dry eyes,increased ocular surface disease index（OSDI）,SIT and FL,decreased BUT and TMH than before treatment（all P〈0.05）.In addition,the total protein,lactoferrin and lysozyme of group A were lower than group B（all P〈0.05）.At 1 month after treatment,patients in group A presented decreased OSDI,SIT,TMH and increased FL,however,patients in group B presented decreased OSDI,SIT,TMH and FL by comparing with before treatment（all P〈0.05）.Besides,there were less O SDI in group A,and BUT,SIT,TMH and FL of group A were higher than group B（all P0.05）.Conclusion Injection of triamcinolone under the meibomian for active vernal keratoconjunctivitis patients can enhance the stability of tear film and increase tear protein.
出处
《眼科新进展》
CAS
北大核心
2016年第1期26-30,共5页
Recent Advances in Ophthalmology
基金
国家自然科学基金资助(编号:81160118
81400372)
全国临床医药研究专项基金(编号:L2012052)
江西省远航工程(编号:2014022)
江西省学位与研究生教育教学改革研究项目(编号:2015)
江西省科技平台建设项目(编号:2013116)
江西省青年科学基金(编号:20151BAB215016)
江西省科技支撑计划项目(编号:20151BBG70223)
江西省教育厅科技计划项目(编号:GJJ14170)
江西省卫计委科技计划项目(编号:20155154)~~
关键词
春季角结膜炎
泪膜
泪液蛋白
曲安奈德
睑板注射
vernal keratoconjunctivitis
tear film
tear protein
triamcinolone
in jection under meibomian
