[1]苏丽萍,刘 郡,王 珏.湿房镜联合氟米龙滴眼液治疗干眼症疗效及对患者泪膜稳定性和血清基质金属蛋白酶-2的影响[J].陕西医学杂志,2022,51(5):586-590.[doi:DOI:10.3969/j.issn.1000-7377.2022.05.017]
　SU Liping,LIU Jun,WANG Jue.Clinical efficacy of moisture chamber spectacles combined with fluminolone eye drops in treatment of xerophthalmia and its effect on tear film stability and serum MMP-2 in patients[J].,2022,51(5):586-590.[doi:DOI:10.3969/j.issn.1000-7377.2022.05.017]
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湿房镜联合氟米龙滴眼液治疗干眼症疗效及对患者泪膜稳定性和血清基质金属蛋白酶-2的影响
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年5期
页码:
586-590
栏目:
药物与临床
出版日期:
2022-05-05

文章信息/Info

Title:
Clinical efficacy of moisture chamber spectacles combined with fluminolone eye drops in treatment of xerophthalmia and its effect on tear film stability and serum MMP-2 in patients
作者:
苏丽萍1; 刘 郡2; 王 珏1
(1.空军军医大学唐都医院眼科,陕西 西安 710038; 2.陕西中医药大学附属医院眼科,陕西 咸阳 712000)
Author(s):
SU Liping; LIU Jun; WANG Jue
(Department of Ophthalmology,Tangdu Hospital of Air Force Medical University,Xi'an 710038,China)
关键词:
干眼症;  湿房镜;  氟米龙滴眼液;  临床疗效;  泪膜稳定性;  基质金属蛋白酶-2
Keywords:
Xerophthalmia;  Moisture chamber spectacles;  Flumirone eye drops;  Clinical efficacy;  Tear film stability;  Matrix metalloproteinase-2
分类号:
R 777.2
DOI:
DOI:10.3969/j.issn.1000-7377.2022.05.017
文献标志码:
A
摘要:
目的:探讨湿房镜联合氟米龙滴眼液治疗干眼症临床疗效及对患者泪膜稳定性和血清基质金属蛋白酶-2(MMP-2)水平的影响。方法:选取干眼症患者80例,按照随机数字表法将其分为对照组和观察组,各40例,其中对照组予以氟米龙滴眼液治疗,观察组在对照组基础上佩戴湿房镜治疗。评价两组主观症状(眼痛、干涩、异物感、灼烧感、畏光)视觉疼痛模拟评分、泪膜稳定性指标[泪膜破裂时间(BUT)、泪液分泌试验(SIt)和角膜荧光色染色评分(CFS)]、血清MMP-2水平变化等指标,并进行统计比较。结果:①两组患者治疗前眼痛、干涩、异物感、灼烧感和畏光等症状VAS评分比较差异无统计学意义(均P>0.05),治疗后两组各主观症状VAS评分均显著降低,且观察组低于对照组(均P<0.05)。②治疗前两组BUT、SIt和CFS评分等泪膜稳定性比较差异无统计学意义(均P>0.05),治疗后两组BUT和SIt显著增加,CFS评分显著降低(均P<0.05); 观察组治疗后BUT[(13.15±2.20)与(6.96±1.82)]和Sit[(12.53±2.04)与(7.17±1.79)]显著高于对照组,CFS评分(1.45±0.50)分显著低于对照组(3.99±0.67)分(均P<0.05)。③两组患者治疗前血清MMP-2水平以及泪液细胞介素-18(IL-18)、IL-1β和肿瘤坏死因子-α(TNF-α)水平比较差异无统计学意义(均P>0.05),治疗后两组血清MMP-2水平以及泪液IL-18、IL-1β和TNF-α水平均显著低于治疗前(均P<0.05),观察组治疗后血清MMP-2和泪液炎性指标水平均显著低于对照组(均P<0.05)。④治疗前两组NEI-VFQ-25量表评分比较差异无统计学意义(P>0.05); 治疗后观察组高于对照组(P<0.05)。⑤观察组愈显率93.75%,总有效率100.00%,均显著高于对照组(P<0.05)。结论:湿房镜联合氟米龙滴眼液可有效提高干眼症的治疗效果,改善患者临床症状,促进泪液分泌并增强泪膜稳定性,同时可降低血清MMP-2水平,缓解患者眼部炎症状态,提升生命质量。
Abstract:
Objective:To investigate the clinical efficacy of moisture chamber spectacles combined with flumilone eye drops in the treatment of xerophthalmia and its effect on tear film stability and serum MMP-2 in patients.Methods: Eighty patients with xerophthalmia were randomly divided into control group and observation group,with fourty cases in each group.The control group was treated with flumilone eye drops,and the observation group was treated with moisture chamber spectacles on the basis of the control group.The subjective symptoms(eye pain,dryness,foreign body sensation,burning sensation,photophobia)visual analog scale(VAS)score,tear film stability indexes [break-up time(BUT),Schirmer I test(Sit),corneal fluoresescein staining(CFS)score] and serum MMP-2 were compared between the two groups.Results:① There was no significant difference in the VAS scores of symptoms such as eye pain,dryness,foreign body sensation,burning sensation and photophobia between the two groups before treatment(all P>0.05).After treatment,VAS scores of subjective symptoms in the two groups were significantly lower,and the observation group was lower than the control group(all P<0.05).②Before treatment,there was no significant difference in tear film stability such as BUT,SIt and CFS scores between the two groups(all P>0.05).After treatment,BUT and SIt were significantly increased and CFS scores were significantly decreased in both groups(all P<0.05).After treatment,the BUT(13.15±2.20 vs.6.96±1.82)and SIt(12.53±2.04 vs.7.17±1.79)of the observation group were significantly higher than those of the control group,and the CFS score(1.45±0.50 vs.3.99±0.67)was significantly lower than that of the control group(all P<0.05).③ There was no significant difference in serum MMP-2 level and tear IL-18,IL-1β and TNF-α levels before treatment between the two groups(all P>0.05).After treatment,serum MMP-2 level and tear IL-18,IL-1β and TNF-α levels in both groups were significantly lower than those before treatment(all P<0.05).After treatment,the levels of serum MMP-2 and tear inflammatory indexes in observation group were significantly lower than those in control group(all P<0.05).④Before treatment,there was no significant difference in NEI-VFQ-25 scale score between the two groups(P>0.05).After treatment,the observation group was higher than the control group(P<0.05).⑤The cure rate of the observation group was 93.75%,and the total effective rate was 100.00%,which were significantly higher than those of the control group(all P<0.05).Conclusion:Moisture chamber spectacles combined with fluoromilone eye drops can effectively improve the therapeutic effect of xerophthalmia,improve the clinical symptoms of patients,promote tear secretion and enhance the tear film stability.At the same time,it can reduce the level of serum MMP-2,alleviate the ocular inflammation in patients and improve the quality of life.

参考文献/References:

[1] 张海霞,冯雪云,张林昌.MGD伴蒸发过强型干眼症患者泪液Fractalkine/CX3CL1、IL-1Ra水平与眼部体征的关系[J].山东医药,2016,56(37):98-100.
[2] 冯均信,刘希茹.针刺治疗干眼症临床观察[J].陕西中医,2017,38(11):1594-1595.
[3] 刘 红,滕 月,俞晓艺,等.岭南火针联合0.1%玻璃酸钠滴眼液治疗干眼症的随机对照研究[J].针刺研究,2021,46(10):863-868.
[4] Cifuentes M,Barrio D,Vera-Kellet C.Pilocarpine and artificial saliva for the treatment of xerostomia and xerophthalmia of sjögren's syndrome:A double blind control trial[J].British Journal of Dermatology,2018,179(5):1056-1061.
[5] 麻 凯,李青松,张振永,等.干眼症的物理治疗研究进展[J].国际眼科杂志,2018,18(4):660-663.
[6] Berufsverband V.Opinion of the BVA and the DOG on physical therapy of dry eye[J].Der Ophthalmologe,2017,114(4):1015-1018.
[7] 陈 洁.加热型湿房镜治疗环境型干眼的短期有效性和安全性[D].温州:温州医科大学,2016.
[8] 李娟利,姜 红,刘 燕,等.NEIVFQ-25中文版在老年性黄斑变性患者中应用的性能评价[J].眼科,2018,27(3):232-236.
[9] 葛莉莉.玻璃酸钠滴眼液联合中药外熏治疗干眼症疗效及安全性Meta分析[J].陕西中医,2021,42(10):1474-1479.
[10] Tsubota K,Yokoi N,Shimazaki J,et al.New perspectives on dry eye definition and diagnosis:A consensus report by the asia dry eye society[J].Ocular Surface,2017,15(1):65-76.
[11] 赵仲平,郭翠玲,邵鸿展,等.普拉洛芬联合玻璃酸钠治疗中重度干眼症的临床观察[J].中国药房,2016,27(35):4956-4959.
[12] 邢 悦,张晓梅.干眼病因的研究进展[J].中国现代医学杂志,2021,31(18):49-54.
[13] Elamin A,Fawzi W,Herrera MG,et al.Vitamin A supplementation and dietary vitamin A in relation to the risk of xerophthalmia[J].American Journal of Clinical Nutrition,2019,58:385-391.
[14] 胡文静,沈红良,张 萌,等.干眼症小鼠泪液中胸腺基质淋巴细胞生成素和白介素18水平变化及相关机制研究[J].陕西医学杂志,2021,50(11):1333-1335,1344.
[15] 葛红岩.干眼症发病机制与发病因素的研究进展[J].医学综述,2019,25(11):2196-2201.
[16] 肖 楠.普拉洛芬联合玻璃酸钠对干眼症患者泪液分泌试验时间及泪膜破裂时间的影响[J].当代医学,2021,27(35):180-181.
[17] Kim YH,Jung JC,Jung SY,et al.Comparison of the efficacy of fluorometholone with and without benzalkonium chloride in ocular surface disease[J].Cornea,2016,35(2):234-242.
[18] 银 哲,银 锐,李元彬.不含防腐剂的玻璃酸钠联合氟米龙滴眼液治疗白内障伴干眼的随机单盲对照研究[J].中华实验眼科杂志,2017,35(9):843-847.
[19] 赵 慧,刘祖国,肖辛野,等.非加热型湿房镜治疗干眼的临床疗效[J].中华眼视光学与视觉科学杂志,2014,16(9):517-521.
[20] Hee MC,Yong KJ,Joon KM,et al.Effect of three-dimensional printed personalized moisture chamber spectacles on the periocular humidity[J].Journal of Ophthalmology,2016,34(2):1-7.

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备注/Memo

备注/Memo:
基金项目:陕西省自然科学基础研究计划项目(2021JQ-739); 空军军医大学唐都医院创新发展基金资助项目(2019LCYJ014)
更新日期/Last Update: 2022-05-05