更昔洛韦眼用凝胶与干扰素滴眼液治疗小儿单疱病毒性角膜炎的效果探究

An investigation of the effect of ganciclovir ophthalmic gel and interferon eye drops in the treatment of pediatric herpes simplex virus keratitis

目的 评定更昔洛韦眼用凝胶与干扰素滴眼液治疗小儿单纯疱疹(单疱)病毒性角膜炎的效果。方法 100例小儿单疱病毒性角膜炎患儿,以计算机随机化方法分为对照组与试验组,每组50例。对照组患儿应用干扰素滴眼液治疗,试验组患儿应用更昔洛韦眼用凝胶联合干扰素滴眼液治疗。比较两组患儿治疗效果,症状消退时间,视力水平,炎性因子指标[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、干扰素-α(IFN-α)]水平及不良反应发生情况。结果 试验组总有效率(98.00%)较对照组(84.00%)更高(P<0.05)。试验组眼部刺激征、溃疡、角膜充血消退时间分别为(6.50±1.22)、(12.51±5.32)、(7.01±1.44)d,均短于对照组的(10.41±2.50)、(21.08±4.65)、(12.38±2.30)d(P<0.05)。治疗后,两组视力、INF-α水平均高于治疗前, CRP、TNF-α、IL-8水平均低于治疗前,且试验组视力(0.95±0.13)、INF-α(118.20±9.83)ng/L较对照组的(0.80±0.12)、(87.64±7.25)ng/L更高, CRP(3.44±0.10)mg/L、TNF-α(29.53±9.20)ng/L、IL-8(49.63±6.05)ng/L较对照组的(8.62±0.75)mg/L、(44.08±8.46)ng/L、(70.22±4.76)ng/L更低(P<0.05)。试验组不良反应发生率(6.00%)与对照组(8.00%)比较差异较小(P>0.05)。结论 小儿单疱病毒性角膜炎患儿接受更昔洛韦眼用凝胶联合干扰素滴眼液方案治疗,能获取较好的效果,缩短康复的时间,更好地改善炎性因子指标水平,且不会增加不良反应的发生几率,意义重大。

Objective To evaluate the effect of ganciclovir ophthalmic gel and interferon eye drops in the treatment of pediatric herpes simplex virus keratitis.Methods 100 cases of pediatric herpes simplex virus keratitis were divided into a control group and an experimental group by computer randomized method,with 50 cases in each group.The control group was treated with interferon eye drops,and the experimental group was treated with ganciclovir eye gel combined with interferon eye drops.Comparison was made on therapeutic effect,symptom resolution time,visual acuity level,inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),interferon-α(IFN-α)]levels and the occurrence of adverse reactions between the two groups.Results The total effective rate of 98.00%in the experimental group was higher than 84.00%in the control group(P<0.05).The regression time of ocular irritation,ulcer and corneal congestion in the experimental groups were(6.50±1.22),(12.51±5.32)and(7.01±1.44)d,which were shorter than(10.41±2.50),(21.08±4.65)and(12.38±2.30)d in the control group(P<0.05).After treatment,the visual acuity and INF-αlevels in both groups were higher than those before treatment,while CRP,TNF-αand IL-8 levels were lower than those before treatment;the experimental group had visual acuity of(0.95±0.13)and INF-αof(118.20±9.83)ng/L,which were higher than(0.80±0.12)and(87.64±7.25)ng/L in the control group;the experimental group had CRP of(3.44±0.10)mg/L,TNF-αof(29.53±9.20)ng/L,IL-8 of(49.63±6.05)ng/L,and TNF-αof(29.53±9.20)ng/L,which were lower than(8.62±0.75)mg/L,(44.08±8.46)ng/L,and(70.22±4.76)ng/L in the control group(P<0.05).The incidence of adverse reactions in the experimental group(6.00%)was lower than that in the control group(8.00%)(P>0.05).Conclusion Ganciclovir ophthalmic gel combined with interferon eye drops regimen for the treatment of pediatric herpes simplex virus keratitis can obtain better results,shorten the recovery time,better improve the level of inflammatory factors,and do not increase the incidence of adverse reactions,which is of great significance.