更昔洛韦滴眼液、泛昔洛韦分散片联合注射用干扰素α-2a治疗难治性单纯疱疹病毒角膜炎临床效果观察

Effect of ganciclovir eye drops,famciclovir dispersible tablets combined with interferonα-2a for injection in refractory herpes simplex virus keratitis

目的观察更昔洛韦滴眼液、泛昔洛韦分散片联合注射用干扰素(IFN)α-2a治疗难治性单纯疱疹病毒角膜炎(HSK)的临床效果。方法选取北部战区总医院自2014年6月至2019年3月收治的79例(79眼)难治性HSK患者为研究对象,将患者随机分入A组(n=40,40眼)和B组(n=39,39眼)。A组接受更昔洛韦滴眼液、泛昔洛韦分散片治疗:更昔洛韦滴眼液每天滴眼3次,每次1~2滴;泛昔洛韦分散片每天口服3次,每次0.25 g。B组在A组基础上联合注射用IFNα-2a:注射用IFNα-2a每天1次患眼眉弓注射,注射剂量1000000 IU,连续3 d;之后隔天注射1次,注射剂量1000000 IU,连续2~3次。比较两组患者治疗1周后的有效率、治愈时间、不良反应发生情况及随访12个月的复发率。结果A组治疗有效率为45.0%(18/40),B组为76.9%(30/39),差异有统计学意义(P<0.05)。A组中位治愈时间为24.5(6.0~60.0)d,B组为5.0(4.0~45.0)d,差异有统计学意义(P<0.05)。治疗期间,两组患者均未发生严重不良反应。随访12个月,A组复发率为55.6%(10/18),B组为30.0%(9/30),差异无统计学意义(P>0.05)。结论更昔洛韦滴眼液、泛昔洛韦分散片联合注射用IFNα-2a治疗难治性HSK临床效果显著,可在短期内控制病情,缩短病程,且安全性佳。

Objective To compare the clinical efficacy of ganciclovir eye drops,famciclovir dispersible tablets and interferonα-2 a(IFNα-2 a)in the treatment of refractory herpes simplex keratitis(HSK).Methods A retrospective study was performed on 79 patients(79 eyes)with refractory HSK who were admitted from June 2014 to March 2019.Patients were divided into the Group A(n=40,40 eyes)and Group B(n=39,39 eyes).Patients of Group A were given ganciclovir eye drops(3 times/day,1~2 drops each time)and famciclovir dispersible tablets(orally take 3 times/day,0.25 g each time).Patients of Group B were given ganciclovir eye drops,famciclovir dispersible tablets combined with IFNα-2 a for injection;IFNα-2 a for injection was injected into the eyebrow arch once a day,and the injection dose was 1 million IU for 3 consecutive days.After the next day injection once,injection dose 1 million IU,continuous 2~3 times.The effective rate,cure time,adverse reactions and recurrence rates of 12 months were compared between both groups after 1 week of treatment.Results The effective rate was 45.0%(18/40)in Group A and 76.9%(30/39)in Group B,and the difference was statistically significant(P<0.05).The median cure time of Group A was 24.5(6.0~60.0)days,and Group B was 5.0(4.0~45.0)days(P<0.05).During the treatment,no serious adverse reactions occurred in both groups.After 12 months of follow-up,the recurrence rate was 55.6%(10/18)in Group A and 30.0%(9/30)in Group B,showing no statistically significant difference(P>0.05).Conclusion The treatment of ganciclovir eye drops,famciclovir dispersible tablets combined with IFNα-2 a for injection has a significant clinical effect in refractory HSK,which can control the disease in a short time,shorten the course of the disease,and has great safety.