奥洛他定联合FK506滴眼液治疗儿童严重春季角结膜炎的疗效观察

The clinical observation of topical olopatadine hydrochloride and FK506 for severe vernal keratoconjunctivitis in children

目的观察0.1%盐酸奥洛他定滴眼液联合0.05%他克莫司(FK506)滴眼液治疗儿童严重春季角结膜炎的效果。设计前瞻性病例系列。研究对象62例(104眼)3～14岁儿童严重春季角结膜炎患者。方法采用自身对照方法观察0.1%盐酸奥洛他定滴眼液联合0.05%FK506滴眼液治疗前后患者症状和体征的变化及副作用,检测用药期间血常规和肝肾功能。主要指标症状和体征变化。结果随诊3～34个月。所有患者在用药1周后症状和体征明显改善。1～2周内盾形角膜溃疡全部修复,上睑粗大乳头明显变小扁平,1个月左右消失。2例(3.2%)患者初用帕坦洛滴眼时诉一过性轻微刺激症状,未发现其他眼表毒副作用;38例(61.3%)患者在停药2周～8个月后症状复发,重新用帕坦洛滴眼液可迅速控制症状。出现粗大乳头者同时再加用FK506滴眼液后控制。用药期间血常规和肝肾功能正常。结论0.1%盐酸奥洛他定滴眼液联合0.05%他克莫司(FK506)滴眼液治疗儿童严重春季角结膜炎安全有效,舒适度和满意度高,无明显不良反应,尤其是对上睑严重粗大乳头者、激素不能耐受者或合并严重角膜溃疡者效果满意。

Objective To observe the clinical effect of eye drops of 0,1% olopatadine hydrochloride （patanol） and 0.05% FK506 （taerolimus） for treating severe vernal keratoeonjunctivitis in children. Design Prospective ease siries. Participants 62 cases （104 eyes） of severe vernal keratoeonjunetivitis aged 3-14 years old. Methods We observed the symptoms and signs of severe vernal keratoconjunetivitis before and after the treatment of 0.1% olopatadine hydrochloride and 0.05% FK506. We examined regularly the blood, liver and kidney functions for all patients during treatment. Main Outcome Measures Symptoms and signs. Results Following by 3- 34months, all patients were much better in different degree at 1 week than that before. The papillae were decreased and almost disappeared gradually at 1 month. The corneal lesions were cured rapidly in less than 2 weeks. 2 cases （3.2%） complained a little disconfort just at the beginning. 38 cases （61.3%） recurred from 2 weeks to 8 months after stopping the eye drops, and were controlled rapidly after reusing the eye drops. The blood routine and the biochemical functions of all patients were normal during treatment. Conclusions 0.1% olopatadine hydroehloride and 0.05% FK506 have remarkable effects for alleviating symptoms and signs of severe vernal keratoconjunctivitis. The patients are comfortable and content with the treatment, and side effects are very few.