糖皮质激素在流行性角结膜炎治疗中应用分析

Clinical research of glucocorticoids in treatment with the epidemic keratoconjunctivitis

目的 探讨应用糖皮质激素眼药水治疗流行性角结膜炎的方法及效果.方法 回顾性自身对照研究.收集2002～2007年在天津眼科医院就诊的流行性角结膜炎患者共480例.随机分成4组,每组120例,各组患者均自就诊即给予抗病毒和抗菌眼药.第一组未用激素;第二组从治疗开始即加用激素眼药水;第三组待角膜上皮出现点状混浊,荧光素染色阳性时加用激素眼药水;第四组,表层角膜炎症消失,上皮下出现的灰白色圆形病变时再加用激素眼药水治疗.结果 第一组80%角膜上皮出现点状混浊并遗留上皮下的灰白色圆形混浊;第二组无角膜病变发生;第三组中13.33%患者和第四组全部患者遗留角膜上皮下的灰白色圆形混浊.结论 在流行性角结膜炎患者应用抗病毒、抗菌药物的同时及时加用激素为最好地治疗方法.

Objective To study the effect of glucocorticoids in treatment with the epidemic keratoconjunctivitis. Methods All 480 patients with epidemic keratoconjunctivitis were collected in our hospital from 2002 to 2007 and randomly divided into four groups. The first group did not use glucocorticoids; the second group started using glucocorticoids from the very beginning of the treatment; the third group started using glucocorticoids when punctate epithelial corneal opacity and fluorescein staining positive; the fourth group started using glucocorticoids until the appearance of the white round subepithelial corneal opacity. Results 80% of the first group appears punctate epithelial corneal opacity and left white round subepithelial corneal opacity in the end; the second group showed no keratopathy occurred; 21% of the third group and all the patients in the fourth group of all patients left white round subepithelial corneal opacity in the end. Conclusions Using glucocorticoids timely is an effective and safe treatment in patients with epidemic keratoconjunctivitis.