免疫调节剂治疗单疱病毒角膜基质炎的临床观察

Clinical observation of immunomodulatory agent in treatment of herpes simplex stromal keratitis

目的观察探讨免疫调节剂在单疱病毒性角膜基质炎治疗中的临床效果。方法 44例(44眼)单疱病毒性角膜基质炎急性期局部滴用更昔洛韦滴眼液,4次/d,及0.25%地塞米松滴眼液,3次/d,两周后加服左旋咪唑50mg,3次/d,间歇口服3个月。结果 44例单疱病毒性角膜基质炎7～14d角膜基质水肿消退,达到临床治愈,随访两年29例(65.9%)无复发。结论单疱病毒角膜基质炎,急性炎症期应用抗病毒药加入小剂量地塞米松,恢复期口服免疫抑制剂左旋咪唑,可以快速有效控制炎症,缩短病程,阻止或减少单疱病毒性角膜基质炎复发。

Objective To investigate the effect of immunomodulatory agent in the treatment of herpes simplex stromal keratitis. Methods TotaLly 44 patients （44 eyes） with herpes simplex stromal keratitis were enrolled in the study. All patients were treated with ganciclor plus 0.25% dexametha- sone eye drops during acute inflammation, four times and three times a day for each. After 2 weeks, 50 mg LMS were given orally three times a day for 3 months intermittently. Results All 44 patients achieved clinical cure, the corneal matrix edema were dissipated during 7 -14d, 29 patients（65.9% ） were followed up for two years without recurrence. There was no serious adverse drug reactions. Conclusions Using antiviral drugs plus small dose of dexamethasone during acute inflammation and immu- nomodulatory agent （LMS） in the recovery period can rapidly and effectively assist to control the inflammation, shorten the duration of the disease, and prevent or reduce the recurrence of herpes simplex stromal keratitis.