微量皮质类固醇联合抗病毒药物治疗单纯疱疹病毒性角膜炎

Trace corticosteroid combined with antiviral agent against herpes simplex keratitis

目的观察微量皮质类固醇与抗病毒药物合用对单纯疱疹病毒性角膜炎（ＨＳＫ）的疗效。方法将１６０例ＨＳＫ患者随机分为治疗组和对照组，治疗组用５ｇ·Ｌ－１可的松、１ｇ·Ｌ－１无环鸟苷（ＡＣＶ）和２５ｇ·Ｌ－１三氮唑核苷（ＲＢＶ）３种眼液，对照组用１ｇ·Ｌ－１ＡＣＶ和２５ｇ·Ｌ－１ＲＢＶ２种眼液交替滴眼治疗。结果治疗组治愈率、有效率明显高于对照组（Ｐ＜０．０１），治愈时间明显短于对照组（Ｐ＜０．０１），随访１４～２４ｍｏ复发率明显低于对照组（Ｐ＜０．０１）。结论在临床上用微量皮质类固醇联合足量有效的抗病毒药物，对上皮型和实质层型ＨＳＫ都能促进其痊愈过程，并可降低复发率。

Objective To investigate the combined clinical effect of trace corticosteriod and antiviral agent against herpes simplex keratitis (HSK).Methods 160 patients were randomly divided into treatment group and control group envenly.Cortisol(5g·L -1 ),acyclovir(ACV)(1g·L -1 ) and ribavirin(RBV)(25g·L -1 ) were used to the treatment group.ACV(1g·L -1 ) and RBV(25g·L -1 )were used to the control group.Results The treatment group had a higher cure rate and an even shorter cure period than the control group( P <0.01).In the 14￣24 months of follow up,the relapses were fewerin the treatment group than in the control group.Conclusion It is believed that the trace coticosteroid can promote the process of the cure of epithelial and stromal HSK and reduce the relapse rate when sufficient and effective antiviral agent is used simultaneously.