高三尖杉酯碱预防翼状胬肉术后复发

Homoharringtonine for the prevention of recurrent pterygium

目的探讨局部注射高三尖杉酯碱减少翼状胬肉术后复发的效果。方法６３例翼状胬肉患者随机分为３组：Ａ组２９例２９眼，术前局部注射高三尖杉酯碱；Ｂ组１６例１６眼术前局部注射地塞米松；Ｃ组１８例１８眼术前不用药。术后观察其眼部反应、复发率及行增殖细胞核抗原（ＰＣＮＡ）免疫组化染色检查。结果术后平均随访１９．１ｍｏ，复发率分别为：Ａ组和Ｂ组分别为３．４０％和６．２５％（Ｐ＞０．５０），Ｃ组２７．７７％（Ｐ＜０．０５，与Ａ组相比较）。病理结果显示，Ａ组ＰＣＮＡ阳性率（６．０１±３．８５）％，Ｂ组（１０．２８±４．１８）％，Ｃ组（１１．５３±３．６２）％．Ａ组与Ｂ组、Ｃ组比较均有显著性差异（Ｐ＜０．０５）。结论术前翼状胬肉局部注射高三尖杉酯碱可以减少翼状胬肉术后复发。

Objective To study the effect of homoharringtonine in the prevention of recurrence of pterygium.Methods Sixty three patients with pterygium were randomly divided into three groups.Before excision,the group A(29 cases) received homoharringtonine injection of topical pterygium,the group B(16 cases) received dexamethasone injection of topical pterygium,and the group C(18 cases) received no drug injection.The postoperative reaction,recurrence rate and the proliferate cell nuclear antigen(PCNA)were studied.Results In the mean follow up of 19.1 months,the recurrence rate was 3.40% in group A,6.25% in group B( P >0.50)and 27.77% in group C( P <0.05,compared with group A).The pathological study showed that the PCNA positive rate was (6.01±3.85)% in group A,(10.28±4.18)% in group B( P <0.05) and (11.53±3.62)% in group C( P <0.01,compared with group A).Conclusions The homoharringtonine injection of topical pterygium before excision was effective for decreasing the recurrent pterygium.