抗病毒药联合甲基强的松龙治疗病毒性视神经炎

Preliminary clinical research on the viral optic neuritis in a comprehensive therapy of anti-viral drug combined methylprednisolone

目的:比较更昔洛韦联合甲基强的松龙综合疗法和甲基强的松龙综合疗法治疗病毒性视神经炎(opticneuritis,ON)的疗效。方法:将41例60眼病毒抗体检测阳性的ON患者随机分为治疗组(更昔洛韦组,21例30眼)和对照组(20例30眼)。于治疗前和治疗后3,7,14,30,90,180d观察两组患者的视力、视觉诱发电位(visual evoked potential,VEP)。结果:两组患者的视力、LP100随时间得到改善(P<0.01)。两组患者视力在治疗的第3d开始恢复,治疗30d时治疗组视力明显优于对照组(P=0.009),治疗180d时两组视力改善无差异(P>0.05);两组LP100在治疗初期(14d内),恢复速率均快,与治疗前差异具有统计学意义(P<0.01),但LP100的近期恢复效果治疗组优于对照组,远期差别减小。结论:更昔洛韦联合甲基强的松龙综合疗法较单纯甲基强的松龙综合疗法治疗ON能更快提高患者视力,增强视神经电活动,改善患者视觉质量。

AIM：To compare the effect of the treatment on viral optic neuritis in a comprehensive therapy of Ganciclovir combined methylprednisolone and comprehensive therapy of methylprednisolone.METHODS：Fourty-one cases 41 patients（60 eyes） with viral optic neuritis were randomly divided into a control group with 20 cases（30 eyes） and a treatment group with 21 cases（30 eyes）.Visual acuity and visual evoked potential（VEP）were observed on patients before treatment and on 3rd,7th,14th,30th,90th,180th day after treatment.RESULTS：Visual acuity and LP100 in two groups were improved over time（P0.01）.Visual recovery had begun on 3rd day after treatment,visual acuity in the treatment group was better than that in the control group after 1 month（P=0.009）,no difference was between the two groups in improved visual acuity after 6 months（P0.05）;the trend that LP100 in both groups was improved with time（P0.01）was showed,a fast recovery rate was showed for LP100 in both groups in treatment early（within 2 weeks）stage,the difference was significant compared with pretreatment（P0.01）.However,the recent recovery effect on LP100 in the treatment group was better than that in the control group and a little difference was showed in the late treatment stage.CONCLUSION：Visual acuity and LP100 can be more quickly improved and the optic nerve electrical activity be strengthened in the comprehensive therapy of Ganciclovir combined methylprednisolone to treat viral optic neuritis compared with the comprehensive therapy of methylprednisolone so as to improve the visual quality of patients.