更昔洛韦联合甲泼尼龙治疗病毒性视神经炎

Clinical Effects of Ganciclovir Combined with Methylprednisolone in Treating Viral Optic Neuritis

目的比较更昔洛韦联合甲泼尼龙综合疗法和甲泼尼龙综合疗法治疗病毒性视神经炎的疗效。方法将2008年10月-2010年3月入院41例(60只眼)病毒抗体检测阳性的病毒性视神经炎患者随机分为治疗组,21例30只眼)和对照组(20例30只眼)。于治疗前和治疗第3、7、14、30、90、180天观察两组患者的视力、视野。结果两组患者的视力、平均视野缺损治疗组采用更昔洛韦联合甲泼尼龙综合疗法,对照组采用甲泼尼龙综合疗法。均随时间得到改善(P<0.001)。两组患者视力在治疗的第3天开始恢复,30 d治疗组视力明显优于对照组(P<0.05),治疗180 d时两组视力改善无差异(P>0.05);治疗组与对照组分别在第7天和第14天平均视野缺损开始恢复(P<0.001)。结论更昔洛韦联合甲泼尼龙综合疗法较单纯甲泼尼龙综合疗法治疗病毒性视神经炎能更快提高患者视力、恢复视野、改善患者视觉质量。

Objective To compare the clinical effects of ganciclovir combined with methylprednisolone and a comprehensive therapy with methylprednisolone in treating viral optic neuritis. Methods Forty-one patients （60 eyes） with viral optic neuritis admitted into hospital during October 2008 and March 2010 were randomly divided into a control group with 20 patients （30 eyes） and a treatment group with 21 patients （30 eyes）. Visual acuity and visual field were observed before and 3rd, 7th, 14th, 30th, 90th, 180th days after the treatment. Results Visual acuity and visual field mean deviation （MD） in two groups were both improved over time （P 〈 0.001）. Visual recovery began three days after treatment, and visual acuity in the treatment group was significantly better than that in the control group 1 month after the treatment （P=0.009, 〈 0.01）. Three was no difference between the two groups in visual acuity improvement 6 months after the treatment （P 〉 0.05）. MD began to improve on the 7th day in the treatment group and on the 14th day in the control group （P 〈 0.001）. Conclusion Visual acuity and visual field can be quickly improved by the comprehensive therapy of ganciclovir combined with methylprednisolone for viral optic neuritis, campared with the comprehensive therapy of methvlorednisolone.