重组人表皮生长因子对白内障超声乳化术后角膜水肿疗效观察

Efficacy of recombinant human epidermal growth factor in treatment of corneal edema after phacoemulsification

目的探讨重组人表皮生长因子（rhEGF）滴眼液对年龄相关性白内障超声乳化联合人工晶状体植入术后角膜水肿的疗效。方法临床病例随机对照研究。选取透明角膜切口白内障超声乳化联合人工晶状体植入术后发生角膜水肿或角膜切口水肿的患者51例（54只眼），随机分为治疗组（rhEGF组）和对照组，对照组采用妥布霉素地塞米松滴眼液等常规治疗，治疗组加用重组人表皮生长因子滴眼液（易贝滴眼液），观察术后角膜水肿程度、Pentacam测量角膜中央3mm、5mm、7mm直径范围内的角膜容积和角膜内皮镜观察中央角膜内皮细胞密度。采用正态性和方差齐性检验，两组独立样本资料的t检验、配对t检验等对数据进行统计学分析。结果角膜水肿情况显示，治疗组在术后3d和7d角膜水肿程度均低于对照组，差异均有统计学意义（P〈0．05）。角膜容积显示，术后7d时两组之间的CV3、CV5和CV7相比较，差异均有统计学意义（P〈O．05），且rhEGF治疗组均小于对照组。角膜内皮镜检查结果显示，术后1月时1级角膜水肿的病例，rhEGF治疗组的角膜内皮丢失率小于对照组，差异有统计学意义（P〈0．05）。结论重组人表皮生长因子对年龄相关性白内障术后早期角膜水肿有明显的疗效。

ObJective To evaluate the clinical efficacy of recombinant human epidermal growth factor in treatment of corneal edema after cataract phacoemulsification. Methods Fifty-one （54 eyes） patients with corneal edema caused by clear corneal incision phacoemulsification and intraocu- lar lens implantation were randomly divided into treatment group and control group. Control group using tobramycin and dexamethasone eye drops and other conventional treatment, the treatment group received recombinant human epidermal growth factor, observed corneal edema subsided case corneal volume （CV） and central corneal endothelial cell density （CED）. The variants in the study were tested using two independent sample t-test, paired t-test, adjusted chi square test, Fisher＇s ex- act probabilities. Results The level of corneal edema in the treated group was lower than that of in the control group （P 〈0.05）. The corneal volume at 3,0 mm, 5,0mm and 7.0mm in the treated group were lower than those of in the control group （P 〈0.05） in the 7 days after surgery. The central corneal endothelial cell density in the treated group was more than that of in the control group （P 〈0.05） in the 1 month after surgery. Conclusions Recombinant human epidermal growth factor has exact and obvious efficacy for early corneal edema after cataract phacoemulsification.