脐带血清滴眼液治疗中重度干眼的临床研究

Umbilical cord serum eyedrops for dry eye

目的观察脐带血清滴眼液治疗中重度干眼的临床疗效。方法收集22例(44眼)中重度干眼患者,予以脐带血清滴眼液治疗。治疗前及治疗后1周、1个月行干眼症状调查量表评分、泪膜破裂时间、泪液分泌试验、角膜荧光素染色检查并检测泪液中IL-6含量变化,治疗前及治疗后1个月行结膜印迹细胞学检查。结果治疗前及治疗后1周、1个月患者干眼症状调查量表评分、泪膜破裂时间、泪液分泌试验、角膜荧光素染色评分、泪氉液中IL-6含量分别为[(28.09±5.15)、(26.95±5.06)、(15.95±3.11)]、[(3.45±1.63)s、(3.82±1.76)s、(7.05±1.99)s]、[(3.31±1.08)mm、(3.44±1.06)mm、(3.61±1.15)mm)]、[(5.86±3.18)、(5.27±3.71)、(2.27±0.94)]、[(35.25±9.65)ng·L-1、(34.68±9.88)ng·L-1、(20.15±6.66)ng·L-1)]。治疗后1周各项检查指标与治疗前相比差异无统计学意义(均为P>0.05),治疗后1个月症状调查量表评分、泪膜破裂时间、角膜荧光素染色评分与治疗前相比均有明显改善,差异有统计学意义(均为P<0.001),泪液中IL-6含量下降差异有统计学意义(P<0.001),但泪液分泌量增加差异无统计学意义(P=0.054)。治疗后1个月结膜上皮细胞Nelson分级降低,杯状细胞密度由(89.77±15.85)mm-2增加到(161.36±24.79)mm-2,差异有统计学意义(P<0.001)。结论脐带血清滴眼液对于中重度干眼患者具有良好的治疗效果,能有效改善干眼患者的临床症状、体征和眼表炎症。

Objective To evaluate the therapeutic effect of umbilical cord serum eyedrops for moderate and severe dry eye. Methods Twenty-two patients （44 eyes） with moderate or severe dry eye were recruited and treated with umbilical cord serum eyedrops. Symptom questionnairs were self-answered and multiple dry eye-related clini- cal tests （tear film break-up time, Schirmer I test, corneal fluorescein staining）were performed before treatment and 1 week, 1 month after treatment. IL-6 levels in tears were measured, and conjunctival impression cytology was performed. Results The questionnaire score,tear film break-up time, Schirmer I test, fluorescein staining score and concentration of IL-6 in tears before treatment and 1 week, 1 month after treatment were （28.09 ±5.15,26.95 ±5.06,15.95 ±3. 11）, [ （3.45 ±1.63）s, （3.82 ±1.76）s and （7.05 ±1.99） s], （3.31 ±1.08） mm, （3.44 ±1.06） mm, （3.61 ±1.15） mm, （5.86 ±3.18, 5.27 ±3.71,2.27 ±0.94） ,[ （35.25 ±9.65）ng· L^-1, （34.68 ±9.88）ng· L^-1, （20. 15 ±6. 66）ng · L^-1 ] ,respectively,there was no statistical improvement in all parameters at 1 week after treatment （ all P〉0.05） ,and there was significant improvement in question- naire score, tear film break-up time, fluorescein staining score at 1 month after treat- ment（all P 〈 0. 001 ）. The concentration of IL-6 in tears significantly decreased at 1 month after treatment（P 〈0. 001 ） ,but there was no statistical change in Schirmer I test at 1 month after treatment （P = 0. 054 ）. In impression cytology, the grade of squamous metaplasia decreased and goblet cell density increased from （ 89.77 ±15.85 ） mm^-2 to （161.36 ±24.79）mm^-2（P〈0. 001）. Conclusion Umbilical cord serum eyedrops is effective and safe for moderate and severe dry eye,and the symptom and sign of dry eye and the ocular surface imflanunation can be ameliorated.