0.5g/L环孢素A滴眼液对中重度干眼患者眼部症状及体征评分的影响

Effect of 0.5g /L cyclosporine A for symptom and sign scores in patients with moderate to severe dry eye

目的：探讨0.5g/L环孢素A滴眼液对中重度干眼患者眼部症状及体征评分的影响。方法：中重度干眼症患者80例160眼依据随机双盲试验原则将其分为两组：观察组40例80眼,采用10g/L羧甲基纤维素钠和0.5g/L环孢素A滴眼液治疗,对照组40例80眼,采用10g/L羧甲基纤维素钠滴眼液治疗,比较两组患者眼部症状和体征评分变化。结果：观察组治疗总有效率95.0%,显著高于对照组（85.0%）,差异有统计学意义（P〈0.05）;观察组和对照组患者未治疗时症状积分分别为36.1±4.4、36.4±4.5分,经治疗后,观察组1、3mo时症状积分下降至25.2±3.2、11.09±3.9分,对照组下降至29.4±4.1、22.05±3.1分,治疗前后差异具有统计学意义（P〈0.05）,但观察组治疗1、3mo的症状积分显著低于对照组,差异有统计学意义（P〈0.05）;治疗前,两组患者泪膜破裂时间（BUT）、泪液分泌试验（SⅠt）、角膜荧光素染色（FL）和生活质量（OSDI）评分之间无统计学差异（P〉0.05）;经治疗后,观察组四项指标均显著下降（P〈0.05）,对照组仅FL和OSDI评分显著下降,差异有统计学意义（P〈0.05）;观察组治疗后四项指标均显著高于对照组,差异具有统计学意义（P〈0.05）;观察组在用药14~28d时3眼出现刺痛感,对照组2眼刺痛感,1眼结膜充血,继续用药时2d后全部消失。结论：0.5g/L环孢素A滴眼液能够有效缓解中重度干眼患者症状和体征,促进泪液分泌,改善患者眼表环境,治疗效果良好。

AIM ： To investigate the effect of 0. 5g /L cyclosporine A for symptomand sign scores in patients with moderate to severe dry eye.METHODS： Eighty patients（ 160 eyes） with moderate to severe dry eye were divided into two groups by double-blind and randomprinciples： 40 patients（ 80 eyes） in observation group were treated with 10 g / L sodiumcarboxymethyl cellulose and 0. 5g / L cyclosporine A eye drops,40 patients（ 80 eyes） in the control group were treated with 10 g / L sodiumcarboxymethyl cellulose eye drops. The changes of ocular sign and symptomscores were compared between the two groups.RESULTS： The total effective rate of observation group was 95. 0%,which was significantly higher than that of control group（ 85. 0%,P〈0. 05）. Symptomscores before treatment in observation group and the control group were 36. 1 ± 4. 4 and 36. 4 ± 4. 5 points, respectively;symptomscores at 1 and 3mo after treatment were 25. 2 ±3. 2,11. 09 ± 3. 9 points in observation group,29. 4 ± 4. 1,22. 05 ± 3. 1 points in control group. The differences of the two groups before and after treatment were statistically significantly（ P〈0. 05）. The scores of observation group at 1 and 3mo after treatment were lower than those of control group（ P〈0. 05）. Before treatment,break- up time（ BUT）,Schirmer I test（ S Ⅰ t）,fluorescein staining（ FL） and ocular surface disease index（ OSDI） scores hadno significant differences between the two groups（ P〈0. 05）. After treatment, the four parameters of observation group were improved significantly（ P〈0. 05）,while only FL and OSDI of control group were improved（ P〈0. 05）. The four parameters of observation group were higher than those of control group（ P〈0. 05）. Three eyes in observation group felt tingling during 14- 28 d of the drug using,2 eyes in control group felt tingling and one eye in control group had conjunctival congestion. All the symptoms disappeared after 2d without stopping the drugs.CONCLUSION： The 0. 5g /L cyclosporine A eye drops can effectively relieve the symptoms and signs of moderate to severe dry eye, promote tear secretion, and improve ocular surface environment. The treatment effect is good.