局部应用治疗青光眼药物对患者眼表结构的影响

Effect of Partial Application of Anti-Glaucoma Drugs on Oculofacial Structure

目的:探讨局部应用治疗青光眼药物对患者眼表结构的影响。方法:选取2016年3月—2017年3月潜江市中心医院收治的药物治疗>3个月的青光眼患者74例作为研究对象,以抽签法随机分为A组和B组,每组37例。A组患者给予硝酸毛果芸香碱滴眼液联合马来酸噻吗洛尔滴眼液治疗,B组患者仅给予硝酸毛果芸香碱滴眼液。观察两组患者治疗前后泪液分泌试验(schirmerⅠtest,SIT)情况、泪膜破裂时间(break up time,BUT)、角膜荧光素染色(fluorescein staining,FL)评分、结膜上皮虎红染色(rose bengal staining,RB)评分及结膜杯状细胞密度(GCD)、黏蛋白MUC5AC水平。结果:治疗后,A组患者SIT分泌量、BUT、GDC和MUC5AC水平明显少于B组,FL评分及RB评分明显高于B组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率的差异无统计学意义(P>0.05)。结论:局部应用治疗青光眼药物会减少患者泪液分泌,影响泪膜稳定性,损伤眼表结构,且联合用药较单一用药的损伤更大。

OBJECTIVE： To probe into the effect of partial application of anti-glaucoma drugs on oculofacial structure. METHODS： 74 glaucoma patients with over 3-month treatment admitted into Qianjiang Central Hospital from Mar. 2016 to Mar. 2017 were selected and divided into group A and group B via random draw method,with 37 cases in each group. Group A were given pilocarpine nitrate eye drops combined with timolol maleate eye drops,group B was treated with pilocarpine nitrate eye drops alone. The Schirmer Ⅰ test（ SIT）,break up time of tear film（ BUT）,cornea fluorescein staining（ FL） scores,rose bengal staining of conjunctival epithelium（ RB）,conjunctival goblet cells density（ GCD） and mucoprotein MUC5 AC levels of two groups before and after treatment were observed.RESULTS： After treatment,the SIT,BUT,GDC and MUC5 AC levels of group A were significantly lower than those of group B,the FL scores and RB scores of group A were significantly higher than those of group B,with statistically significantly differences（ P〈0. 05）. There was no statistical significance in incidence of adverse drug reactions between two groups（ P〉0. 05）. CONCLUSIONS： Partial application of anti-glaucoma drugs can reduce patients＇ tear secretion,affect the stability of tear film and damage oculofacial structure,besides,drug combination can cause more damage than single medication.