环孢素滴眼液联合氟米龙对干眼患者泪液EGF、TGF-β1含量的影响

Effect of cyclosporine eye drops combined with fluorometholone on the contents of EGF and TGF-β1 in tear of dry eye patients

目的 探究环孢素滴眼液联合氟米龙对干眼症患者泪液表皮生长因子(EGF)、转化生长因子-β1(TGF-β1)含量的影响。方法 选取2017 年1 月至2019 年1 月本院收治的74例干眼症患者,按随机数表法分成对照组(37例)与观察组(37例)。对照组使用氟米龙滴眼液,观察组在对照组基础上联合环抱素滴眼液,比较两组治疗前后眼部检查指标[泪膜破裂时间(BUT)、角膜荧光素染色(FL)、Schirmer Ⅰ、角膜树突细胞密度]、眼部细胞因子(EGF、TGF-β1)、不良反应发生率。结果 治疗后,观察组BUT(7.85±2.16)s、Schirmer Ⅰ(7.03±1.22)mm/5 min,高于对照组的(6.58±2.11)s、(6.09±1.26)mm/5 min;观察组FL(3.44±1.29)分、角膜树突细胞密度(15.63±3.57)个/mm^2,低于对照组的(5.92±1.65)分、(18.79±4.26)个/mm^2;观察组EGF(5.11±0.63)ng/ml、TGF-β1(45.98±6.04)pg/ml,高于对照组的(4.03±0.54)ng/ml、(41.26±5.62)pg/ml;差异有统计学意义(均P<0.05)。观察组不良反应发生率13.51%,对照组10.81%,差异无统计学意义(P > 0.05)。结论 环孢素滴眼液联合氟米龙治疗干眼症可促进EGF、TGF-β1 正常表达,延长泪膜破裂时间,增加泪液分泌,改善泪膜功能,且不会增加不良反应,治疗方案安全可靠。

Objective To investigate the effect of cyclosporine eye drops combined with fluorometholone on the contents of epidermal growth factor (EGF) and transforming growth factor-β1 (TGF-β1) in tear of dry eye patients. Methods 74 patients with dry eye treated at our hospital from January, 2017 to January, 2019 were selected, and were randomly divided into a control group (37 cases) and an observation group (37 cases). The control group was treated with fluorometholone eye drops, and the observation group with fluorometholone eye drops and cyclosporine eye drops. The eye examination indicators [tear film rupture time (BUT), corneal fluorescence (FL), Schirmer Ⅰ, and corneal dendritic cell density] and eye cytokines (EGF and TGF-β1) before and after the treatment and the incidence of adverse reactions were compared between the two groups. Results After the treatment, the BUT and Schirmer Ⅰ were (7.85 ±2.16) s and (7.03 ±1.22) mm/5 min in the observation group, which were higher than those in the control group [(6.58 ±2.11) s and (6.09 ±1.26) mm/5 min];the FL score and density of corneal dendritic cells were (3.44 ±1.29) and (15.63 ±3.57)/ mm^2 in the observation group, which were lower than those in the control group [(5.92±1.65) and (18.79±4.26) N/mm^2];the EGF and TGF-β1 were (5.11 ±0.63) ng/ml and (45.98 ±6.04) pg/ml in the observation group, which were significantly higher than those in the control group [(4.03 ±0.54) ng/ml and (41.26 ±5.62) pg/ml];the differences were statistically significant (all P < 0.05). There was no statistical difference in the incidence of adverse reactions between the observation group (13.51%) and the control group (10.81%)(P > 0.05). Conclusion Cyclosporine eye drops combined with fluorometholone can promote the normal expressions of EGF and TGF-β1, prolong the rupture time of tear film, increase the secretion of tear film, and improve the function of tear film, and does not increase the adverse reactions, so the treatment scheme is safe and reliable.