自体血清联合玻璃酸钠治疗白内障术后干眼症患者的效果

Effect of Autologous Serum Combined with Sodium Hyaluronate on the Xeroma after Cataract Surgery

目的:研究自体血清联合玻璃酸钠治疗白内障术后干眼症患者的临床效果。方法:选择2015年1月~2018年12月我院收治的186例白内障术后干眼症患者,随机分为观察组以及对照组,每组各83例。对照组采用玻璃酸钠滴眼液治疗,观察组联合采用自体血清滴眼液治疗。连续给药4 w后,比较两组的治疗有效率,治疗前后的泪膜破裂试验和泪液分泌试验结果,泪液坏死因子(TNF)-α、白介素(IL)-6以及高敏C-反应蛋白(hs-CRP)水平的改变情况。结果:治疗后,观察组的有效率为95.18%(79/83),明显高于对照组[79.52%(66/83)](P<0.05)。两组治疗后的泪膜破裂试验和泪液分泌试验结果均较治疗前明显改善(P<0.05),且观察组的泪膜破裂试验和泪液分泌试验的改善程度明显优于对照组(P<0.05);两组治疗后的泪液hs-CRP、TNF-α和IL-6水平均较治疗前明显降低,且观察组更少指标明显低于对照组(P<0.05)。结论:自体血清联合玻璃酸钠对白内障术后干眼症患者的临床效果明显优于单用玻璃酸钠滴眼液,其可更有效增加泪膜的稳定性,减轻角膜损伤,减少泪液分泌,这可能与下调患者泪液中hs-CRP、TNF-α和IL-6水平有关。

Objective: To investigate the effect of autologous serum combined with sodium hyaluronate on the xeroma after cataract surgery. Methods: 186 cases of patients with xeroma after cataract surgery who were treated in our hospital from January 2015 to December 2018 were selected and randomly divided into two groups. The control group was treated with sodium hyaluronate eye drops,while the observation group was treated with autologous serum eye drops. After 4 weeks of continuous administration, the therapeutic efficacy, tear film rupture test and tear secretion test before and after treatment, changes of tear necrosis factor(TNF)-alpha, interleukin(IL)-6 and high sensitivity C-reactive protein(hs-CRP) levels were compared between the two groups. Results: After treatment, the effective rate of observation group was 95.18%(79/83), which was significantly higher than that of the control group [79.52%(66/83)](P<0.05). The results of tear film rupture test and tear secretion test in the two groups were significantly improved after treatment(P<0.05), and the improvement of tear film rupture test and tear secretion test in the observation group was significantly better than that in the control group(P<0.05);the levels of hs-CRP, TNF-α and IL-6 in the tear of both groups after treatment were significantly lower than those before treatment, and fewer indexes in the observation group were significantly lower than those in the control group(P<0.05). Conclusion:Autologous serum combined with sodium hyaluronate on xeroma after cataract surgery is more effective than sodium hyaluronate eye drops alone. It can more effectively increase the stability of tear film, reduce the corneal injury and tear secretion, which may be related to the down-regulation of hs-CRP, TNF-α and IL-6 levels in the tear.