巨细胞病毒阳性的青光眼睫状体炎综合征临床特点及20g/L更昔洛韦滴眼液干预效果

Clinical characteristics of cytomegalovirus positive Posner-Schlossman syndrome and the effect of 20g/L Ganciclovir eye drops intervention

目的:比较巨细胞病毒(CMV)阳性和阴性的青光眼睫状体炎综合征(PSS)患者的临床特征,评价20g/L更昔洛韦滴眼液局部治疗CMV阳性PSS患者的临床疗效及短期复发情况。方法:比较CMV阳性(86例86眼)和CMV阴性(60例60眼)PSS患者的差异,比较CMV阳性患者中常规组(30例30眼,仅给予抗炎降压治疗)和试验组(56例56眼,在常规组治疗基础上,给予配制的20g/L更昔洛韦滴眼液点眼)的一般资料、眼部参数和分布、房水中IFN-γ和IL-4水平、临床疗效以及1a内复发情况。结果:纳入的146例PSS患者中,CMV阳性率为58.9%。CMV阳性患者的平均眼压、发作眼与对侧眼的角膜内皮细胞数差显著升高,发作眼角膜内皮细胞数显著减少(P<0.05)。治疗后,试验组各眼部参数及分布均显著优于常规组(P<0.05),试验组IFN-γ水平显著低于常规组,IL-4水平显著高于常规组(P<0.05)。与常规组相比,试验组总有效率高,所需治愈时间短,1a内复发率低、复发间隔时间长(P<0.05)。结论:CMV阳性的PSS患者比阴性患者眼压更高,角膜内皮细胞损伤更大。20g/L更昔洛韦滴眼液局部点眼通过抵抗CMV感染可有效控制眼压及炎症发展,临床疗效显著,短期不易复发。

·AIM:To compare the clinical characteristics of cytomegalovirus positive and negative patients with Posner-Schlossman syndrome(PSS),and the clinical efficacy and short-term recurrence of 20g/L ganciclovir eye drops in local treatment of patients with CMV positive PSS were evaluated.·METHODS:Differences between CMV positive(86 cases,86 eyes)and CMV negative(60 cases,60 eyes)PSS patients were compared.General information,ocular parameters and distribution,IFN-γand IL-4 levels in aqueous humor,clinical efficacy and recurrence within 1a were compared between the conventional group(30 cases,30 eyes)and the experimental group(56 cases,56 eyes).·RESULTS:Among the 146 PSS patients included,the CMV positive rate was 58.9%.The average intraocular pressure and the difference in the number of corneal endothelial cells between the onset eye and the contralateral eye in CMV positive patients were significantly increased,and the number of corneal endothelial cells in the onset eye was significantly decreased(P<0.05).After treatment,all ocular parameters and distribution in the experimental group were significantly better than those in the conventional group(P<0.05),IFN-γlevel in the experimental group was significantly lower than that in the conventional group,and IL-4 level was significantly higher than that in the conventional group(P<0.05).Compared with the conventional group,the experimental group had a high total effective rate,a short cure time,a low recurrence rate within 1a and a long recurrence interval,with statistically significant differences(P<0.05).·CONCLUSION:Patients with CMV positive PSS had higher intraocular pressure and greater damage to corneal endothelial cells than PSS patients with CMV negative.20g/L ganciclovir eye drops can effectively control intraocular pressure and inflammation by resisting CMV infection,with significant clinical efficacy and not easy to relapse in the short term.