rhEGF联合双氯芬酸钠治疗白内障术后干眼症患者的效果及其对泪液炎症因子及氧化应激水平的影响

Effect of rhEGF combined with diclofenac sodium in the treatment of dry eye patients after cataract surgery and its influence on lacrima inflammatory factors and oxidative stress

目的探讨重组人表皮生长因子(rhEGF)联合双氯芬酸钠治疗白内障术后干眼症患者的效果及其对泪液炎症因子及氧化应激水平的影响。方法选取我科2018年7月至2020年7月期间113例白内障超声乳化吸除术后干眼症患者作为研究对象,按随机数字表法分为对照组和观察组,对照组56例采用双氯芬酸钠滴眼液治疗,观察组57例在对照组基础上增加联合rhEGF滴眼液治疗。观察两组的临床疗效(干燥、烧灼等不适症状),泪膜功能,泪液炎症因子,氧化应激状态,不良反应。结果观察组的临床疗效优于对照组(z=2.0360,P=0.0420),观察组治疗后的FL评分低于对照组,泪液分泌长度、BUT长于对照组(t_(1)=10.613,t_(2)=8.173,t_(3)=8.070,P<0.05),TNF-α、IL-6均低于对照组(t_(1)=5.430,t_(2)=2.535,P<0.05),丙二醛、LPO均低于对照组,SOD高于对照组,(P<0.05),两组不良反应发生率(16.07%VS 10.53%)对比无统计学意义(χ^(2)=1.5730,P=0.2100)。结论rhEGF联合双氯芬酸钠可通过减轻白内障术后干眼症患者的氧化应激状态降低泪液炎症水平,进而改善泪膜功能,提高临床疗效,且不会增加不良反应。

Objetive To investigate the effect of recombinant human epidermal growth factor(rhEGF)combined with diclofenac sodium in the treatment of dry eye after cataract surgery and influence on lacrima inflammatory factors and oxidative stress.Methods 113 patients with dry eye after phacoemulsification in our department from July 2018 to July 2020 were selected and randomly divided into the control group and the observation group.56 cases in the control group were treated with diclofenac sodium eye drops,while 57 cases of observation group were treated with diclofenac sodium eye drops combined with rhEGF eye drops.The clinical efficacy(Discomfort symptoms such as dryness and burning),tear film function,lacrima inflammatory factors,oxidative stress status and adverse reactions of the two groups were observed.Results The clinical efficacy of the observation group was better than that of the control group(z=2.0360,P=0.0420).The flscore of the observation group was lower than that of the control group after treatment,the length of tear secretion and but were longer than those of the control group(t_(1)=10.613,t_(2)=8.173,t_(3)=8.070,P<0.05),TNF-αand IL-6 were lower than those of the control group(t_(1)=5.430,t_(2)=2.535,P<0.05),malondialdehyde and LPO were lower than those of the control group,SOD was higher than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions(16.07%VS 10.53%)between the two groups(χ^(2)=1.5730,P<0.05),rhEGF combined with diclofenac sodium can reduce the oxidative stress of patients with dry eye after cataract surgery,reduce the level of tear inflammation,improve the tear film function,improve the clinical efficacy,and will not increase the adverse reactions.