自体血清联合玻璃酸钠治疗白内障术后干眼症疗效及对患者泪液炎症因子的影响

Efficacy of autologous serum combined with sodium hyaluronate in treatment of dry eyes after cataract surgery and the influence on tear inflammatory factor levels

目的:探究自体血清联合玻璃酸钠治疗白内障术后干眼症的疗效及对患者泪液炎症因子水平的影响。方法:选择白内障术后干眼症患者124例为研究对象,随机分为两组,每组62例。给予对照组患者玻璃酸钠滴眼液治疗。观察组在对照组基础上联合自体血清治疗。比较两组临床疗效。于治疗前后进行干眼症状评分,统计泪液分泌试验(SIT)、泪膜破裂时间(BUT)及角膜荧光素染色(FL)评分,测定泪液中白细胞介素-1β(IL-1β)、IL-6、肿瘤坏死因子-α(TNF-α)水平,并进行两组间比较。结果:经过4周治疗,观察组总有效率与对照组比较差异无统计学意义(P>0.05)。两组治疗前干眼症状评分、SIT、BUT、FL评分以及IL-1β、IL-6、TNF-α水平比较差异无统计学意义(均P>0.05)。治疗后,两组干眼症状评分较治疗前降低,且观察组低于对照组(均P<0.05);两组SIT、BUT高于治疗前,FL评分低于治疗前,且观察组SIT、BUT高于对照组,FL评分低于对照组(均P<0.05);两组IL-1β、IL-6、TNF-α水平低于治疗前,且观察组较对照组更低(均P<0.05)。结论:自体血清联合玻璃酸钠可显著改善白内障术后干眼症状,降低泪液炎症因子水平,较单纯玻璃酸钠治疗效果更好。

Objective:To explore the efficacy of autologous serum combined with sodium hyaluronate in the treatment of dry eyes after cataract surgery,and the influence on tear inflammatory factor levels.Methods:A total of 124 patients with dry eyes after cataract surgery were selected and divided into two groups by random number table method,62 cases in each group.Patients in the control group were treated with sodium hyaluronate eye drops,and patients in the observation group were treated with autologous serum based on the treatment of the control group.The clinical efficacy of the two groups were compared.Before and after treatment,dry eye symptoms were scored,tear secretion test(SIT),tear film rupture time(BUT)and corneal fluorescein staining(FL)scores were counted,and tear inflammatory factors IL-1β,IL-6 and TNF-αlevels were measured,and above indexes were compared between the two groups.Results:After 4 weeks of treatment,there was no significant difference in the total effective rate between the observation group and the control group(P>0.05).There was no significant difference in the scores of dry eye symptom score,SIT,BUT,FL score,IL-1β,IL-6 and TNF-αlevels between the two groups before treatment(all P>0.05).After treatment,the scores of dry eye symptoms in the two groups were significantly lower than those before treatment,and the score in the observation group was lower than that in the control group(all P<0.05);SIT and BUT of the two groups were higher than those before treatment,FL score was lower than that before treatment,and SIT and BUT of the observation group were higher than those of the control group,FL score was lower than that of the control group(all P<0.05);the levels of IL-1β,IL-6 and TNF-αin the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(all P<0.05).Conclusion:Autologous serum combined with sodium hyaluronate can significantly improve dry eye symptoms after cataract surgery and reduce the levels of inflammatory factors in tears,which is better than sodium hyaluronate alone.