选择性5-羟色胺再摄取抑制剂治疗焦虑对眼表干眼指标的影响

Effects of paroxetine hydrochloride on dry eye indicators in patients with anxiety disorder

目的观察选择性5-羟色胺再摄取抑制剂(SSRI)盐酸帕罗西汀片治疗焦虑对患者眼表干眼指标的影响。方法将2018年9月至2021年2月在嘉兴市第二医院就诊的49例诊断焦虑的患者采用随机数字表法分为对照组25例和药物治疗组24例。对照组仅给予心理治疗;药物治疗组在辅以心型治疗的同时给予盐酸帕罗西汀片治疗。在治疗前、治疗2周及2个月后分别进行眼表干眼相关的指标:眼表疾病指数(OSDI)评分、荧光素染色泪膜破裂时间(FBUT)、基础泪液分泌试验(SⅠt)、角膜荧光素钠染色评分(SCSF)、睑板腺异常睑缘相关指标测定,评价两组治疗前后差异变化。结果治疗2周及2个月后,药物治疗组的OSDI、FBUT、SⅠt、SCSF、睑板腺异常睑缘相关指标较对照组均变差,差异均有统计学意义(均P<0.05)。对照组治疗2周及2个月后,OSDI、SⅠt均较治疗前改善,差异均有统计学意义(均P<0.05);FBUT、SCSF、睑板腺异常睑缘相关指标改变差异均无统计学意义(均P>0.05)。药物治疗组治疗2周及2个月后OSDI、FBUT、SⅠt、SCSF、睑板腺异常睑缘相关指标较治疗前均变差,且治疗2个月后较治疗2周变差更为显著,差异均有统计学意义(均P<0.05)。结论焦虑患者使用SSRI盐酸帕罗西汀片治疗2周后出现眼表干眼指标加重,治疗2个月后加重更加明显或引发干眼。

Objective To investigate the effect of selective serotonin reuptake inhibitor(SSRI)paroxetine hydrochloride on dry eye indicators in patients with anxiety disorder.Methods Forty nine patients with anxiety disorder who were treated in Jiaxing Second Hospital from September 2018 to February 2021 were enrolled.Patients were randomly divided into two groups:control group was treated with psychotherapy alone,study group was treated with paroxetine hydrochloride tablets and psychotherapy.The dry eye indicators,including tear film stability test,ocular surface disease index score assessment(OSDI),fluorescein tear film break-up time(FBUT),Schirmer I test(SⅠt),staining scores of sodium fluorescein(SCSF)and tarsal gland abnormal tarsal margin correlation index were measured before treatment,2 weeks and 2 months after treatment in two groups.Results After 2 weeks and 2 months of treatment,the OSDI,FBUT,SⅠt,SCSF and abnormal eyelid margin in study group were worse than those in control group(all P<0.05),and dry eye symptoms were aggravated in study group.In control group,the OSDI and SⅠt were significantly improved after 2 weeks and 2 months of treatment compared with those before treatment(all P<0.05);however,there were no significant changes in FBUT,SCSF,and eyelid glands(P>0.05).The OSDI,FBUT,SⅠt,SCSF,and abnormal eyelid margin in the study group were worse after treatment for 2 weeks and 2 months than those before treatment;and the deterioration was more significant at 2 months than that at 2 weeks of treatment(all P<0.05).Conclusion The study shows that anxiety patients treated with SSRI for 2 weeks showed a deterioration of the ocular surface dry eye index,and the aggravation becomes more obvious or triggers dry eyedisease after 2 months.