维生素A棕榈酸酯眼用凝胶辅助治疗白内障术后干眼症的效果及其对泪液炎症因子的影响

Effect of vitamin A palmitate ophthalmic gel in adjuvant treatment of dry eye after cataract surgery and its effect on tear inflammatory factors

目的探讨维生素A棕榈酸酯眼用凝胶辅助治疗白内障术后干眼症的效果及其对泪液炎症因子的影响。方法选取2019年3月至2021年2月在渭南市第二医院治疗的94例白内障术后干眼症患者为研究对象,依据随机数表法分为对照组和研究组各47例。对照组患者使用玻璃酸钠滴眼液治疗,研究组患者在对照组治疗的基础上使用维生素A棕榈酸酯眼用凝胶治疗。治疗30 d后,比较两组患者的临床疗效、治疗前后的泪液炎症因子水平[包括肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)]、干眼症状评分及视觉相关生存质量评分。结果研究组患者的治疗总有效率为91.49%,明显高于对照组的74.47%,差异有统计学意义(P<0.05);治疗前,两组患者的TNF-α、IL-1β水平比较差异均无统计学意义(P>0.05);治疗后,研究组患者的TNF-α、IL-1β水平分别为(133.94±12.26)ng/L、(34.20±5.66)ng/L,明显低于对照组的(239.15±26.39)ng/L、(67.42±5.49)ng/L,差异均有统计学意义(P<0.05);治疗前,两组患者的干眼症状评分比较差异无统计学意义(P>0.05);治疗后,研究组患者的干眼症状评分为(0.81±0.19)分,明显低于对照组的(1.70±0.31)分,差异有统计学意义(P<0.05);治疗前,两组患者的心理健康、社会活动、眼痛、一般健康评分比较差异均无统计学意义(P>0.05);治疗后,研究组患者的心理健康、社会活动、眼痛、一般健康评分分别为(73.77±4.92)分、(72.35±5.34)分、(76.32±4.92)分、(64.35±5.90)分,明显高于对照组的(65.39±5.61)分、(64.43±3.26)分、(60.31±4.23)分、(58.36±4.32)分,差异均有统计学意义(P<0.05)。结论维生素A棕榈酸酯眼用凝胶辅助治疗白内障术后干眼症疗效显著,同时可显著改善患者泪液炎症因子水平,提高生活质量。

Objective To investigate the effect of vitamin A palmitate ophthalmic gel in adjuvant treatment of dry eye after cataract surgery and its effect on tear inflammatory factors.Methods A total of 94 patients with dry eye after cataract surgery who were treated in Weinan Second Hospital from March 2019 to February 2021 were selected as the research objects.According to the random number table method,they were divided into the control group and the study group,with 47 patients in each group.The control group was treated with sodium hyaluronate eye drops,and the study group was treated with vitamin A palmitate ophthalmic gel on the basis of the control group.After 30 d of treatment,the clinical efficacy,levels of tear inflammatory factors[including tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)],dry eye symptom score,and vision-related survival were compared between the two groups.Results The total effective rate of the study group was 91.49%,significantly higher than 74.47%of the control group(P<0.05);before treatment,there were no significant differences in the levels of TNF-αand IL-1βbetween the two groups(P>0.05);after treatment,the levels of TNF-αand IL-1βin the study group were(133.94±12.26)ng/L and(34.20±5.66)ng/L,which were significantly lower than(239.15±26.39)ng/L and(67.42±5.49)ng/L in the control group(P<0.05).Before treatment,there were no significant difference in dry eye symptom score between the two groups(P>0.05);after treatment,the score of dry eye symptom in the study group was(0.81±0.19)points,which was significantly lower than(1.70±0.31)points in the control group(P<0.05).Before treatment,there were no significant differences in mental health,social activities,eye pain,and general health scores between the two groups(P>0.05);after treatment,the scores of mental health,social activities,eye pain,and general health of the study group were(73.77±4.92)points,(72.35±5.34)points,(76.32±4.92)points,(64.35±5.90)points,which were significantly higher than(65.39±5.61)points,(64.43±3.26)points,(60.31±4.23)points,(58.36±4.32)points in the control group(P<0.05).Conclusion Vitamin A palmitate ophthalmic gel has a significant effect in the adjuvant treatment of dry eye after cataract surgery,which can significantly improve the level of tear inflammatory factors and improve the quality of life of patients.