地夸磷索钠联合玻璃酸钠对角膜屈光术后中重度眼干燥症的影响分析

Effect of Combination Therapy with Diquafosol Sodium and Sodium Hyaluronate on Moderate to Severe Xerophthalmia after Corneal Refractive Surgery

目的:探讨地夸磷索钠联合玻璃酸钠治疗角膜屈光手术后中重度眼干燥症患者的影响。方法:选取2019年3月~2020年12月某院收治的80例(160眼)角膜屈光手术后中重度眼干燥症患者,按随机数字表法分为观察组和对照组,每组40例(80眼)。对照组给予玻璃酸钠滴眼液治疗,在此基础上,观察组联合地夸磷索钠滴眼液治疗。比较两组治疗前后眼表疾病指数(OSDI)量表评分、眼表功能指标、视觉质量指标、转化生长因子-β1(TGF-β1)、细胞间黏附分子-1(ICAM-1)、白介素-6(IL-6)水平,临床疗效及不良反应发生情况。结果:两组治疗后OSDI量表、角膜荧光素染色(FL)评分低于治疗前(P<0.05),无麻醉下SchirmerⅠ试验(SⅠt)和泪河高度高于治疗前(P<0.05),荧光素染色泪膜破裂时间(FBUT)长于治疗前(P<0.05),且观察组高于对照组(P<0.05)。与治疗前相比,两组治疗后TF-OSI均下降(P<0.05),调制传递函数截止频率(MTF cutoff)增加(P<0.05),且观察组优于对照组(P<0.05)。两组治疗后泪液中TGF-β1水平高于治疗前(P<0.05),泪液中ICAM-1、IL-6水平低于治疗前(P<0.05);且观察组优于对照组(P<0.05)。观察组总有效率(92.5%)高于对照组(75.0%,P<0.05)。观察组不良反应总发生率(7.5%)高于对照组(5.0%,P>0.05)。结论:应用地夸磷索钠滴眼液联合玻璃酸钠滴眼液治疗角膜屈光手术后中重度眼干燥症具有确切的临床疗效,能安全有效地缓解患者眼干燥症病情,改善眼表功能,提高视觉质量,并能进一步正性调节泪液中TGF-β1、ICAM-1和IL-6的表达水平。

Objective:To investigate the effect of combination therapy with diquafosol sodium and sodium hyaluronate in the treatment of patients with moderate to severe xerophthalmia after corneal refractive surgery.Methods:Eighty patients(160 eyes)with moderate to severe xerophthalmia after corneal refractive surgery admitted in our hospital between March 2019 and December 2020 were randomly divided into an observation group(n=40,80 eyes)and a control group(n=40,80 eyes)according to the random number table.Patients in the control group were treated with sodium hyaluronate eye drops,and those in the observation group were treated with diquafosol sodium eye drops on the basis of the treatment for the control group.The ocular surface disease index(OSDI)score,measures of ocular surface function,parameters of visual quality,transforming growth factor-β1(TGF-β1),intercelluar adhesion molecule-1(ICAM-1),interleukin-6(IL-6),clinical efficacy and adverse reactions were compared between the two groups before and after treatment.Results:After treatment,both groups were observed with lower OSDI and corneal fluorescein staining(FL)scores(P<0.05),higher values of SchirmerⅠtest without anesthesia(SⅠt)and tear meniscus height(P<0.05),and a longer fluorescein break-up time(FBUT)(P<0.05)compared with baseline;significant improvement was noted in the observation group(P<0.05).Compared with baseline,both groups achieved a reduction of TF-OSI(P<0.05)and an increase in modulation transfer function cutoff(MTF cutoff)(P<0.05)after treatment,and the observation group was noted with a significant improvement(P<0.05).Both groups had higher levels of TGF-β1 in tears(P<0.05)and lower levels of ICAM-1 and IL-6 in tears after treatment(P<0.05)as compared with baseline,and the observation group showed a significant improvement(P<0.05).The total response rate in the observation group was 92.5%,higher than that(75.0%)in the control group(P<0.05).The incidence of adverse reactions was 7.5%in the observation group and 5.0%in the control group(P>0.05).Conclusion:Combination therapy with diquafosol sodium eye drops and sodium hyaluronate eye drops exhibited definite clinical efficacy in the treatment of patients with moderate to severe xerophthalmia after corneal refractive surgery,and is safe and effective in relieving the condition,improving the ocular surface function and the visual quality,and positively regulating the expression levels of TGF-β1,ICAM-1 and IL-6 in tears.