普拉洛芬对白内障术后炎症反应和黄斑中心凹视网膜厚度的影响

Effect of pranoprofen on inflammatory response and retinal thickness in the macular center pit after cataract surgery

目的探讨普拉洛芬对白内障术后患者炎症反应和黄斑中心凹视网膜厚度的影响。方法选取2018年8月至2020年12月吉安市中心人民医院眼科收治的60例白内障手术患者作为研究对象,按照随机数字表法分为观察组与对照组,每组30例。所有患者术后均给予妥布霉素地塞米松滴眼液治疗,观察组加用普拉洛芬滴眼液治疗。比较两组术后1天、7天和14天眼部症状及体征评分、炎症因子[肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]水平、术后第1天、术后第7天、14天黄斑中心凹视网膜厚度(CMT)及不良反应发生情况。结果术后第7、14天,两组眼部症状及体征评分均低于术后第1天,差异有统计学意义(P<0.05),但组间比较差异无统计学意义。术后第7天,两组TNF-α、hs-CRP水平均高于术后第1天,但观察组低于对照组,差异有统计学意义(P<0.05);术后第14天,两组TNF-α、hs-CRP水平均高于术后第1天,两组TNF-α水平均高于术后第7天,对照组hs-CRP水平高于术后第7天,但观察组TNF-α、hs-CRP水平均低于对照组,差异有统计学意义(P<0.05),但观察组hs-CRP水平术后第7天与术后14天比较差异无统计学意义。观察组术后不良反应总发生率为10.00%,低于对照组的33.33%,复发率为0.00%,低于对照组的20.00%,差异有统计学意义(P<0.05)。术后第7天,对照组CMT高于术后第1天,但观察组低于对照组,差异有统计学意义(P<0.05);术后第14天,对照组CMT低于术后第1天,第7天,且观察组低于对照组,差异有统计学意义(P<0.05),其余两两比较差异无统计学意义。结论加用普拉洛芬滴眼液可有效改善白内障手术患者眼部症状、体征,显著减轻白内障术后炎症反应,缩小黄斑中心凹视网膜厚度,减少复发,值得临床推广应用。

Objective To investigate the effects of praprofen on the inflammatory response and the thickness of macular fovea retina after cataract surgery.Methods A total of 60 cataract surgery patients admitted to the Ophthalmology department of Ji'an Central People's Hospital from August 2018 to December 2020 were selected as research subjects,and they were divided into the observation group and the control group according to random number table method,with 30 cases in each group.All patients were treated with tobramycin dexamethasone eye drops after operation,and the observation group was treated with praloprofen eye drops.The score of ocular symptoms and signs,levels of inflammatory factors(tumor necrosis factor-α[TNF-α],high-sensitive C-reactive protein[hs-CRP]),central macular retinal thickness(CMT)at 1,7 and 14 day after surgery and the incidence of adverse reactions were compared between the two groups.Results At the 7th and 14th d after surgery,the scores of ocular symptoms and signs of the two groups were lower than those on the 1st d after surgery,the difference was statistically significant(P<0.05),but there was no statistically significant difference between groups;at the 7th d after surgery,the levels of TNF-αand hs-CRP of the two groups were higher than those on the 1st day after surgery,but the observation group was lower than the control group,the differences were statistically significant(P<0.05);at the 14th day after surgery,the levels of TNF-αand hs-CRP of the two groups were higher than those at the 1st d after surgery;the levels of TNF-αand hs-CRP of the two groups were higher than those at the 7th d after surgery;the levels of hs-CRP in the control group were higher than those at the 7th day after surgery;however,the levels of TNF-αand hs-CRP in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).However,there was no significant difference in the hs-CRP levels between the observation group at the 7th and 14th day after surgery.The total incidence of postoperative adverse reactions in the observation group was 10.00%,which was lower than 33.33%in the control group,and the recurrence rate was 0.00%,which was lower than 20.00%in the control group,the differences were statistically significant(P<0.05).At the 7th day after surgery,CMT in the control group was higher than that at the 1st day after surgery,but the observation group was lower than the control group,the difference was statistically significant(P<0.05);at the 14th day after surgery,the CMT in the control group was lower than that of the 1st and 7th day after surgery,and the observation group was lower than that in the control group,the differences were statistically significant(P<0.05),the other pairwise comparisons were not statistically significant.Conclusion Plalloprofen eye drops can effectively improve the ocular symptoms and signs of cataract surgery patients,significantly reduce the postoperative inflammatory response,reduce the thickness of macular fovea retina,and reduce recurrence,which is worthy of clinical application.