胸腺法新联合更昔洛韦滴眼液(凝胶)治疗单纯疱疹病毒性上皮型角膜炎的效果观察

Effect of thymalfasin combined with ganciclovir eye drops(gel)on herpes simplex virus epithelial keratitis

目的观察胸腺法新联合更昔洛韦滴眼液(凝胶)治疗单纯疱疹病毒性上皮型角膜炎的效果。方法选取2019年1月至2020年12月山西省汾阳医院眼科收治的单纯疱疹病毒性上皮型角膜炎患者80例,采用随机数字表法分为对照组和观察组各40例。两组均使用更昔洛韦滴眼液(包括眼用凝胶)治疗3周。对照组常规治疗,观察组则同时采用胸腺法新治疗。两组随访2年。比较两组治疗10 d内达到显效+有效的比例及2年内复发情况,并测定对比两组机体细胞免疫功能变化情况。结果对照组10 d内达到显效+有效的例数有10例,观察组有28例,观察组疗效优于对照组,差异有统计学意义(χ^(2)=16.24,P<0.001)。观察组2年内复发率低于对照组(10.00%比30.00%),差异有统计学意义(χ^(2)=5.00,P<0.05)。治疗后,观察组的各项细胞免疫功能指标(CD3^(+),CD4^(+),CD4^(+)/CD8^(+),NK细胞数)均高于同组治疗前和对照组同期,差异均有统计学意义(t组间=19.27、20.85、11.32、15.82,均P<0.001)。结论单纯疱疹病毒性上皮型角膜炎患者采用胸腺法新联合更昔洛韦滴眼液(凝胶)治疗,能在提高疗效的同时改善患者的免疫功能,有助于降低复发率。

Objective To investigate the efficacy of thymalfasin combined with ganciclovir eye drops(gel)in the treatment of herpes simplex virus epithelial keratitis.Methods This study enrolled 80 patients with herpes simplex virus epithelial keratitis who were treated at the Department of Ophthalmology,Fenyang Hospital,between January 2019 and December 2020.These patients were randomly divided into a control group and an observation group,with 40 patients in each group using the random number table method.All patients were treated with ganciclovir eye drops(gel)for 3 weeks.The control group received conventional treatment,while the observation group received both conventional treatment and thymalfasin treatment.All patients were followed up for 2 years.The proportion of patients who achieved a significant response and an effective response within 10 days of treatment,as well as the recurrence rate,were compared between the two groups.Additionally,the changes in cellular immune function were compared between the two groups.Results In the control group,there were 10 cases that achieved a significant or effective response within 10 days of treatment,while in the observation group,there were 28 cases.The therapeutic effect of the observation group was superior to that of the control group,and the difference was statistically significant(χ^(2)=16.24,P<0.001).The recurrence rate of the observation group within 2 years was significantly lower than that of the control group(10.00%vs.30.00%,χ^(2)=5.00,P<0.05).After treatment,the counts of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and natural killer cells,which are indices of cellular immune function,were significantly increased in the observation group compared with both their pre-treatment levels and the levels measured concurrently in the control group(tbetween-group=19.27,20.85,11.32,15.82,all P<0.001).Conclusion The combination of thymalfasin and ganciclovir eye drops(gel)for the treatment of herpes simplex virus epithelial keratitis can improve both the therapeutic effect and the immune function of patients,which helps to reduce the recurrence rate.