重组人表皮生长因子对白内障超声乳化术后视功能恢复的影响

Effect of recombinant human epidermal growth factor on visual function recovery after phacoemulsification

目的 探究重组人表皮生长因子联合羟苯磺酸钙对白内障超声乳化术后视功能恢复的影响。方法 选取石家庄市人民医院2018年1月—2023年2月接受白内障超声乳化术患者106例进行研究,按抽签法分为实验组及对照组,各53例。对照组采用羟苯磺酸钙治疗,实验组采用重组人表皮生长因子联合羟苯磺酸钙治疗,对比术后1周、1个月、6个月最佳矫正视力(BCVA)、眼压,术前术后泪膜破裂时间(BUT)、泪液分泌检测(SIT)、膜荧光素染色(FL)、黄斑中心凹视网膜厚度(CSMT)、黄斑总容积(TMV)、血管内皮生长因子(VEGF)、内皮素-1(ET-1)、一氧化氮(NO)水平,比较药物不良反应及黄斑水肿发生率。结果 二组BCVA术后1个月、6个月恢复分别优于术后1周,眼压分别低于术后1周,BCVA术后6个月恢复优于术后1个月,眼压低于术后1周;术后1周、1个月、6个月BCVA恢复均优于对照组,眼压低于对照组(P<0.05);二组术前BUT、SIT、FL比较,差异无统计学意义(P>0.05);术后1个月,BUT、FL均低于术前,且SIT高于术前(P<0.05)。与对照组比较,实验组BUT、FL均较低,SIT较高(P<0.05);二组黄斑水肿发生率比较,差异无统计学意义(P>0.05);术前CSMT、TMV比较,差异无统计学意义(P>0.05)。术后1个月,二组CSMT低于术前,实验组低于对照组(P<0.05),二组术后TMV均升高,实验组升高幅度低于对照组(P<0.05);二组患者术前VEGF、ET-1、NO水平比较,差异无统计学意义(P>0.05);术后1个月,二组ET-1水平均明显低于术前,VEGF、NO高于术前,实验组ET-1水平低于对照组,VEGF、NO高于对照组(P<0.05);二组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 羟苯磺酸钙及重组人表皮生长因子联合用于白内障超声乳化术后,能明显促进术后患者视力恢复,减少对泪膜的影响,改善黄斑状况,用药安全性高。

Objective Exploring the effect of recombinant human epidermal growth factor combined with calcium hydroxybenzenesulfonate on visual function recovery after cataract phacoemulsification.Methods One hundred and six patients who underwent phacoemulsification in Shijiazhuang People's Hospital from January2018 to February 2023 were selected for research. They were divided into experimental group and control group using a lottery method, with 53 cases in each group. The control group received calcium dobesylate treatment, while the experimental group received recombinant human epidermal growth factor combined with calcium dobesylate treatment. The best corrected visual acuity(BCVA), intraocular pressure, preoperative and postoperative tear film rupture time(BUT) were compared at 1-week, 1-month, and 6-month after surgery Tear secretion test(SIT), membrane fluorescence staining(FL), macular fovea retinal thickness(CSMT), total macular volume(TMV), vascular endothelial growth factor(VEGF), endothelin-1(ET-1), nitric oxide(NO) levels, and comparison of drug adverse reactions and incidence of macular edema. Results In the two groups, the recovery of BCVA at 1-month and 6-month after operation was better than that at 1-week after operation, and the intraocular pressure was lower than that at 1-week after operation. The recovery of BCVA at 6-months after operation was better than that at 1-month, and the intraocular pressure was lower than that at 1-week after operation. The recovery of BCVA was better than that of the control group at 1-week, 1-month and 6-months after operation, and the intraocular pressure was lower than that of the control group(P<0.05). There was no significant difference in preoperative BUT, SIT and FL between the two groups(P>0.05). One month after operation, BUT and FL were lower than those before operation, and SIT was higher than that before operation(P<0.05). Compared with the control group, the BUT and FL in the experimental group were lower and the SIT was higher(P<0.05). There was no significant difference in the incidence of macular edema between the two groups(P>0.05). There was no significant difference between CSMT and TMV before operation(P>0.05). One month after operation, the CSMT of the two groups was lower than that before operation, and that of the experimental group was lower than that of the control group(P<0.05). The TMV of both groups increased after operation, and the increasing range of the experimental group was lower than that of the control group(P<0.05). There was no significant difference in the preoperative levels of VEGF, ET-1 and NO between the two groups(P>0.05). 1-month after operation, the levels of ET-1 in the two groups were significantly lower than those before operation, while the levels of VEGF and NO in the experimental group were lower than those in the control group, while the levels of VEGF and NO were higher than those in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion The combination of calcium ISobenesulfonate and recombinant human epidermal growth factor in phacoemulsification of cataract can significantly promote postoperative visual acuity recovery, reduce the impact on tear film, and improve macular status, with high safety.