中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2013年
10期
1460-1462
,共3页
细菌性角膜溃疡%皮质类固醇激素%最佳矫正视力%不良反应
細菌性角膜潰瘍%皮質類固醇激素%最佳矯正視力%不良反應
세균성각막궤양%피질류고순격소%최가교정시력%불량반응
Bacterial corneal ulcers%Corticosteroids%Best spectacle corrected visual acuity%Adverse event
目的 探讨在足量应用抗生素的前提下局部应用皮质醇激素对于细菌性角膜溃疡(BCU)的疗效及安全性.方法 选择确诊为BCU且符合纳入标准的患者62例,按数字表法随机分为观察(n=33)和对照(n=29).两组予以为期3周的妥布霉素滴眼液治疗,观察组在使用妥布霉素至少48 h以上后辅以0.02％氟未龙滴眼液治疗,持续3周,逐渐减量至停药.观察治疗前后患者的最佳矫正视力(BSCVA)、眼压波动情况、角膜上皮愈合时间、透明度及严重不良事件.结果 治疗3周后,两组平均BSCVA均较基线水平提高,但提高程度的差异无统计学意义；对照组眼压＞21 mm Hg的患者显著增加,与观察组差异有统计学意义(x2=7.272,P＜0.05).随访3个月发现,观察组BSCVA的提高程度显著优于对照组(t=2.388,P＜0.05)；两组眼压基本恢复至基线水平.对照组角膜平均上皮愈合时间为(11.3±4.5)d,明显短于观察组的(14.7±5.2)d(t =2.707,P＜0.05)；但观察组角膜透明度的恢复优于对照组(x2=8.207,P＜0.05).治疗及随访期间,未出现严重不良事件.结论 对BCU患者局部给予皮质醇激素,尽管会延长愈合时间,但可以有效抑制炎症,减少瘢痕形成,控制眼压波动,对远期视力的恢复有积极意义.
目的 探討在足量應用抗生素的前提下跼部應用皮質醇激素對于細菌性角膜潰瘍(BCU)的療效及安全性.方法 選擇確診為BCU且符閤納入標準的患者62例,按數字錶法隨機分為觀察(n=33)和對照(n=29).兩組予以為期3週的妥佈黴素滴眼液治療,觀察組在使用妥佈黴素至少48 h以上後輔以0.02％氟未龍滴眼液治療,持續3週,逐漸減量至停藥.觀察治療前後患者的最佳矯正視力(BSCVA)、眼壓波動情況、角膜上皮愈閤時間、透明度及嚴重不良事件.結果 治療3週後,兩組平均BSCVA均較基線水平提高,但提高程度的差異無統計學意義；對照組眼壓＞21 mm Hg的患者顯著增加,與觀察組差異有統計學意義(x2=7.272,P＜0.05).隨訪3箇月髮現,觀察組BSCVA的提高程度顯著優于對照組(t=2.388,P＜0.05)；兩組眼壓基本恢複至基線水平.對照組角膜平均上皮愈閤時間為(11.3±4.5)d,明顯短于觀察組的(14.7±5.2)d(t =2.707,P＜0.05)；但觀察組角膜透明度的恢複優于對照組(x2=8.207,P＜0.05).治療及隨訪期間,未齣現嚴重不良事件.結論 對BCU患者跼部給予皮質醇激素,儘管會延長愈閤時間,但可以有效抑製炎癥,減少瘢痕形成,控製眼壓波動,對遠期視力的恢複有積極意義.
목적 탐토재족량응용항생소적전제하국부응용피질순격소대우세균성각막궤양(BCU)적료효급안전성.방법 선택학진위BCU차부합납입표준적환자62례,안수자표법수궤분위관찰(n=33)화대조(n=29).량조여이위기3주적타포매소적안액치료,관찰조재사용타포매소지소48 h이상후보이0.02％불미룡적안액치료,지속3주,축점감량지정약.관찰치료전후환자적최가교정시력(BSCVA)、안압파동정황、각막상피유합시간、투명도급엄중불량사건.결과 치료3주후,량조평균BSCVA균교기선수평제고,단제고정도적차이무통계학의의；대조조안압＞21 mm Hg적환자현저증가,여관찰조차이유통계학의의(x2=7.272,P＜0.05).수방3개월발현,관찰조BSCVA적제고정도현저우우대조조(t=2.388,P＜0.05)；량조안압기본회복지기선수평.대조조각막평균상피유합시간위(11.3±4.5)d,명현단우관찰조적(14.7±5.2)d(t =2.707,P＜0.05)；단관찰조각막투명도적회복우우대조조(x2=8.207,P＜0.05).치료급수방기간,미출현엄중불량사건.결론 대BCU환자국부급여피질순격소,진관회연장유합시간,단가이유효억제염증,감소반흔형성,공제안압파동,대원기시력적회복유적겁의의.
Objective To investigate the clinical efficacy and safety of topical corticosteroids as adjunctive plan in the therapy of bacterial corneal ulcers (BCU).Methods 62 eligible patients with confirmed BCU were screened and divided into 2 groups randomly.Both groups were treated with topical tobramycin for 3 weeks,the observation group received topical tobramycin for at least 48 hours and then treated with 0.02％ fluorometholone for 3 weeks,and decrement setp by step.Best spectacle corrected visual acuity(BSCVA),fluctuation of intraocular pressure (IOP) before and after therapy,time to corneal reepithelialization and clarity,severe adverse event were observed.Results After 3 weeks,BSCVA of both groups increased compared to their baselines,however,no significant difference between the two groups.Patients whose IOP exceed 21mm Hg in the control group was statistically more than that in the observation group(x2 =7.272,P ＜ 0.05).Follow up for 3 months,increasing of BSCVA in the observationgroup was significantly higher than the control group(t =2.388,P ＜ 0.05) ;and lOP of both two groups almost recuperated to baselines.Although the time to corneal reepithelialization of the control group (11.3 ± 4.5) d was shorter than observation group [(14.7 ± 5.2) d] (t =2.707,P ＜ 0.05),the recovery of corneal clarity in observation group was superior to control group (x2 =8.207,P ＜ 0.05).In addition,no severe adverse events were observed during this period.Conclusion Although prolong the healing time of corneal epithelium,corticosteroids as an adjunctive plan in the therapy of BCU may reduce immune-mediated damage,decrease scarring,control IOP fluctuation and improve BSCVA,but with no safety concerns.
