CAJ | 학술논문

目的：评价免疫抑制剂---他克莫司滴眼液治疗春季卡他性角结膜炎（ vernal keratoconjunctivitis ，VKC）的治疗效果。 　　方法：随机双盲试验，安慰剂对照。收集四川大学华西医院眼科16例门诊患者，将16例患者按就诊顺序随机分为治疗组与对照组。治疗组使用他克莫司滴眼液，对照组使用他克莫司滴眼液基础液，观察期为28 d。对研究眼眼部体征和自觉症状分别进行单项评分，以治疗前后眼部体征总分变化量为主要疗效指标，主观症状为次要疗效指标。 　　结果：（1）组内比较：两组症状和体征在用药前后的差异具有统计学意义，治疗组用药后各个时期的自觉症状评分均低于用药前，且随着时间推移，症状评分逐渐降低，差异有统计学意义，对照组用药后不同时期之间的差异无统计学意义。（2）组间比较：两组患者的主观症状和体征在用药前和用药后第一次复查时差异无统计学意义，之后两次复查差异均具有统计学意义。评分变化量（用药前评分-用药后评分）在用药后第一次复查时差异无统计学意义，之后两次复查差异均具有统计学意义。 　　结论：他克莫司滴眼液能改善VKC患者的体征与症状，对于使用抗过敏滴眼液无明显改善的VKC，具有迅速、优良的改善效果，可应用于临床。
목적：평개면역억제제---타극막사적안액치료춘계잡타성각결막염（ vernal keratoconjunctivitis ，VKC）적치료효과。 　　방법：수궤쌍맹시험，안위제대조。수집사천대학화서의원안과16례문진환자，장16례환자안취진순서수궤분위치료조여대조조。치료조사용타극막사적안액，대조조사용타극막사적안액기출액，관찰기위28 d。대연구안안부체정화자각증상분별진행단항평분，이치료전후안부체정총분변화량위주요료효지표，주관증상위차요료효지표。 　　결과：（1）조내비교：량조증상화체정재용약전후적차이구유통계학의의，치료조용약후각개시기적자각증상평분균저우용약전，차수착시간추이，증상평분축점강저，차이유통계학의의，대조조용약후불동시기지간적차이무통계학의의。（2）조간비교：량조환자적주관증상화체정재용약전화용약후제일차복사시차이무통계학의의，지후량차복사차이균구유통계학의의。평분변화량（용약전평분-용약후평분）재용약후제일차복사시차이무통계학의의，지후량차복사차이균구유통계학의의。 　　결론：타극막사적안액능개선VKC환자적체정여증상，대우사용항과민적안액무명현개선적VKC，구유신속、우량적개선효과，가응용우림상。
AIM: To evaluate the curative effects of tacrolimus on vernal keratoconjunctivitis( VKC) . METHODS: A double-blind, randomized, placebo-controlled trial. Sixteen ambulatory patients from department of ophthalmology in West China Hospital of Sichuan University were randomly divided into drug treatment group and control group.Patients in treatment group were treated with tacrolimus eye drops, and control group with the basic placebo eye drops. Observation period of the trial was 28 days after taking the drops. The signs and symptoms were recorded and marked respectively.Total variation of ocular signs before or after therapy was main therapeutic index but subjective symptoms were the secondary index. RESULTS:Comparison in groups:there were significant differences on the scores of signs and symptoms before and after medication. After the drug treatment group, consciousness of each period symptom score was lower than before the medication, and over time, symptom score gradually reduced, the difference was statistically significant, but the control group after the medication had no statistically significant differences between different periods.Compared between the groups: There were no significant differences of subjective symptoms and signs before and after medication at the first review, but there were statistically significant differences during the other two reviews. Score variation ( scores before or after medication) had no significant differences in the first review but had it in the following two times. CONCLUSION:Tacrolimus can be used to improve the signs and symptoms of VKC, especially for the severe patients who are nonresponse to the anti-anaphylaxis drops.Tacrolimus can be quick and excellent to improve the effects, so it can be applied into clinic.