更昔洛韦在病毒性角膜炎围手术期的应用价值

张明鸿; 王春红

文章摘要

更昔洛韦在病毒性角膜炎围手术期的应用价值

Application value of ganciclovir in perioperative period of viral keratitis

DOI：10.3969/j.issn.1007-8134.2019.04.017

中文关键词: 更昔洛韦病毒性角膜炎炎症因子疗效角膜炎视力角膜移植术

英文关键词: ganciclovir viral keratitis inflammatory factors efficacy keratitis vision corneal transplantation

基金项目:

作者	单位
张明鸿	信阳市中心医院眼科
王春红	信阳市中心医院核医学科

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中文摘要:

目的　探讨深板层角膜移植术后应用更昔洛韦滴眼液对单纯疱疹病毒性角膜炎的疗效，并分析其对血清炎症因子IL-6、IL-8、TNF-α、IFN-α水平的影响。方法　选择2015年1月—2017年11月我院眼科收治的病毒性角膜炎患者共80例作为研究对象，用随机数字表法将患者分为2组，2组均行深板层角膜移植手术。观察组（40例）术后采用更昔洛韦滴眼液治疗，对照组采用阿昔洛韦滴眼液治疗。比较2组患者治疗疗效、治疗前后视力、炎性因子IL-6、IL-8、TNF-α、IFN-α水平的变化。结果　观察组治疗有效率高于对照组（92.50% vs. 75.00%，P＜0.05），不良反应率低于对照组（2.50% vs. 22.50%，P＜0.05）。观察组和对照组治疗后裸眼非矫正视力[（4.83±0.36）vs.（4.52±0.39）]、最佳矫正视力[（4.36±0.35）vs.（4.05±0.33）]比较，观察组均高于对照组（P均＜0.05）。观察组和对照组治疗后血清IL-6[（50.24±9.67）ng/L vs.（67.52±10.52）ng/L]、IL-8[（68.52±12.05）ng/L vs. （79.52±13.54）ng/L]、TNF-α[（76.24±15.13）ng/L vs. （85.24±16.74）ng/L]、IFN-α[（95.32±15.69）ng/L vs.（82.51±13.74）ng/L]比较，观察组均低于对照组（P均＜0.05）。所有患者均接受定期复查和随访，随访期间2组病毒复发率（2.50% vs. 7.50%）、基质免疫排斥反应发生率（2.50% vs. 12.50%）比较，观察组均低于对照组（P均＜0.05）。结论　深板层角膜移植术后应用更昔洛韦滴眼液可提高单纯疱疹性病毒感染治疗疗效，改善患者视力，不良反应少，且可有效降低机体炎性反应损伤。

英文摘要:

Objective　To investigate the therapeutic effect of ganciclovir eye drops on herpes simplex keratitis after deep lamellar keratoplasty, and analyze the effects on serum levels of inflammatory factors including IL-6, IL-8, TNF-α and IFN-α. Methods　From January 2015 to November 2017, 80 patients with viral keratitis who were treated in Department of Ophthalmology, Xinyang Central Hospital were included. These patients were divided into 2 groups according to random number table. The patients in both groups underwent deep lamellar keratoplasty. The observation group (40 cases) was treated with ganciclovir eye drops after operation, while the control group was treated with acyclovir eye drops. The therapeutic effect, visual acuity, levels of inflammatory factors IL-6, IL-8, TNF-α and IFN-α before and after treatment were compared between the 2 groups. Results　The effective rate of treatment in the observation group was higher than that in the control group (92.50% vs. 75.00%, P＜0.05), and the incidence of adverse reaction was lower than that in the control group (2.50% vs. 22.50%, P＜0.05). The UCVA [(4.83±0.36) vs. (4.52±0.39)], BCVA [(4.31±0.35) vs. (4.10±0.33)] in the observation group were higher than those in the control group after treatment (P＜0.05). The serum levels of IL-6 [(50.24±9.67) ng/L vs. (67.52±10.52) ng/L], IL-8 [(68.52±12.05) ng/L vs. (79.52±13.54) ng/L], TNF-α [(76.24±15.13) ng/L vs. (85.24±16.74) ng/L], IFN-α [(95.32±15.69) ng/L vs. (82.51±13.74) ng/L] in the observation group were lower than those in the control group (P＜0.05). All patients received regular review and follow-up. During the follow-up period, the rates of virus recurrence (2.50% vs. 7.50%) and matrix immune rejection (2.50% vs. 12.50%) in the observation group were lower than those in the control group (P＜0.05). Conclusions　Ganciclovir eye drops after deep lamellar keratoplasty can enhance the therapeutic effect of herpes simplex keratitis infection, improve the visual acuity of patients, induce fewer adverse reactions and effectively reduce the body inflammatory reaction injury.

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