低渗性透明质酸眼液对干燥综合症的眼干更有效
发表者：收集
日期：2015-03-10
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目的：了解低渗性或等渗性透明质酸眼液治疗干燥综合症眼干的疗效。
方法：40例干燥综合症患者分2个治疗组，第一组用0.4%低渗透明质酸眼液(150 mOsm/l)，第二组用0.4%等渗透明质酸眼液，每日滴眼6次，持续90天。在0、15、30和90天分别进行主观症状分级、泪膜破裂时间、角膜荧光染色、结膜罗丹明染色、滤纸试验和结膜印记细胞学检查。患者检查方式均为盲法。统计学方法是t检验、U检验和卡方检验。
结果：两组在第15天的症状均得到明显改善，但第一组患者总体得分明显好于第二组（P=0.02）。与治疗前相比，第15天时第一组患者的泪膜破裂时间、荧光素得分和罗丹明染色得分均明显改善(p分别为0.003、0.000001 和0.0004)，第二组患者的泪膜破裂时间和荧光素染色得分也有明显好转（p值分别为0.05和0.0001)。与第二组相比，第一组在第15天的罗丹明染色得分和泪膜破裂时间 (p分别为0.01和0.05)和第90天的荧光素染色得分明显占优(p=0.0003)，且从第15天开始持续整个研究过程的结膜印记细胞学检查有更好的统计学总得分(p<0.02)。 第二组从第30天开始结膜印记细胞学检查也比最初有明显改善(p=0.000005)。
结论：透明质酸眼液可治疗干燥综合症的严重眼干，低渗性制剂对角结膜上皮细胞的疗效明显好于等渗性制剂。
附原文：AIM: To study the effect of the treatment of dry eye in Sjögren's syndrome patients with hypotonic or isotonic hyaluronate eye drops. METHODS: 40 Sjögren's syndrome patients were divided in two groups and treated as follows: group 1 with hypotonic (150 mOsm/l) 0.4% hyaluronate eye drops; group 2 with isotonic 0.4% hyaluronate eye drops. The eye drops were instilled six times a day for 90 days. Grading of subjective symptoms, break up time (BUT), corneal fluorescein staining, conjunctival rose bengal staining, Schirmer's I test, and conjunctival impression cytology were carried out at 0 and 15, 30, 90 days from the beginning of the study. Patients were examined in a blind fashion. For the statistical analysis the Student's t test, Mann-Whitney U test, and chi(2) test were performed. RESULTS: Symptoms were statistically significantly improved at day 15 in both groups but group 1 patients had a global score statistically significantly better group 2 (p=0.02). At day 15 group 1 patients had an improvement from baseline values of BUT (p=0.003), fluorescein, and rose bengal score (p=0.000001 and p=0.0004 respectively). Group 2 patients had, at day 15, an improvement of BUT and fluorescein score compared to baseline values (p=0.05 and p=0.0001 respectively). A comparison between the two groups showed better results for group 1 patients at day 15 for rose bengal stain (p=0.01) and for BUT (p=0.05) and fluorescein score (p=0.0003) at day 90. The conjunctival impression cytology showed that group 1 had a statistically significant better total score than group 2 starting from day 15 and lasting throughout the study (p<0.02). Also group 2 patients showed an improvement from baseline values starting from day 30 (p=0.000005). CONCLUSION: Hyaluronate eye drops are useful for treating severe dry eye in Sjögren's syndrome patients. The use of a formulation with pronounced hypotonicity showed better effects on corneoconjunctival epithelium than the isotonic solution.
引自：Aragona P, Di Stefano G, Ferreri F,et al.Sodium hyaluronate eye drops of different osmolarity for the treatment of dry eye in Sjögren's syndrome patients. Br J Ophthalmol. 2002,86(8):879-84 （注：干燥综合症病人或亲属可加QQ群交流，群号： 118194945 ，本网站站长私人微信号： ssgzz88 ）
方法：40例干燥综合症患者分2个治疗组，第一组用0.4%低渗透明质酸眼液(150 mOsm/l)，第二组用0.4%等渗透明质酸眼液，每日滴眼6次，持续90天。在0、15、30和90天分别进行主观症状分级、泪膜破裂时间、角膜荧光染色、结膜罗丹明染色、滤纸试验和结膜印记细胞学检查。患者检查方式均为盲法。统计学方法是t检验、U检验和卡方检验。
结果：两组在第15天的症状均得到明显改善，但第一组患者总体得分明显好于第二组（P=0.02）。与治疗前相比，第15天时第一组患者的泪膜破裂时间、荧光素得分和罗丹明染色得分均明显改善(p分别为0.003、0.000001 和0.0004)，第二组患者的泪膜破裂时间和荧光素染色得分也有明显好转（p值分别为0.05和0.0001)。与第二组相比，第一组在第15天的罗丹明染色得分和泪膜破裂时间 (p分别为0.01和0.05)和第90天的荧光素染色得分明显占优(p=0.0003)，且从第15天开始持续整个研究过程的结膜印记细胞学检查有更好的统计学总得分(p<0.02)。 第二组从第30天开始结膜印记细胞学检查也比最初有明显改善(p=0.000005)。
结论：透明质酸眼液可治疗干燥综合症的严重眼干，低渗性制剂对角结膜上皮细胞的疗效明显好于等渗性制剂。
附原文：AIM: To study the effect of the treatment of dry eye in Sjögren's syndrome patients with hypotonic or isotonic hyaluronate eye drops. METHODS: 40 Sjögren's syndrome patients were divided in two groups and treated as follows: group 1 with hypotonic (150 mOsm/l) 0.4% hyaluronate eye drops; group 2 with isotonic 0.4% hyaluronate eye drops. The eye drops were instilled six times a day for 90 days. Grading of subjective symptoms, break up time (BUT), corneal fluorescein staining, conjunctival rose bengal staining, Schirmer's I test, and conjunctival impression cytology were carried out at 0 and 15, 30, 90 days from the beginning of the study. Patients were examined in a blind fashion. For the statistical analysis the Student's t test, Mann-Whitney U test, and chi(2) test were performed. RESULTS: Symptoms were statistically significantly improved at day 15 in both groups but group 1 patients had a global score statistically significantly better group 2 (p=0.02). At day 15 group 1 patients had an improvement from baseline values of BUT (p=0.003), fluorescein, and rose bengal score (p=0.000001 and p=0.0004 respectively). Group 2 patients had, at day 15, an improvement of BUT and fluorescein score compared to baseline values (p=0.05 and p=0.0001 respectively). A comparison between the two groups showed better results for group 1 patients at day 15 for rose bengal stain (p=0.01) and for BUT (p=0.05) and fluorescein score (p=0.0003) at day 90. The conjunctival impression cytology showed that group 1 had a statistically significant better total score than group 2 starting from day 15 and lasting throughout the study (p<0.02). Also group 2 patients showed an improvement from baseline values starting from day 30 (p=0.000005). CONCLUSION: Hyaluronate eye drops are useful for treating severe dry eye in Sjögren's syndrome patients. The use of a formulation with pronounced hypotonicity showed better effects on corneoconjunctival epithelium than the isotonic solution.
引自：Aragona P, Di Stefano G, Ferreri F,et al.Sodium hyaluronate eye drops of different osmolarity for the treatment of dry eye in Sjögren's syndrome patients. Br J Ophthalmol. 2002,86(8):879-84 （注：干燥综合症病人或亲属可加QQ群交流，群号： 118194945 ，本网站站长私人微信号： ssgzz88 ）