更昔洛韦眼用凝胶联合干扰素治疗单纯疱疹病毒性角膜炎疗效观察(1)
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2010年6月25日
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[摘要] 目的:探讨更昔洛韦眼用凝胶联合干扰素治疗单纯疱疹病毒性角膜炎的临床效果。方法:选取单纯疱疹病毒性角膜炎患者59例(78眼),将其随机分为观察组和对照组,观察组29例(40眼),采用干扰素球结膜下注射,联用更昔洛韦眼用凝胶治疗;对照组30例(38眼),单独采用更昔洛韦眼用凝胶治疗,并对两组治疗效果进行对照分析。结果:观察组疗效明显优于对照组,差异有统计学意义(P<0.05)。结论:应用更昔洛韦眼用凝胶联合干扰素治疗单纯疱疹病毒性角膜炎具有治愈率高、副作用少的优点,值得临床推广应用。
[关键词] 更昔洛韦眼用凝胶;干扰素;单纯疱疹;病毒性角膜炎
[中图分类号] R772.21 [文献标识码]B [文章编号]1674-4721(2010)06(c)-053-02
Clinical observation about ganciclovir ophthalmic gel combined interferon in the treatment of herpes simplex viral keratitis
SU Yiyun,HE Yuezhi,WEN Tianshi
(Department of Ophthalmology,People's Hospital of Huaiji County,Guangdong Province,Huaiji526400, China)
[Abstract] Objective: To study the clinical effects of application of the combine ganciclovir ophthalmic gel and interferon treatment in herpes simplex viral keratitis. Methods: 59 patients(78 eyes) of herpes simplex virus keratitis were selected,and were divided into two groups randomly,there were observation group and control group. 29 patients (40 eyes) in observation group, were used subconjunctival injection of interferon which combined with ganciclovir ophthalmic gel in the treatment;30 patients (38 eyes) in the control group,were only used ganciclovir ophthalmic gel.Then compared and analyzed the therapeutic effects of two groups. Results: The therapeutic effects of the observation group was better than that of the control group. The difference was statistically significant (P<0.05). Conclusion: The application of ganciclovir ophthalmic gel combined interferon in herpes simplex virus keratitis, with high cure rate, the fewer side-effects advantages, is worthy of clinical applications.
[Key words] Ganciclovir ophthalmic gel;Interferon;Herpes simplex;Viral keratitis
单纯疱疹病毒性角膜炎(HSK)是由单纯疱疹病毒(HSV)感染所致的一种临床常见病,是严重的世界性致盲性眼病,发病率及致盲率占角膜病的首位[1]。本病的特点是病毒潜伏于三叉神经节,角膜病反复发作,多次发作后角膜混浊并逐渐加重,最终导致失明[2]。临床常见原发感染及复发感染两类,其中复发感染主要表现为树枝状、地图状、盘状角膜炎,往往病程长,症状易复发,最终影响视功能及眼部外观。发病机制是HSV原发性感染(常发生于幼儿期)后,HSV沿感染组织的感觉神经末梢经神经轴突进入感觉神经节的细胞体内,其染色体进入细胞核潜伏存留,病情静止,当机体抵抗力下降时,潜伏的病毒再活化,沿神经轴突逆行至感觉神经末梢,再扩散到眼表或角膜上皮细胞,导致复发感染。近几年来,本科应用更昔洛韦眼用凝胶联合干扰素球结膜下注射治疗单纯疱疹病毒性角膜炎取得了良好的效果,现报道如下:
1 资料与方法
1.1 一般资料
选取2008年10月～2010年1月本院收治的HSK患者59例(78眼),其中右眼40只,左眼38只;年龄8～60岁,平均34岁;初发50例,复发9例;病程6 d～2年。将患者随机分为观察组和对照组,观察组29例(40眼),对照组30例(38眼)。两组在年龄、性别、病情及病程方面差异无统计学意义,具有可比性。
1.2 治疗方法
对照组给予0.15%更昔洛韦眼用凝胶(湖北科益药业股份有限公司生产,商品名丽科明)滴眼4次/d,每次2滴。观察组应用干扰素1 000 000 U,用2%利多卡因1 ml溶解或稀释后,表面麻醉后行球结膜下注射,注射后涂更昔洛韦眼用凝胶,眼垫包扎,隔日1次,共6～8次 ......
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