维生素A棕榈酸酯与溴芬酸钠对长期应用曲伏前列素控制眼压患者抗眼表损伤的效果比较

摘要

目的:比较维生素A棕榈酸酯和溴芬酸钠对长期应用曲伏前列素控制眼压患者抗眼表损伤的效果.方法:选取2015年5月至2017年10月郑州市第二人民医院收治的长期应用曲伏前列素控制眼压的患者153例208眼, 按随机数字表法分为对照组 (51例71眼) 、观察1组 (51例68眼) 和观察2组 (51例69眼).对照组患者仅给予曲伏前列素滴眼液, 观察1组在对照组的基础上加用维生素A棕榈酸酯眼用凝胶, 观察2组在对照组的基础上加用溴芬酸钠水合物滴眼液.于治疗前后分别进行泪膜破裂时间 (break-up time, BUT) 、泪液分泌试验 (schirmer I test, SIt) 、角膜荧光素染色 (corneal fluorescein staining, CFS) 和睑板腺形态及功能评价, 比较三组患者的区别.结果:治疗30 d后, 观察1组患者BUT、SIt结果和CFS评分明显优于对照组和观察2组;观察2组患者的睑板腺形态及功能评分明显优于对照组和观察1组, 差异均有统计学意义 (P＜0.05).结论:维生素A棕榈酸酯和溴芬酸钠均可改善长期应用曲伏前列素控制眼压患者的眼表损伤, 其中维生素A棕榈酸酯对泪腺细胞和角膜细胞的修复作用较好, 溴芬酸钠在改善睑板腺形态及功能方面的优势更为明显.%OBJECTIVE: To compare the effects between vitamin A palmitate and bromfenac sodium on anti-ocular surface damage in treatment of patients with intraocular pressure controlled by long-term application of travoprost. METHODS: 153 patients (208 eyes) with intraocular pressure controlled by long-term application of travoprost admitted into Zhengzhou Second Hospital from May 2015 to Oct. 2017 were selected and divided into control group (51 cases, 71 eyes), observation group 1 (51 cases, 68 eyes) and observation group 2 (51 cases, 69 eyes) via random number table. The control group was treated with travoprost eye drops, the observation group 1 was treated with vitamin A palmitate eye gel based on the control group, while the observation group 2 was given bromfenac sodium hydrate eye drops based on the control group. Evaluations on break-up time (BUT), Schirmer I test (SIt), corneal fluorescein staining (CFS), morphology and function of meibomian glands were conducted and compared among three groups before and after treatment. RESULTS: At 30 days after treatment, the CFS score, BUT and SIt results of observation group 1 were significantly better than those of control group and observation group 2; the morphology and function of meibomian glands of observation group 2 was significantly better than that of control group and observation group 1, with statistically significant differences (P＜0.05). CONCLUSIONS: Both vitamin A palmitate and bromfenac sodium can improve ocular surface damage in patients with intraocular pressure controlled by long-term application of travoprost, of which vitamin A palmitate has better repair effect on lacrimal gland cells and corneal cells, and bromfenac sodium has better effects in improving morphology and function of meibomian glands.