小牛血去蛋白提取物和重组牛碱性成纤维细胞生长因子眼用凝胶对超声乳化术后泪膜影响

摘要

目的 观察白内障患者超声乳化手术后应用小牛血去蛋白提取物和重组牛碱性成纤维细胞生长因子眼用凝胶对术后泪膜的影响.方法 临床病例对照研究.对2014年4至10月在北京同仁眼科中心选取60岁以上行白内障超声乳化患者78例(78只眼),术后1~7 d所有患者均应用妥布霉素地塞米松滴眼液点眼4次/d,术后8~30 d应用普拉洛芬滴眼液4次/d, 按信封法随机将患者分为A、B、C 3组,各为26例.A组为对照组不再加药;术后1~30 d B组加用小牛血去蛋白提取物眼用凝胶;C组加用重组牛碱性成纤维细胞生长因子眼用凝胶.观察A、B、C 3组术前、术后7 d、30 d泪膜破裂时间(BUT)及角膜荧光素染色(FL)、基础泪液分泌(Schirmer I).结果 A、B、C三组术前BUT、FL、Schirmer I差异无统计学意义(P>0.05).术后7 d A组FL较术前增加,BUT较术前减少,差异显著有统计学意义(P<0.02).术后7 d C组FL分值较A组B组明显减少,差异具有统计学意义(P<0.02).术后7 d B组BUT较A组、C组增加,差异显著有统计学意义(P<0.02,P<0.05).结论 超声乳化白内障术后早期泪膜的稳定性下降,应用牛碱性成纤维细胞生长因子眼用凝胶更利于术后早期角膜上皮的修复,应用小牛血去蛋白提取物眼用凝胶组术后早期可延长BUT,加快术后早期泪膜恢复.%Objective To evaluate the effects of deproteinized extract of calf blood and recombinant bFGF on the teal film after phacoemulsification.Methods From April to October 2014, 78 patients (78 eyes) diagnosed with age-related cataracts were enrolled in the study at Beijing Tongren Eye Center.Cataract patients were randomly divided into three groups.Postoperatively, all patients received topical tobramycin dexamethasone eye drops from day 1 to 7 and pranoprofen eye drops from day 8 to 30. Group A (26 eyes) was control group.Group B (26 eyes) received topical deproteinized extract of calf blood in addition, and group C (26 eyes) received topical bFGF in addition for 30 days.Corneal fluorescein staining (FL), break-up time (BUT), Schirmer I test (SIt) were observed preoperatively and postoperatively at 7 days and 30 days.Results At 7 days BUT reduced and corneal fluorescein staining increased significantly in control group (group A).At 7 days after surgery, significant differences were found between the 3 groups.FL were significantly less in group C, BUT were significantly longer in group B.At 30 days, there was no significant difference.Conclusions Tear film stability decreased in earlier period after phacoemulsification.bFGF can improve the restoration of corneal epithelial cells, and topical deproteinized extract of calf blood can increase BUT and accelerate the recovery of tear film.