非单剂量自体血清滴眼治疗重度干眼的自身对照研究

Self-control study of autologous serum with Thiomersal in the management of recalcitrant dry eye syndrome in Outpatient Department

摘要:

目的：评估含0.01g/L硫柳汞非单剂量自体血清（Autologous serum,AS）滴眼治疗重度干眼的有效性和安全性。方法：接受至少12wk传统干眼治疗无效的重度干眼患者13例26眼,采用自身对照方法,用20%含0.01g/L硫柳汞非单剂量的AS滴眼8wk后,再用50%相同制剂AS滴眼8wk。滴眼后2,4,8,12,16wk分别比较基础泪河高度、泪膜破裂时间、角膜荧光染色、基础泪液分泌试验、角膜知觉、自觉症状评分。结果：滴眼后2wk,基础泪河高度、患者自觉症状与用药前比较差异有统计学意义（P<0.01 和 P<0.05）；滴眼后4wk,泪膜破裂时间、角膜荧光素染色与用药前比较差异有统计学意义（P<0.05）；滴眼后8wk,基础泪液分泌、角膜知觉与用药前比较差异有统计学意义（P<0.01和P<005）。滴眼观察期间未发现明显并发症。结论：含0.01g/L硫柳汞非单剂量AS滴眼能安全有效地缓解重度干眼患者的症状和体征。

Abstract:

AIM: To evaluate the efficacy and safety of autologous serum(AS) eye drops with 0.01g/L Thiomersal in the treatment of recalcitrant dry eye syndrome. METHODS: Twenty-six eyes of 13 patients with recalcitrant dry eye syndrome were enrolled in this self-control study, and treated with 2 months of AS 20% with 0.01g/L Thiomersal followed by 2 months of AS 50% with 0.01g/L Thiomersal. Tear membrane lever(TML), tear film break-up time (BUT), corneal fluorescein staining(FL), SchirmerⅠ test with topical anaesthesia(SⅠt), corneal sensitivity test and subjective symptom scoring were performed at entry, 2, 4, 8, 12 and 16 weeks. Statistical analysis was carried out using Wilcoxon''s signed rank test. RESULTS: Both TML and subjective symptom scorning showed significant improvement after 2 weeks of treatment (P<0.01,P<0.05); after 4 weeks of treatment, BUT and FL were significant improvement(P<0.05); SⅠt and corneal sensitivity were significant increased after 8 weeks of treatment(P<0.01,P<0.05). No significant complications were reported in this study. CONCLUSION: AS eye drops 20% with 0.01g/L Thiomersal are effective and safe in treating refractory dry eye syndrome, and should be available as an alternative management option in developing countries.