摘要
目的 比较两种不同给药方案治疗急性视网膜坏死综合征（ARN）的治疗效果及安全性.方法 回顾分析47例53只眼ARN患者临床资料.其中22例24只眼予以静脉滴注阿昔洛韦750 mg每日3次,连续注射2周,以后改为口服阿昔洛韦片0.2 g,每日5次,连续用药6周（A组）;另外25例29只眼予以静脉滴注阿昔洛韦注射液800 mg每日5次,连续注射2周,以后改为口服阿昔洛韦片0.8 g每日5次,连续用药8周（B组）.所有患眼均予以视网膜激光光凝或玻璃切除联合视网膜激光光凝治疗.对于已并发视网膜脱离、增生性玻璃体视网膜病变的13只眼及抗病毒药物联合激光治疗病情不能控制的9只眼行玻璃体视网膜手术.随访半年观察两组治疗后视力及视网膜情况.结果 A组10只眼视力提高;B组20只眼视力提高.B组治疗后视力明显优于A组（P＜0.05）.A组8只眼在治疗过程中发生孔源性视网膜脱离而行玻璃体视网膜手术,5只眼眼部病变复发;B组1只眼治疗过程中出现孔源性视网膜脱离而行玻璃体视网膜手术,1只眼眼部病变复发.B组治疗后视网膜脱离的发生率及病变的复发率明显低于A组,差异有统计学意义（P＜0.05）.A组治疗过程中2例出现血肌酐升高;B组4例患者出现血尿素氮或血肌酐升高,停药一周后均恢复正常,两组差异无统计学意义（P＞0.05）.结论 急性视网膜坏死是一种严重的致盲性眼病,早期、足量、多次给予阿昔洛韦静滴及口服治疗联合视网膜激光光凝或玻璃体视网膜手术能有效控制疾病发展,改善预后,是一种安全、有效的治疗方法。
Objective To compare the efficacy and safety of two different modes of administration for the treatment of acute retinal necrosis （ARN）.Methods The clinical data of 47 patients （53 eyes） with ARN were retrospective analyzed, 22 patients （24 eyes） were treated with intravenous acyclovir （750mg thrice daily） for two weeks, followed by oral acyclovir （200mg 5 times daily） for a further 6 weeks （Group A）.The other 25 patients （29 eyes） were treated with intravenous acyclovir （800mg 5 times daily） for two weeks, followed by oral acyclovir （800mg 5 times daily） for 6 weeks （Group B）.All patients were treated with fundus laser or treated with vitrectomy and laser photocoagulation.Thirteen eyes of retinal detachment and 9 eyes which could not be controlled by medication and laser, were treated with vitreous-retinal surgery.Post-treatmem vision and the retinal reposition were observed for 6 months of the two groups.Results In group A, the vision improved in 10 eyes, and the number in group B was 20.The vision acuity was better in group B than group A after treatment （P 〈0.05）.Eight eyes developed retinal detachment in group A duringthe treatment, and then performed vitreous-retinal surgery, 5 eyes reoccurred.One eye developed retinal detachment in group B, and 1 eye reoccurred.The incidence of retinal detachment and reoccurrence rate of disease were lower in group B （P 〈0.05）.The creatinine increased in 2 patients in group A during the treatment, the creatinine or urea nitrogen increased in 4 patients in group B.No significant difference was found between the two groups （P 〉0.05）.Conclusions ARN is a severe syndrome leading to blindness.Early, enough and frequent administrated with acyclovir and fundus laser or vitreous-retinal surgery can effectively control the progression of ARN, it＇s an effective and safe treatment.
出处
《中国实用眼科杂志》
2015年第9期1059-1062,共4页
Chinese Journal of Practical Ophthalmology
关键词
急性视网膜坏死
阿昔洛韦
视网膜脱离
副反应
Acute retinal necrosis syndrome
Acyclovir
Retinal detachment
Side effects
