摘要
目的探讨两种泪小管栓子Visiplug和Smart plug治疗轻中度水样液缺乏型干眼病（ATD）的临床疗效。方法临床病例对照研究。选取2013年4月至2015年4月在龙华医院眼科就诊的Sjogren综合征并发轻中度ATD患者54例108只眼，随机平均分为Visiplug组和Smart plug组，进行泪小管栓子植入治疗。术前及术后1周、1月、3月、6月进行主观症状评分，记录泪液分泌功能（Sit）、泪膜破裂时间（BUT）、角膜荧光素染色（FL）评分、泪河高度（TMH）、泪河深度（TMD），计算两组治疗的总有效率。结果两组术后不同时间临床症状评分和使用人工泪液次数均降低，且均在术后1月时降至最低并持续至术后3月；术后6月Visiplug组较术后1月临床症状评分回升、使用人工泪液次数增加，差异有统计学意义（t=0．419、0．267，P=0．001、0．005），Smart plug组术后变化幅度则均低于Visiplug组，差异有统计学意义（t=0．388、O．219，P=0．000、0．002）；两组术后均出现SIt增加、BUT延长、FL评分降低、TMH和TMD升高，Visiplug组术后6月较术后1月时SIt降低、BUT缩短、FL评分增加、TMH和TMD值降低，差异有统计学意义（t=-0．186、-0．348、0．172、-0．176、-0．249，P=0．001、0．001、0．000、0．001、0．001），Smart plug组术后6月较术后1月仅BUT缩短，差异有统计学意义（t-0．536，P=0．001）；术后1周、1月、3月、6月Visiplug组总有效率分别为81．48％、77．48％、74．07％和44．44％，Smart plug组总有效率分别为85．18％、81．48％、77．48％和77．48％。结论两种泪小管栓子均能有效治疗ATD且Smart plug疗效更为持久，临床上可根据患者实际情况灵活选用。
Objective To approach the therapeutic effect of Visiplug and Smart plug in the treatment of light and moderate aqueous tear deficiency （ATD）. Methods In this clinical case-control study, 54 light or moderate ATD patients complicated with Sjsgren syndrome were selected and divided equally into two groups curing with Visiplug or Smart plug. Rational symptoms, Schirmier＇s test （Sit）, BUT, cornea fluorescent （FL）, tear meniscus height （TMH） and depth （TMD） were observed before and after the treatment and the total effective rate were also calculated in each group. Results Clinical symptom scores and the frequency of artificial tears were maximum declined in lm after treatment and the effects continued till 3m. The reverses in group Visiplug were observed in 6m after treatment （t =0.419, 0.267, P =0.001, 0.005） while the range ability was lower in group Smart plug （t =-0.388, 0.219, P =0.000, 0.002）. The value of Sit, BUT, FL, TMH and TMD had significantly improved after treatment in 1w, 1m, 3m and 6m （t =-0.186, -0.348, 0.172, -0.176, -0.249, P = 0.001, 0.001, 0.000, 0.001, 0.001）. All the indexes before reversed in 6m in group Visiplug, however, only BUT shortening was detected in group Smart plug （t =-0.536, P =0.001）. The total effective rate of lw, lm, 3m, 6m was 81.48%,77.48%,74.07% and 44.44% in group Visiplug, while which was 85.18%, 81.48%, 77.48% and 77.48% in group Smart plug. Conclusions Both Visiplug and Smart plug do effect to ATD and Smart plug has more lasting therapeutic effect. We may choose the better one according to the situation.
出处
《中国实用眼科杂志》
2016年第7期670-674,共5页
Chinese Journal of Practical Ophthalmology
基金
上海市卫生局中医药科研基金（2012JOOSA）
