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白内障手术中使用含依诺肝素冲洗液对糖尿病患者术后炎症的影响。

The effect of enoxaparin-containing irrigation fluid used during cataract surgery on postoperative inflammation in patients with diabetes.

机构信息

Mustafa Kemal University, Medical Faculty, Department of Ophthalmology, Hatay, Turkey.

出版信息

Am J Ophthalmol. 2013 Dec;156(6):1120-1124.e3. doi: 10.1016/j.ajo.2013.07.017. Epub 2013 Sep 25.

DOI:10.1016/j.ajo.2013.07.017
PMID:24075427
Abstract

PURPOSE

To investigate effects of enoxaparin on postoperative inflammation in patients with moderate nonproliferative diabetic retinopathy (NPDR) and nuclear cataract.

DESIGN

Prospective masked controlled trial.

METHODS

setting: Institutional practice. study population: The study included 51 eyes of 51 diabetes mellitus (DM) patients with moderate NPDR and grade 2-3 nuclear cataracts. Group 1 included randomly selected patients who received enoxaparin in balanced salt solution (BSS) during cataract surgery, while standard BSS was used in Group 2. observation procedure: Patients were followed up 1 day, 1 week, and 1 and 2 months after the surgery. main outcome measures: Anterior chamber cell and flare.

RESULTS

Postoperatively, 20 patients from Group 1 and 4 patients in Group 2 had less than a mean of 10 cells at day 1 (P = .012). At the first week, 20 patients from Group 1 and 10 patients from Group 2 had less than a mean of 10 cells (P = .004). When compared for flare, 20 patients from Group 1 and 8 patients from Group 2 had a flare between 0 and +1 at postoperative day 1 (P < .001). By the end of postoperative first week, 24 patients from Group 1and 18 patients from Group 2 had a flare between 0 and +1 (P = .012). There was no difference between groups in terms of postoperative inflammation at the first and second months after the surgery.

CONCLUSION

The results of the study suggest that enoxaparin added into the infusion fluid may reduce postoperative inflammation in patients with DM, and this result supports the anti-inflammatory effect of enoxaparin.

摘要

目的

研究依诺肝素对合并中度非增生性糖尿病视网膜病变(NPDR)和核性白内障的患者术后炎症的影响。

设计

前瞻性、设盲、对照临床试验。

方法

研究场所:院内常规。研究人群:共纳入 51 例 51 只眼糖尿病(DM)合并中度 NPDR 且核硬度为 2-3 级的患者。1 组患者随机接受含依诺肝素的平衡盐溶液(BSS)冲洗,2 组接受单纯 BSS 冲洗。观察流程:术后第 1、1 周、1 和 2 个月随访。主要观察指标:前房细胞和前房闪辉。

结果

术后第 1 天,1 组中 20 例和 2 组中 4 例患者的前房细胞数<10 个细胞/HP(P=0.012)。术后第 1 周,1 组中 20 例和 2 组中 10 例患者的前房细胞数<10 个细胞/HP(P=0.004)。比较前房闪辉,术后第 1 天,1 组中 20 例和 2 组中 8 例患者的前房闪辉为 0+1(P<0.001)。术后第 1 周结束时,1 组中 24 例和 2 组中 18 例患者的前房闪辉为 0+1(P=0.012)。术后第 1 和 2 个月两组患者的术后炎症无差异。

结论

该研究结果提示,依诺肝素加入冲洗液中可能会减轻 DM 患者术后炎症,这一结果支持依诺肝素的抗炎作用。

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