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一项比较海水冲洗与羧甲基纤维素人工泪液滴眼液治疗干眼综合征的随机多中心研究。

A randomized multicenter study comparing seawater washes and carmellose artificial tears eyedrops in the treatment of dry eye syndrome.

作者信息

Diaz-Llopis Manuel, Pinazo-Duran Maria Dolores, Diaz-Guiñon Loreto, Rahhal-Ortuño Miriam, Perez-Ramos Mercedes, Bosch Rosabel, Gallego-Pinazo Roberto, Dolz-Marco Rosa, Diaz-Guiñon Teresa, Diaz María, Romero Francisco Javier, Cisneros Angel

机构信息

University of Valencia, Valencia, Spain,

Ophthalmology Unit, Faculty of Medicine, University of Valencia, Valencia, Spain,

出版信息

Clin Ophthalmol. 2019 Mar 12;13:483-490. doi: 10.2147/OPTH.S185409. eCollection 2019.

Abstract

PURPOSE

To investigate the safety and efficacy of sterile isotonic seawater washes vs standard treatment with carmellose artificial tears in dry eye syndrome (DES).

PATIENTS AND METHODS

This is a randomized multicenter prospective study with 12 weeks of follow-up. A group of patients with DES (N=60) were treated with seawater spray (Quinton) five times daily, and another similar group (N=60) were treated with carmellose artificial tears eyedrops (Viscofresh 0.5%) five times a day. The parameters studied and measured were as follows: Ocular Surface Disease Index questionnaire score, Schirmer I test (without anesthesia) score, tear osmolarity (TearLab), tear breakup time, tear meniscus height (meniscography OCT), fluorescein corneal staining score (National Eye Institute scale), lissamine green conjunctival staining score, and levels of IL-1 beta and IL-6 in tears (Luminex 200).

RESULTS

In the group treated with seawater, symptoms decreased by 68%, and the decrease was 26% statistically superior to the group treated with carmellose artificial tears eyedrops (<.001). Levels of IL-1 beta and IL-6 in tears significantly decreased in the seawater group compared to the carmellose artificial tears group (19%/17% vs 52%/51%) (<0.001). There were no statistically significant differences in the other measured parameters. There were no cases of poor tolerance or side effects.

CONCLUSION

Administration of seawater is more effective than treatment with carmellose artificial tears in reducing symptoms and pro-inflammatory molecules (IL-1 beta and IL-6) in tears of patients with DES.

摘要

目的

研究无菌等渗海水冲洗与用羧甲基纤维素人工泪液进行标准治疗在干眼症(DES)中的安全性和有效性。

患者与方法

这是一项为期12周随访的随机多中心前瞻性研究。一组干眼症患者(N = 60)每天使用海水喷雾(昆顿)治疗5次,另一组类似患者(N = 60)每天使用羧甲基纤维素人工泪液滴眼液(Viscofresh 0.5%)治疗5次。研究和测量的参数如下:眼表疾病指数问卷评分、Schirmer I试验(无麻醉)评分、泪液渗透压(TearLab)、泪膜破裂时间、泪液弯月面高度(光学相干断层扫描泪液造影)、荧光素角膜染色评分(美国国立眼科研究所标准)、丽丝胺绿结膜染色评分以及泪液中白细胞介素-1β和白细胞介素-6水平(Luminex 200)。

结果

在使用海水治疗的组中,症状减轻了68%,且该降幅在统计学上比使用羧甲基纤维素人工泪液滴眼液治疗的组高(26%)(P <.001)。与羧甲基纤维素人工泪液组相比,海水组泪液中白细胞介素-1β和白细胞介素-6水平显著降低(分别为19%/17% 对52%/51%)(P < 0.001)。其他测量参数无统计学显著差异。未出现耐受性差或副作用的病例。

结论

对于干眼症患者,使用海水治疗在减轻症状以及降低泪液中的促炎分子(白细胞介素-1β和白细胞介素-6)方面比使用羧甲基纤维素人工泪液更有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fb5/6419589/2cb27c729f09/opth-13-483Fig1.jpg

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