目的 探討甲鈷胺聯(lián)合卵磷脂絡合碘治療中心性漿液性脈絡膜視網(wǎng)膜病變的臨床療效。方法 選取2019年5月—2022年5月在中國人民解放軍海軍軍醫(yī)大學第一附屬醫(yī)院治療的120例中心性漿液性脈絡膜視網(wǎng)膜病變患者。隨機分對照組和治療組，每組各60例。對照組口服卵磷脂絡合碘片，2片/次，3次/d。在對照組的基礎上，治療組口服甲鈷胺片，0.5 mg/次，3次/d。兩組用藥7周。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀緩解時間，視力改善情況，血清全血黏度（WBV）、血漿黏度（PV）、黃斑中心凹厚度（CMT）和視網(wǎng)膜下積液（SRF）指標水平及不良反應。結(jié)果 治療后，治療組臨床總有效率（98.33%）明顯高于對照組（83.33%，P＜0.05）。治療后，治療組癥狀緩解時間均明顯早于對照組（P＜0.05）。治療后，兩組患者標準對數(shù)視力表值比治療前明顯升高（P＜0.05），且治療組的視力改善情況明顯高于對照組（P＜0.05）。治療后，兩組患者WBV、PV、CMT、SRF指標均明顯下降（P＜0.05），且治療組患者的指標水平明顯低于對照組（P＜0.05）。治療組不良反應發(fā)生率（6.67%）明顯低于對照組（15.06%，P＜0.05）。結(jié)論 甲鈷胺聯(lián)合卵磷脂絡合碘治療中心性漿液性脈絡膜視網(wǎng)膜病變效果確切，可改善眼底血液微循環(huán)，糾正眼底狀態(tài)，有效提高患者視力。

Objective To investigate the clinical effect of mecobalamin combined with iodized lecithin in treatment of central serous chorioretinopathy.Methods Patients (120 cases) with central serous chorioretinopathy in Changhai Hospital from May 2019 to May 2022 were randomly divided into control and treatment group,and each group had 60 cases.Patients in the control group were po administered with Iodized Lecithin Tablets,2 tablets/time,three times daily.Patients in the treatment group were po administered with Mecobalamin Tablets on the basis of the control group,0.5 mg/time,three times daily.Patients in two groups were treated for 7 weeks.After treatment,the clinical evaluation was evaluated,the improvement time of symptom,the improvement of visual acuity,the levels of WBV,PV,CMT and SRF,and adverse reaction in two groups before and after treatment were compared.Results After treatment,the clinical effective rate in the treatment group (98.33%) was significantly higher than that in the control group (83.33%,P<0.05).After treatment,the time of symptom relief in the treatment group was significantly earlier than that in the control group (P<0.05).After treatment,the standard logarithmic visual acuity chart of the two groups was significantly higher than that before treatment (P<0.05),and which in the treatment group was significantly higher than that of the control group (P<0.05).After treatment,the indexes of WBV,PV,CMT and SRF in both groups were significantly decreased (P<0.05),and the level of these indexes in the treatment group was significantly lower than that in the control group (P<0.05).The incidence of adverse reactions in the treatment group (6.67%) was significantly lower than that in the control group (15.06%,P<0.05).Conclusion Mecobalamin combined with Iodized Lecithin Tablets is effective in the treatment of central serous chorioretinopathy,which can improve fundus blood microcirculation,correct fundus state and effectively improve patients'visual acuity.

R988.1