目的 探討牛堿性成纖維細(xì)胞生長(zhǎng)因子滴眼液聯(lián)合維生素A棕櫚酸酯眼用凝膠治療干眼癥的臨床效果。方法 選取2020年12月—2021年12月濮陽市油田總醫(yī)院收治的494例（988眼）干眼癥患者，按隨機(jī)數(shù)字表法分成對(duì)照組和治療組，每組各247例。對(duì)照組予以維生素A棕櫚酸酯眼用凝膠，每眼1滴/次，4次/d。治療組在對(duì)照組基礎(chǔ)上予以牛堿性成纖維細(xì)胞生長(zhǎng)因子滴眼液，每眼1滴/次，4次/d。兩組均連續(xù)治療4周。觀察兩組的臨床療效，比較治療前后兩組相關(guān)量表[中國干眼問卷量表、眼表疾病指數(shù)（OSDI）量表、視功能相關(guān)生存質(zhì)量量表-25（NEI VFQ-25）]評(píng)分、眼表功能指標(biāo)[熒光素染色淚膜破裂時(shí)間（FBUT）、淚河高度、無麻醉下SchirmerⅠ試驗(yàn)（SⅠt）、角膜熒光素染色（FL）評(píng)分]及淚液腫瘤壞死因子（TNF）-α、白介素細(xì)胞（IL）-1β、IL-6和基質(zhì)金屬蛋白酶9（MMP-9）水平。結(jié)果 治療后，治療組總有效率為91.1%，顯著高于對(duì)照組的83.0%（P＜0.05）。治療后，兩組中國干眼問卷量表評(píng)分、OSDI量表評(píng)分均顯著低于治療前，NEI-VFQ-25評(píng)分均顯著高于治療前（P＜0.05）；且均以治療組的改善更顯著（P＜0.05）。兩組治療后FBUT均顯著延長(zhǎng)，淚河高度和SⅠt（無麻醉）均顯著增加，F(xiàn)L評(píng)分均顯著降低（P＜0.05）；且治療后，治療組對(duì)FBUT、淚河高度、SⅠt（無麻醉）和FL評(píng)分的改善作用較對(duì)照組更顯著（P＜0.05）。兩組治療后淚液TNF-α、IL-1β、IL-6、MMP-9水平均顯著下降（P＜0.05）；且治療后，治療組淚液TNF-α、IL-1β、IL-6、MMP-9水平均顯著低于對(duì)照組（P＜0.05）。結(jié)論 牛堿性成纖維細(xì)胞生長(zhǎng)因子滴眼液聯(lián)合維生素A棕櫚酸酯眼用凝膠治療干眼癥能安全有效地減輕患者干眼癥狀、改善眼表功能、促進(jìn)病情緩解及提高生活質(zhì)量，并可進(jìn)一步下調(diào)淚液TNF-α、IL-1β、IL-6及MMP-9的水平，值得臨床推廣。

Objective To investigate the clinical effect of Recombinant Bovine Basic Fibrolast Growth Factor Eye Drops combined with Vitamin A Palmitate Eye Gel in treatment of dry eye syndrome. Methods A total of 494 patients (988 eyes) with dry eye syndrome admitted to Puyang Oilfield General Hospital from December 2020 to December 2021 were selected and divided into control group and treatment group according to the random number table method, with 247 cases in each group. Patients in the control group were given Vitamin A Palmitate Eye Gel, 1 drop/eye, 4 times daily. Patients in the treatment group were given Recombinant Bovine Basic Fibrolast Growth Factor Eye Drops on the basis of the control group, 1 drop/eye, 4 times daily. Both groups were treated for 4 weeks. The clinical efficacy of the two groups was observed. The related scales[China Dry Eye Questionnaire, Ocular Surface Disease Index (OSDI) scale, Visual function related Quality of Life Scale-25 (NEI) VFQ-25)] score, ocular surface functional indicators[fluorescein stained tear film rupture time (FBUT), lacrimal river height, SchirmerⅠ test without anesthesia (SⅠt), corneal fluorescein staining (FL) score], tumor necrosis factor-α(TNF)-α, interleukin-1β, IL-6 and matrix metalloproteinase-9 (MMP-9)) level of two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 91.1%, which was significantly higher than that of the control group (83.0%, P<0.05). After treatment, the scores of Chinese Dry Eye Questionnaire and OSDI in the two groups were significantly lower than before treatment, and the scores of NEI-VFQ-25 were significantly higher than before treatment (P<0.05). The improvement in treatment group was more significant (P<0.05). After treatment, FBUT was significantly prolonged, lacrimal river height and SⅠt (without anesthesia) were significantly increased, and FL score was significantly decreased in both groups (P<0.05). After treatment, the improvement of FBUT, height of lacrimal river, SⅠt (without anesthesia) and FL score in the treatment group were more significant than those in the control group (P<0.05). After treatment, the levels of TNF-α, IL-1β, IL-6 and MMP-9 in tear fluid of the two groups were significantly decreased (P<0.05). After treatment, the levels of TNF-α, IL-1β, IL-6 and MMP-9 in tear of the treatment group were significantly lower than those of the control group (P<0.05). Conclusion Recombinant Bovine Basic Fibrolast Growth Factor Eye Drops combined with Vitamin A Palmitate Eye Gel in treatment of dry eye syndrome can safely and effectively relieve dry eye symptoms, improve ocular surface function, promote disease remission and improve quality of life, which can further down-regulate the expression levels of TNF-α, IL-1β, IL-6 and MMP-9 in tears.

R988.1

濮陽市科技局科技攻關(guān)項(xiàng)目（193068）