目的 探討重組牛堿性成纖維細(xì)胞生長因子眼用凝膠聯(lián)合環(huán)孢素滴眼液治療中重度干眼癥的效果。方法 選取2020年5月—2023年4月天長市人民醫(yī)院就診的88例中重度干眼癥患者，使用隨機(jī)數(shù)字表法將所有患者分為對照組和治療組，每組各44例。對照組給予環(huán)孢素滴眼液，每眼1滴/次，4次/d。治療組在對照組治療基礎(chǔ)上給予重組牛堿性成纖維細(xì)胞生長因子眼用凝膠，涂于患眼，早晚各1次。兩組療程均為8周?？疾靸山M患者的臨床療效，比較治療前后眼表狀況指標(biāo)、眼表疾病指數(shù)量表（OSDI）、簡式抑郁–焦慮–壓力量表（DASS-21）評分、視覺質(zhì)量指標(biāo)和血清白細(xì)胞介素-6（IL-6）水平。結(jié)果 治療后，治療組總有效率是95.45%，顯著高于對照組的81.82%（P＜0.05）。治療后，兩組SⅠt（無麻醉）、熒光素染色淚膜破裂時(shí)間（FBUT）顯著增加，而角膜熒光素染色（FL）評分、瞼板腺缺失面積評分顯著降低（P＜0.05）；治療后，治療組眼表狀況指標(biāo)改善優(yōu)于對照組（P＜0.05）。治療后，兩組OSDI、DASS-21評分均顯著降低（P＜0.05）；且以治療組顯著更低（P＜0.05）。治療后，兩組調(diào)制傳遞函數(shù)截止頻率（MTF cut off）、斯特列爾比（SR）均顯著增高，而淚膜動(dòng)態(tài)客觀散射指數(shù)（TF-OSI）、血清IL-6水平均顯著下降（P＜0.05）；治療后，治療組患者視覺質(zhì)量指標(biāo)和血清IL-6水平改善更明顯（P＜0.05）。結(jié)論 重組牛堿性成纖維細(xì)胞生長因子眼用凝膠聯(lián)合環(huán)孢素滴眼液治療中重度干眼癥可取得顯著效果，能有效改善患者淚液分泌功能，促進(jìn)眼表損傷和癥狀緩解，對心理狀態(tài)改善具有積極作用，值得臨床應(yīng)用和推廣。

Objective To investigate the effect of Recombinant Bovine Basic Fibroblast Growth Factor Eye-Gel combined with Cyclosporin Eye Drops in treatment of moderate to severe dry eye. Methods A total of 88 patients with moderate to severe dry eye treated in Tianchang People’s Hospital from May 2020 to April 2023 were selected, and all patients were divided into control group and treatment group using random number table method, with 44 cases in each group. Patients in the control group were given Cyclosporin Eye Drops, 1 drop/time per eye, four times daily. Patients in the treatment group were given Recombinant Bovine Basic Fibroblast Growth Factor Eye-Gel on the basis of the control group, applied to affected eye once in the morning and once in the evening. The treatment course of both groups was 8 weeks. After treatment, the clinical efficacy was evaluated, and eye surface condition indicators, eye surface disease index (OSDI), simplified depression anxiety stress scale (DASS-21) scores, visual quality indicators, and serum interleukin-6 (IL-6) levels between the two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 95.45%, which was significantly higher than that of the control group (81.82%, P < 0.05). After treatment, the tear film rupture time (FBUT) of SⅠt (without anesthesia) and fluorescein staining were significantly increased in both groups, but the score of corneal fluorescein staining (FL) and the score of missing area of meibomian gland were significantly decreased (P < 0.05). After treatment, the improvement of ocular surface indexes in the treatment group was better than that in the control group (P < 0.05). After treatment, OSDI and DASS-21 scores were significantly decreased in both groups (P < 0.05). It was significantly lower in the treatment group (P < 0.05). After treatment, MTF cut off frequency (MTF cut off) and Streller ratio (SR) were significantly increased in both groups, while dynamic objective scattering index (TF-OSI) and serum IL-6 levels were significantly decreased in both groups (P < 0.05). After treatment, the visual quality index and serum IL-6 level were improved more significantly in the treatment group (P< 0.05). Conclusion Recombinant Bovine Basic Fibroblast Growth Factor Eye-Gel combined with Cyclosporin Eye Drops has significant effect in treatment of moderate to severe dry eye, and can effectively improve the tear secretion function of patients, promote the ocular surface injury and symptom relief, and has a positive effect on the improvement of psychological state, which is worthy of clinical application and promotion.

R988.1

江蘇省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目(202103018)