玻璃酸钠联合重组牛碱性成纤维细胞生长因子对糖尿病性白内障超声乳化术后泪膜稳定性的影响
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摘要
目的:探讨玻璃酸钠联合重组牛碱性成纤维细胞生长因子(b FGF)对糖尿病性白内障超声乳化术后泪膜稳定性的影响。方法:选取2015年1月到2017年1月期间在我院接受治疗的150例糖尿病性白内障患者,根据随机数字表法分为对照组和研究组,各75例。两组均进行常规治疗,在常规治疗的基础上对照组采用玻璃酸钠滴眼液进行治疗,研究组在对照组的基础上加用bFGF眼用凝胶进行治疗,两组均治疗1个月。比较两组术前、术后1周、术后1个月的泪膜破裂时间(BUT)、基础泪液分泌试验(SIt)值、角膜荧光素染色(FL)评分、干眼症状评分和眼表疾病指数(OSDI)评分,并比较两组术前、术后1个月的最佳矫正视力。结果:术后1周,两组患者的BUT明显低于术前和术后1个月,且研究组的BUT高于对照组(P<0.05);随时间推移两组患者的OSDI评分持续降低(P<0.05),术后1周,两组患者干眼症状评分、SIt值、FL评分明显高于术前和术后1个月,且研究组的OSDI评分、干眼症状评分、SIt值、FL评分均低于对照组(P<0.05)。术后1个月两组患者的最佳矫正视力均明显上升,且研究组明显高于对照组(P<0.05)。结论:玻璃酸钠联合bFGF能有效提升糖尿病性白内障患者在超声乳化术后泪膜稳定性,利于患者术后视力的恢复,值得临床推广应用。
Objective: To investigate the effect of sodium hyaluronate combine with recombinant bovine basic fibroblast growthfactor(b FGF) on tear film stability after phacoemulsification in diabetic cataract. Methods: 150 patients with diabetic cataract who were treated in our hospital from January 2015 to January 2017 were treated. The patients were divided into the control group and the study group by random number table, each with 75 cases. Routine treatment was performed in the two groups, the control group was treated with sodium hyaluronate eye drops on the basis of routine treatment, the study group was treated with b FGF eye gel on the basis of the control group, the two groups were treated for 1 month.The break-up time(BUT), Schirmer test(SIt), corneal fluorescein staining(FL) score, symptoms of dry eye and ocular surface disease index(OSDI) score were compared between the two groups preoperation,1 week after operation and 1 month after operation, and the best corrected visual acuity was compared between the two groups preoperation and 1 month after operation. Results: The BUT of the two groups was significantly lower at 1 week after operation than that at preoperation and 1 month after operation, and the BUT in the study group was higher than that in the control group(P<0.05). The OSDI scores of the two groups continued to decrease over time(P<0.05). The dry eye symptom score, SIt value and FL score of the two groups1 week after operatio were significantly higher than those at preoperation and 1 month after operation, and the OSDI score, dry eye symptom score,SIt value and FL score of the study group were lower than those of the control group(P<0.05). The best corrected visual acuity of the two groups increased significantly 1 month after operation, and the study group was significantly higher than that of the control group(P<0.05). Conclusion: Sodium hyaluronate combine with bFGF can effectively improve the tear film stability of patients with diabetic cataract after phacoemulsification, and it can beneficial to the recovery of postoperative visual acuity, which is worthy of clinical application.
Objective: To investigate the effect of sodium hyaluronate combine with recombinant bovine basic fibroblast growthfactor(b FGF) on tear film stability after phacoemulsification in diabetic cataract. Methods: 150 patients with diabetic cataract who were treated in our hospital from January 2015 to January 2017 were treated. The patients were divided into the control group and the study group by random number table, each with 75 cases. Routine treatment was performed in the two groups, the control group was treated with sodium hyaluronate eye drops on the basis of routine treatment, the study group was treated with b FGF eye gel on the basis of the control group, the two groups were treated for 1 month.The break-up time(BUT), Schirmer test(SIt), corneal fluorescein staining(FL) score, symptoms of dry eye and ocular surface disease index(OSDI) score were compared between the two groups preoperation,1 week after operation and 1 month after operation, and the best corrected visual acuity was compared between the two groups preoperation and 1 month after operation. Results: The BUT of the two groups was significantly lower at 1 week after operation than that at preoperation and 1 month after operation, and the BUT in the study group was higher than that in the control group(P<0.05). The OSDI scores of the two groups continued to decrease over time(P<0.05). The dry eye symptom score, SIt value and FL score of the two groups1 week after operatio were significantly higher than those at preoperation and 1 month after operation, and the OSDI score, dry eye symptom score,SIt value and FL score of the study group were lower than those of the control group(P<0.05). The best corrected visual acuity of the two groups increased significantly 1 month after operation, and the study group was significantly higher than that of the control group(P<0.05). Conclusion: Sodium hyaluronate combine with bFGF can effectively improve the tear film stability of patients with diabetic cataract after phacoemulsification, and it can beneficial to the recovery of postoperative visual acuity, which is worthy of clinical application.
引文
[1]Thevi T,Godinho MA.Predictive factors of visual outcome of Malaysian cataract patients:a retrospective study[J].Int J Ophthalmol,2017,10(9):1452-1459
[2]Aliyu H,Mustak H,Cook C.Using the Postoperative Visual Acuity to Monitor the Quality of Cataract Surgery:Does the Day One Visual Acuity following Cataract Surgery Correlate with the Final Visual Acuity?[J].Middle East Afr J Ophthalmol,2017,24(2):91-93
[3]Shahraki K,Fard MNA,Shahri F,et al.Effects of intracameral cefuroxime on corneal endothelial cell counts and its morphology aftercataract surgery[J].Interv Med Appl Sci,2017,9(2):100-104
[4]Caraher EJ,Kwon S,Haider SH,et al.Receptor for advanced glycation end-products and World Trade Center particulate induced lung function loss:A case-cohort study and murine model of acute particulate exposure[J].PLo S One,2017,12(9):e0184331
[5]De Christopher LR.Perspective:The Paradox in Dietary Advanced Glycation End Products Research-The Source of the Serum and Urinary Advanced Glycation End Products?Is the Intestines,Not the Food[J].Adv Nutr,2017,8(5):679-683
[6]Paradela-Dobarro B,Fernández-Trasancosá,Bou-Teen D,et al.Evolution and bad prognostic value of advanced glycation end products after acute heart failure:relation with body composition[J].Cardiovasc Diabetol,2017,16(1):115
[7]Jimenez-Roman J,Lazcano-Gomez G,Martínez-Baez K,et al.Effect of phacoemulsification on intraocular pressure in patients with primary open angle glaucoma and pseudoexfoliation glaucoma[J].Int J Ophthalmol,2017,10(9):1374-1378
[8]Sahu PK,Das GK,Agrawal S,et al.Comparative Evaluation of Corneal Endothelium in Patients with Diabetes Undergoing Phacoemulsification[J].Middle East Afr J Ophthalmol,2017,24(2):74-80
[9]Lay Suan AL,Hamzah JC,Ken TS,et al.Intracameral mydriatics versus topical mydriatics in pupil dilation for phacoemulsification cataract surgery[J].J Cataract Refract Surg,2017,43(8):1031-1035
[10]Khorshidi HR,Kasraianfard A,Derakhshanfar A,et al.Evaluation of the effectiveness of sodium hyaluronate,sesame oil,honey,and silver nanoparticles in preventing postoperative surgical adhesion formation.An experimental study[J].Acta Cir Bras,2017,32(8):626-632
[11]Ang BCH,Sng JJ,Wang PXH,et al.Sodium Hyaluronate in the Treatment of Dry Eye Syndrome:A Systematic Review and Meta-Analysis[J].Sci Rep,2017,7(1):9013
[12]Todorovi-Rakovi N,Radulovic M,Vujasinovi T,et al.b FGF in tumor tissue independently prognosticates disease outcome of a natural course of invasive breast cancer[J].Cancer Biomark,2017,20(2):151-158
[13]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华内分泌代谢杂志,2014,30(10):893-942Chinese Diabetes Society.Guidelines for the prevention and treatment of type 2 diabetes mellitus in China(2013 Edition)[J].Chinese Journal of Endocrinology and Metabolism,2014,30(10):893-942
[14]艾则孜·吾买尔,丁汝新,玛依拉·依山,等.白内障手术方式的研究进展[J].实用临床医药杂志,2016,20(11):218-220,224Aizezi·Wumaier,Ding Ru-xin,Mayila·Yishan,et al.Research progress of cataract surgery[J].Journal of Clinical Medicine in Practice,2016,20(11):218-220,224
[15]Anisimova N,Malyugin B,Arbisser LB,et al.Femtosecond laser-assisted cataract surgery in vitrectomized eye with posterior chamber phakic intraocular lens[J].Digit J Ophthalmol,2017,23(2):43-44
[16]Yonekawa Y,Thomas BJ,Lau-Sickon LK,et al.Detection of pars plana rupture by ultrasound biomicroscopy after cannula dislodgement duringcataract wound hydration[J].Digit J Ophthalmol,2017,23(1):23-25
[17]Ilveskoski L,Tuuminen R.Combined microinvasive glaucoma and cataract surgery in patients with pseudoexfoliation glaucoma:Clinical results of a gel stent[J].J Cataract Refract Surg,2017,43(8):1124-1125
[18]Wang H,Mei X,Cao Y,et al.HMGB1/Advanced Glycation End Products(RAGE)does not aggravate inflammation but promote endogenous neural stem cells differentiation in spinal cord injury[J].Sci Rep,2017,7(1):10332
[19]Farooqui JH,Jaramillo A,Sharma M,et al.Use of modified international council of ophthalmology-ophthalmology surgical competency assessment rubric(ICO-OSCAR)for phacoemulsification-wet lab training in residency program[J].Indian J Ophthalmol,2017,65(9):898-899
[20]Aron N,Sen S,Khokhar S.Comment on"Comparison of 45-degree Kelman and 45-degree balanced phaco tip designs in torsional microcoaxial phacoemulsification"[J].Int J Ophthalmol,2017,10(8):1334-1336
[21]Xu H,Lutrin D,Wu Z.Outcomes of 23-gauge pars plana vitrectomy combined with phacoemulsification and capsulotomy without intraocular lens implantation in rhegmatogenous retinal detachment associated with choroidal detachment[J].Medicine(Baltimore),2017,96(34):e7869
[22]Vieira IV,Boianovsky C,Saraiva TJ,et al.Safety and efficacy of intracameral moxifloxacin injection for prophylaxis of endophthalmitis after phacoemulsification[J].Arq Bras Oftalmol,2017,80(3):165-167
[23]Fea AM,Rekas M,Au L.Evaluation of a Schlemm canal scaffold microstent combined with phacoemulsification in routine clinical practice:Two-year multicenter study[J].J Cataract Refract Surg,2017,43(7):886-891
[24]Hsia YC,Moghimi S,Coh P,et al.Anterior segment parameters as predictors of intraocular pressure reduction afterphacoemulsification in eyes with open-angle glaucoma[J].J Cataract Refract Surg,2017,43(7):879-885
[25]Gurung T,Singh RK,Mohammad S,et al.Efficacy of arthrocentesis versus arthrocentesis with sodium hyaluronic acid in temporomandibular joint osteoarthritis:A comparison[J].Natl J Maxillofac Surg,2017,8(1):41-49
[26]Jeong JY,Chung PK,Yoo JC.Effect of sodium hyaluronate/carboxymethyl cellulose(Guardix-sol)on retear rate and postoperative stiffness in arthroscopic rotator cuff repair patients:A prospective cohort study[J].J Orthop Surg(Hong Kong),2017,25(2):2309499017718908
[27]冯延琴,王理论,边红莉,等.重组b FGF滴眼液联合杞菊地黄丸对绝经后干眼症女性血清与泪液中MMP-2及性激素水平的影响[J].现代生物医学进展,2016,16(25):4935-4937,4947Feng Yan-qin,Wang Li-lun,Bian Hong-li,et al.Effect of Recombinant b FGF Combined with Qiju Dihuang on MMP-2 and Sex Hormones in Postmenopausal Female Patients with Xerophthalmia[J].Progress in Modern Biomedicine,2016,16(25):4935-4937,4947
[28]Shafei EV,Kurinov AM,Kuznetsova AV,et al.Reprogramming of Human Retinal Pigment Epithelial Cells under the Effect of b FGF In Vitro[J].Bull Exp Biol Med,2017,163(4):574-582
[29]Zalesna I,Osrodek M,Hartman ML,et al.Exogenous growth factors b FGF,EGF and HGF do not influence viability and phenotype of V600EBRAF melanoma cells and their response to vemurafenib and trametinib in vitro[J].PLo S One,2017,12(8):e0183498
[30]金颖,王雁,薛超,等.b FGF与玻璃酸钠治疗FS-LASIK术后干眼与角膜知觉恢复对照研究[J].中国实用眼科杂志,2016,34(8):805-809Jin Ying,Wang Yan,Xue Chao,et al.Comparison study in dry eye and recovery of corneal sensitivity between b FGF and sodium hyaluronate after FS-LASIK surgery[J].Chinese Journal of Practical Ophthalmology,2016,34(8):805-809
[2]Aliyu H,Mustak H,Cook C.Using the Postoperative Visual Acuity to Monitor the Quality of Cataract Surgery:Does the Day One Visual Acuity following Cataract Surgery Correlate with the Final Visual Acuity?[J].Middle East Afr J Ophthalmol,2017,24(2):91-93
[3]Shahraki K,Fard MNA,Shahri F,et al.Effects of intracameral cefuroxime on corneal endothelial cell counts and its morphology aftercataract surgery[J].Interv Med Appl Sci,2017,9(2):100-104
[4]Caraher EJ,Kwon S,Haider SH,et al.Receptor for advanced glycation end-products and World Trade Center particulate induced lung function loss:A case-cohort study and murine model of acute particulate exposure[J].PLo S One,2017,12(9):e0184331
[5]De Christopher LR.Perspective:The Paradox in Dietary Advanced Glycation End Products Research-The Source of the Serum and Urinary Advanced Glycation End Products?Is the Intestines,Not the Food[J].Adv Nutr,2017,8(5):679-683
[6]Paradela-Dobarro B,Fernández-Trasancosá,Bou-Teen D,et al.Evolution and bad prognostic value of advanced glycation end products after acute heart failure:relation with body composition[J].Cardiovasc Diabetol,2017,16(1):115
[7]Jimenez-Roman J,Lazcano-Gomez G,Martínez-Baez K,et al.Effect of phacoemulsification on intraocular pressure in patients with primary open angle glaucoma and pseudoexfoliation glaucoma[J].Int J Ophthalmol,2017,10(9):1374-1378
[8]Sahu PK,Das GK,Agrawal S,et al.Comparative Evaluation of Corneal Endothelium in Patients with Diabetes Undergoing Phacoemulsification[J].Middle East Afr J Ophthalmol,2017,24(2):74-80
[9]Lay Suan AL,Hamzah JC,Ken TS,et al.Intracameral mydriatics versus topical mydriatics in pupil dilation for phacoemulsification cataract surgery[J].J Cataract Refract Surg,2017,43(8):1031-1035
[10]Khorshidi HR,Kasraianfard A,Derakhshanfar A,et al.Evaluation of the effectiveness of sodium hyaluronate,sesame oil,honey,and silver nanoparticles in preventing postoperative surgical adhesion formation.An experimental study[J].Acta Cir Bras,2017,32(8):626-632
[11]Ang BCH,Sng JJ,Wang PXH,et al.Sodium Hyaluronate in the Treatment of Dry Eye Syndrome:A Systematic Review and Meta-Analysis[J].Sci Rep,2017,7(1):9013
[12]Todorovi-Rakovi N,Radulovic M,Vujasinovi T,et al.b FGF in tumor tissue independently prognosticates disease outcome of a natural course of invasive breast cancer[J].Cancer Biomark,2017,20(2):151-158
[13]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华内分泌代谢杂志,2014,30(10):893-942Chinese Diabetes Society.Guidelines for the prevention and treatment of type 2 diabetes mellitus in China(2013 Edition)[J].Chinese Journal of Endocrinology and Metabolism,2014,30(10):893-942
[14]艾则孜·吾买尔,丁汝新,玛依拉·依山,等.白内障手术方式的研究进展[J].实用临床医药杂志,2016,20(11):218-220,224Aizezi·Wumaier,Ding Ru-xin,Mayila·Yishan,et al.Research progress of cataract surgery[J].Journal of Clinical Medicine in Practice,2016,20(11):218-220,224
[15]Anisimova N,Malyugin B,Arbisser LB,et al.Femtosecond laser-assisted cataract surgery in vitrectomized eye with posterior chamber phakic intraocular lens[J].Digit J Ophthalmol,2017,23(2):43-44
[16]Yonekawa Y,Thomas BJ,Lau-Sickon LK,et al.Detection of pars plana rupture by ultrasound biomicroscopy after cannula dislodgement duringcataract wound hydration[J].Digit J Ophthalmol,2017,23(1):23-25
[17]Ilveskoski L,Tuuminen R.Combined microinvasive glaucoma and cataract surgery in patients with pseudoexfoliation glaucoma:Clinical results of a gel stent[J].J Cataract Refract Surg,2017,43(8):1124-1125
[18]Wang H,Mei X,Cao Y,et al.HMGB1/Advanced Glycation End Products(RAGE)does not aggravate inflammation but promote endogenous neural stem cells differentiation in spinal cord injury[J].Sci Rep,2017,7(1):10332
[19]Farooqui JH,Jaramillo A,Sharma M,et al.Use of modified international council of ophthalmology-ophthalmology surgical competency assessment rubric(ICO-OSCAR)for phacoemulsification-wet lab training in residency program[J].Indian J Ophthalmol,2017,65(9):898-899
[20]Aron N,Sen S,Khokhar S.Comment on"Comparison of 45-degree Kelman and 45-degree balanced phaco tip designs in torsional microcoaxial phacoemulsification"[J].Int J Ophthalmol,2017,10(8):1334-1336
[21]Xu H,Lutrin D,Wu Z.Outcomes of 23-gauge pars plana vitrectomy combined with phacoemulsification and capsulotomy without intraocular lens implantation in rhegmatogenous retinal detachment associated with choroidal detachment[J].Medicine(Baltimore),2017,96(34):e7869
[22]Vieira IV,Boianovsky C,Saraiva TJ,et al.Safety and efficacy of intracameral moxifloxacin injection for prophylaxis of endophthalmitis after phacoemulsification[J].Arq Bras Oftalmol,2017,80(3):165-167
[23]Fea AM,Rekas M,Au L.Evaluation of a Schlemm canal scaffold microstent combined with phacoemulsification in routine clinical practice:Two-year multicenter study[J].J Cataract Refract Surg,2017,43(7):886-891
[24]Hsia YC,Moghimi S,Coh P,et al.Anterior segment parameters as predictors of intraocular pressure reduction afterphacoemulsification in eyes with open-angle glaucoma[J].J Cataract Refract Surg,2017,43(7):879-885
[25]Gurung T,Singh RK,Mohammad S,et al.Efficacy of arthrocentesis versus arthrocentesis with sodium hyaluronic acid in temporomandibular joint osteoarthritis:A comparison[J].Natl J Maxillofac Surg,2017,8(1):41-49
[26]Jeong JY,Chung PK,Yoo JC.Effect of sodium hyaluronate/carboxymethyl cellulose(Guardix-sol)on retear rate and postoperative stiffness in arthroscopic rotator cuff repair patients:A prospective cohort study[J].J Orthop Surg(Hong Kong),2017,25(2):2309499017718908
[27]冯延琴,王理论,边红莉,等.重组b FGF滴眼液联合杞菊地黄丸对绝经后干眼症女性血清与泪液中MMP-2及性激素水平的影响[J].现代生物医学进展,2016,16(25):4935-4937,4947Feng Yan-qin,Wang Li-lun,Bian Hong-li,et al.Effect of Recombinant b FGF Combined with Qiju Dihuang on MMP-2 and Sex Hormones in Postmenopausal Female Patients with Xerophthalmia[J].Progress in Modern Biomedicine,2016,16(25):4935-4937,4947
[28]Shafei EV,Kurinov AM,Kuznetsova AV,et al.Reprogramming of Human Retinal Pigment Epithelial Cells under the Effect of b FGF In Vitro[J].Bull Exp Biol Med,2017,163(4):574-582
[29]Zalesna I,Osrodek M,Hartman ML,et al.Exogenous growth factors b FGF,EGF and HGF do not influence viability and phenotype of V600EBRAF melanoma cells and their response to vemurafenib and trametinib in vitro[J].PLo S One,2017,12(8):e0183498
[30]金颖,王雁,薛超,等.b FGF与玻璃酸钠治疗FS-LASIK术后干眼与角膜知觉恢复对照研究[J].中国实用眼科杂志,2016,34(8):805-809Jin Ying,Wang Yan,Xue Chao,et al.Comparison study in dry eye and recovery of corneal sensitivity between b FGF and sodium hyaluronate after FS-LASIK surgery[J].Chinese Journal of Practical Ophthalmology,2016,34(8):805-809