【摘要】：目的觀察個(gè)體化綜合治療慢性移植物抗宿主病相關(guān)干眼的臨床效果。方法回顧性分析2013年3月至2016年11月在我院診治的造血干細(xì)胞移植術(shù)后慢性移植物抗宿主病相關(guān)干眼患者19例(38眼),根據(jù)病情不同個(gè)體化地給予人工淚液、小牛血去蛋白提取物眼用凝膠、成纖維細(xì)胞生長因子眼用凝膠及1 g·L~(-1)氟米龍滴眼液等不同組合的復(fù)合用藥方案進(jìn)行綜合治療。治療前后行裂隙燈檢查、干眼癥狀評分、視力、角膜熒光素染色(fluorescent staining,FS)、淚膜破裂時(shí)間(break-up time,BUT)、基礎(chǔ)淚液分泌試驗(yàn)(SchimerⅠtest,SⅠT)等檢查,觀察治療前及治療2個(gè)月后干眼癥狀及體征的變化。結(jié)果治療前干眼癥狀評分項(xiàng)目中干澀感、異物感、燒灼感、疼痛、眼紅分別為(2.72±0.78)分、(2.58±0.89)分、(2.46±0.64)分、(2.27±0.54)分、(2.54±0.66)分,治療后均較治療前有不同程度的改善,各癥狀評分分別為(1.68±0.82)分、(1.62±0.72)分、(1.57±0.59)分、(1.44±0.62)分、(2.09±0.58)分(均為P0.05);眼部視疲勞、畏光評分較治療前略有改善,但差異均無統(tǒng)計(jì)學(xué)意義(均為P0.05);治療后視力有所提高,差異有統(tǒng)計(jì)學(xué)意義;角膜FS評分由治療前的(8.6±2.4)分減少為治療后的(2.2±1.6)分,差異有統(tǒng)計(jì)學(xué)意義(P=0.000);BUT略有增加,SⅠT略有下降,但兩者治療前后的差異均無統(tǒng)計(jì)學(xué)意義(均為P0.05)。結(jié)論個(gè)體化地給予人工淚液、小牛血去蛋白提取物眼用凝膠、成纖維細(xì)胞生長因子眼用凝膠及1 g·L~(-1)氟米龍滴眼液等綜合治療能改善造血干細(xì)胞移植術(shù)后慢性移植物抗宿主病相關(guān)干眼癥狀和部分體征,提高視覺質(zhì)量。
[Abstract]:Objective to observe the clinical effect of individualized comprehensive treatment of dry eye associated with chronic graft-versus host disease. Methods from March 2013 to November 2016, 19 patients (38 eyes) with chronic graft-versus-host disease associated with dry eye were treated in our hospital from March 2013 to November 2016. The combined treatment of different combinations of bovine blood deproteinizing extract, fibroblast growth factor eye gel and 1 g L ~ (-1) flumilon eye drops were carried out. Slit-lamp examination, dry eye score, visual acuity, corneal fluorescein staining (fluorescent staining,FS), lacrimal film rupture time (break-up time,BUT), basic tear secretion test (Schimer 鈪，

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