背景:临床上,甲状腺相关眼病(TAO)患者患有干眼综合征.只有少数相关研究是关于这个主题。我们的研究被确定为TAO合并干眼综合征的治疗提供高水平的证据。
目的:比较维生素A棕榈酸酯眼用凝胶和透明质酸钠滴眼液治疗TAO干眼症的临床疗效。
方法:本研究于2020年5月至10月在上海交通大学医学院附属第九人民医院眼科进行。将80例轻、中重度TAO干眼症患者随机分为两组。所有受试者的疾病阶段是不活跃的。A组患者采用维生素A棕榈酸酯眼用凝胶治疗3次/天,持续1个月,B组患者采用透明质酸钠滴眼液治疗,指标包括破裂时间(BUT)和SchirmerI试验(ST),角膜荧光染色(FL),眼表疾病指数(OSDI),相同临床医生在基线和治疗后1个月记录不良反应。数据采用SPSS24.0进行分析。
结果:最后,65名受试者完成了治疗。A组患者平均年龄为38.1±11.4岁,B组为37.26±10.67岁。A组82%的受试者为女性,B组74%为女性,包括ST的价值,但是,OSDI,和FL等级。治疗后,A组有效率为91.2%,其中BUT和FL等级值明显提高(P<0.001)。B组有效率为67.7%,其中OSDI评分和FL等级的值显著提高(P=0.002)。此外,A组BUT值明显长于B组(P=0.009)。
结论:INTAO患者干眼症,维生素A棕榈酸凝胶和透明质酸钠滴眼液改善干眼症,促进角膜上皮修复。维生素A棕榈酸酯凝胶改善泪膜的稳定性,而透明质酸钠滴眼液可改善患者的主观不适。
BACKGROUND: Clinically, thyroid-associated ophthalmopathy (TAO) patients were suffered from dry eye syndrome. Only a few relevant studies were about this topic. Our
study was determined to provide high-level evidence for the treatment of TAO with dry eye syndrome.
OBJECTIVE: To compare the clinical effects of vitamin A palmitate eye gel and sodium hyaluronate eye drop forTAO patients with dry eye syndrome.
METHODS: The
study was conducted in the Ophthalmology Department of the Ninth People\'s Hospital Affiliated with the Medical College of Shanghai Jiao Tong University from May to October 2020. A total of 80 mild or moderate-to-severe TAO patients with dry eye syndrome were randomly divided into two groups. The disease stages of all subjects were inactive. Patients in group A were treated with vitamin A palmitate eye gel three times/day for one month and sodium hyaluronate eye drop in group B. The index including break-up time (BUT) and Schirmer I test (ST), corneal fluorescence staining (FL), ocular surface disease index (OSDI), and adverse reactions were recorded by the same clinician at baseline and 1 month after treatment. The data were analyzed by SPSS 24.0.
RESULTS: Finally, 65 subjects completed the treatment. The average age of the patients in Group A was 38.1 ± 11.4 years, and that in Group B was 37.26 ± 10.67 years. 82% of the subjects in group A were female and 74% in group B. There was no significant difference between the two groups at baseline, including the value of ST, BUT, OSDI, and FL grade. After the treatment, the effective rate was 91.2% in group A, of which the value of BUT and FL grade was significantly improved (P < 0.001). The effective rate in group B was 67.7%, of which the value of OSDI score and FL grade was significantly improved (P = 0.002). In addition, the BUT value of group A was significantly longer than that of group B (P = 0.009).
CONCLUSIONS: InTAO patients with dry eye syndrome, vitamin A palmitate gel and sodium hyaluronate eye drop improved the dry eye and promoted corneal epithelial repair. Vitamin A palmitate gel improves the stability of tear film, while sodium hyaluronate eye drop improves patients\' subjective discomfort.