摘要目的 评估应用维生素A棕榈酸酯眼用凝胶治疗干眼的安全性和疗效.方法 临床病例对照研究.对2015年2月至2015年12月在中山大学中山眼科中心门诊就诊的患者57例(57只眼),随机分为三组:A组,予以维生素A棕榈酸酯眼用凝胶(4次/d);B组,予以0.1％玻璃酸钠滴眼液(4次/d);C组,予以0.1％玻璃酸钠滴眼液联合维生素A棕榈酸酯眼用凝胶(4次/d).分别于治疗前、治疗后2周、4周观察患者眼表疾病指数(OSDI)评分、丽丝胺绿染色、角膜素荧光染色(FL)、泪膜破裂时间(BUT)、泪液分泌测试(schirmer test)和结膜印迹细胞检测,各项指标比较采用配对t检验和单因素方差分析.结果 治疗后2周,A、C组较治疗前OSDI评分明显降低,差异有统计学意义(P＜0.05);治疗后4周,C组较其它两组OSDI评分平均值最低,差异有统计学意义(P＜0.05).治疗后4周,A、C组丽丝胺绿染色和FL评分与治疗前比较明显降低,差异有统计学意义(P＜0.05);C组较B组丽丝胺绿染色评分更低,差异有统计学意义(P＜0.05).治疗后4周,A、C组与治疗前相比,ST均增加,差异有统计学意义(P＜0.05);并且A、C组与B组之间比较,ST均增加,差异有统计学意义(P＜0.05).C组患者中的9例轻度干眼患者经治疗4周后,结膜杯状细胞密度与治疗前相比均有所增加,差异有统计学意义(P＜0.05).结论 局部应用维生素A棕榈酸酯眼用凝胶联合玻璃酸钠滴眼液治疗干眼安全且有效.

abstractsObjective To observe the efficacy and safety of Vitamin A palmitate eye ophthalmic gel for the treatment of dry eye.Methods Totally 57 dry eye patients (57 eyes) enrolled in our hospital from February 2015 to December 2015 were randomly divided into three groups∶ group A,Vitamin A palmitate eye ophthalmic gel;group B,0.1％ Ellie eye drops;group C,Vitamin A palmitate eye ophthalmic gel combined with Ellie eye drops.Each eye drops was used 4 times a day.Ocular surface disease index (OSDI),lissamine green staining,fluorescent staining (FL),tear break-up time (BUT),Schirmer I test and conjunctival impression cytology (IC) was observed in these patients before the treatment,in 2 weeks and 4 weeks after treatment.The mean of the results were compared by Paired t test and One-Way ANOVA.Results After 2 weeks of the treatment,the mean score of OSDI was significantly lower than that before the treatment in group A and C (P ＜0.05).After 4 weeks of the treatment,the mean score of OSDI was the lowest in group C.The lissamine green staining and FL in group A and C were significantly lower than that before the treatment (P ＜0.05).Furthermore,the lissamine green staining in group C was significantly lower than group B.After 4 weeks of the treatment,the mean score of ST in group A and C was significantly expanded than that before the treatment (P ＜0.05) and those two groups were significantly expanded than group B.There were 9 mild dry eye patients in group C.After 4 weeks of the treatment,the average density of the goblet cells in these patients were significantly increased than that before the treatment (P ＜0.05).Conclusions Topical Vitamin A palmitate eye ophthalmic gel combined Ellie eye drops is safe and effective for the treatment of dry eye.