Sodium hyaluronate eye drops of different osmolarity for the treatment of dry eye in Sjogren's syndrome patients
Sodium hyaluronate eye drops of different osmolarity for the treatment of dry eye in Sjogren's syndrome patients
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DOI：
10.1136/bjo.86.8.879
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发表时间：
2002-08-01
影响因子：
4.1
通讯作者：
Stilo, A
中科院分区：
文献类型：
--
作者：
Aragona, P;Di Stefano, G;Stilo, A
目的：探讨低渗或等渗透明质酸滴眼液治疗干燥综合征干眼症的疗效。方法：将40例干燥综合征患者分为两组，采用低渗（150mosm /l） 0.4%透明质酸滴眼液治疗；第二组使用等渗0.4%透明质酸滴眼液。滴眼液每天滴入6次，持续90天。在研究开始后的第0、15、30、90天分别进行主观症状评分、破裂时间（BUT）、角膜荧光素染色、结膜玫瑰染色、Schirmer's I试验和结膜印象细胞学检查。患者采用盲法检查，统计分析采用Student’st检验、Mann-Whitney U检验和chi(2)检验。结果：两组患者的症状在第15天均有统计学意义上的改善，但I组患者的整体评分在统计学上明显优于2组（p = 0.02）。在第15天，第一组患者的BUT （p = 0.003）、荧光素和rose bengal评分较基线值有所改善（p = 0.000001和p = 0.0004分别）。第2组患者在第15天，BUT和荧光素评分较基线值有所改善（p = 0.05和p = 0.0001）。两组比较显示，第1组患者在第15天的玫瑰红染色（p = 0.01）和第90天的BUT （p = 0.05）和荧光素评分（p = 0.0003）的结果更好。结膜印象细胞学检查显示，从第15天开始到整个研究过程中，I组的总得分优于2组，差异有统计学意义（p < 0.02）。另外，组2患者从第30天开始较基线值有所改善（p = 0.000005）。结论：透明质酸滴眼液是治疗干燥综合征严重干眼的有效方法。使用低渗溶液对角膜结膜上皮的影响优于等渗溶液。
Aim: To study the effect of the treatment of dry eye in Sjogren's syndrome patients with hypotonic or isotonic hyaluronate eye drops.Methods: 40 Sjogren's syndrome patients were divided in two groups and treated as follows: group I with hypotonic (150 mOsm/l) 0.4% hyaluronate eye drops; group 2 with isotonic 0.4% hyaluronate eye drops. The eye drops were instilled six times a day for 90 days. Grading of subjective symptoms, break up time (BUT), corneal fluorescein staining, conjunctival rose bengal staining, Schirmer's I test, and conjunctival impression cytology were carried out at 0 and 15, 30, 90 days from the beginning of the study. Patients were examined in a blind fashion, For the statistical analysis the Student's t test, Mann-Whitney U test, and chi(2) test were performed.Results: Symptoms were statistically significantly improved at day 15 in both groups but group I patients had a global score statistically significantly better group 2 (p = 0.02). At day 15 group I patients had an improvement from baseline values of BUT (p = 0.003), fluorescein, and rose bengal score (p = 0.000001 and p = 0.0004 respectively). Group 2 patients had, at day 15, an improvement of BUT and fluorescein score compared to baseline values (p = 0.05 and p = 0.0001 respectively). A comparison between the two groups showed better results for group 1 patients at day 15 for rose bengal stain (p = 0.01) and for BUT (p = 0.05) and fluorescein score (p = 0.0003) at day 90. The conjunctival impression cytology showed that group I had a statistically significant better total score than group 2 starting from day 15 and lasting throughout the study (p < 0.02). Also group 2 patients showed an improvement from baseline values starting from day 30 (p = 0.000005).Conclusion: Hyaluronate eye drops are useful for treating severe dry eye in Sjogren's syndrome patients. The use of a formulation with pronounced hypotonicity showed better effects on corneoconjunctival epithelium than the isotonic solution.