袁　菁，胡维琨



·临床报告·

对比两种给药方案治疗急性视网膜坏死综合征患者的效果

袁菁1，胡维琨2

1Department of Ophthalmology, the Sixth Hospital of Wuhan, Wuhan 430015, Hubei Province, China;2Department of Ophthalmology, Tongji Hospital, Wuhan 430015, Hubei Province, China

•METHODS: Thirty patients (40 eyes) with acute retinal necrosis syndrome in our hospital were randomly divided into group A and B. Group A was treated with acyclovir with prednisone acetate tablets, and group B was given ganciclovir with prednisone acetate tablets and aspirin. Clinical effects in the two groups were observed and compared.

•RESULTS: After treatment, the overall response rate in group B (90%) was obviously higher than that in group A (70%), both of two regimens were effective, without significant difference (P>0.05). There was no significant difference on the pre-treatment visual acuity between the two groups (P>0.05). After different treatments, the visual acuity in group B was ≥0.5 in 12 eyes, 0.1≤and<0.5 in 4 eyes, 0.02≤and<0.1 in 3 eyes, and no photosensitive in 1 eye. The visual acuity in group A was ≥0.5 in 9 eyes, 0.1≤and<0.5 in 3 eyes, 0.02≤and<0.1 in 6 eyes, and no photosensitive in 2 eyes. The recovery of visual acuity in group B was obviously better than that in A group (P<0.05). The incidence of complications such as retinal tear, herpes, mouth ulcers, chickenpox, viral encephalitis and central nervous system diseases in group B (10%) was significantly lower than that in A group (35%,P<0.05).

•CONCLUSION: Two drug therapies (acyclovir with prednisone acetate tablets, ganciclovir with prednisone acetate tablets and aspirin) both have positive therapeutic effect, but the latter can better restore visual acuity and decrease the complications.

目的：探讨阿昔洛韦+醋酸泼尼松片、丙氧鸟苷+醋酸泼尼松片+阿司匹林两种给药方案治疗急性视网膜坏死综合征的临床疗效。

方法：采用随机数字表法将我院急性视网膜坏死综合征患者30例40眼分为A、B两组，其中A组采用阿昔洛韦+醋酸泼尼松片的给药方案，B组采用丙氧鸟苷+醋酸泼尼松片+阿司匹林的给药方案，观察并比较两组患者治疗后的临床效果。

结果：经过治疗后，B组总有效率(90%)明显高于A组(70%)，两种给药方案均有效，差异无统计学意义(P>0.05)；两组患者在治疗前视力情况差异无统计学意义(P>0.05)；经不同给药方案治疗后，A组视力≥0.5者9眼，视力0.1～<0.5者3眼，视力0.02～<0.1者6眼，无感光者2眼，B组视力≥0.5者12眼，视力0.1～<0.5者4眼，视力0.02～<0.1者3眼，无感光者1眼， B组患者视力恢复情况优于A组，差异有统计学意义(P<0.05)；B组患者视网膜裂孔、疱疹、口腔溃疡、水痘、病毒性脑炎及中枢神经病变等并发症的发生率(10%)明显低于A组(35%)，差异有统计学意义(P<0.05)。

结论：阿昔洛韦+醋酸泼尼松片、丙氧鸟苷+醋酸泼尼松片+阿司匹林两种给药方案都具有较为肯定的治疗效果，但后者对患者视力的恢复及并发症发生率的降低具有更好的优势。

阿昔洛韦；醋酸泼尼松片；丙氧鸟苷；阿司匹林；急性视网膜坏死综合征

引用：袁菁，胡维琨.对比两种给药方案治疗急性视网膜坏死综合征患者的效果.国际眼科杂志2016;16(7):1366-1368

0引言

急性视网膜坏死综合征是水痘-带状胞疹病毒或单纯疱疹病毒感染引起的一种炎症性疾病[1]。临床上主要表现为起始于中周部并向后极部推进的视网膜坏死病灶、以视网膜动脉炎为主的视网膜血管炎、中度以上的玻璃体混浊和后期发生的视网膜脱落[2]。为提高患者治疗后的临床效果，避免并发症的发生，近年来临床上多采用阿昔洛韦、醋酸泼尼松片、丙氧鸟苷、阿司匹林几种药物联合治疗[3]。为进一步……