目的 探讨甲钴胺联合卵磷脂络合碘治疗中心性浆液性脉络膜视网膜病变的临床疗效。方法 选取2019年5月—2022年5月在中国人民解放军海军军医大学第一附属医院治疗的120例中心性浆液性脉络膜视网膜病变患者。随机分对照组和治疗组，每组各60例。对照组口服卵磷脂络合碘片，2片/次，3次/d。在对照组的基础上，治疗组口服甲钴胺片，0.5 mg/次，3次/d。两组用药7周。观察两组患者临床疗效，比较治疗前后两组患者症状缓解时间，视力改善情况，血清全血黏度（WBV）、血浆黏度（PV）、黄斑中心凹厚度（CMT）和视网膜下积液（SRF）指标水平及不良反应。结果 治疗后，治疗组临床总有效率（98.33%）明显高于对照组（83.33%，P＜0.05）。治疗后，治疗组症状缓解时间均明显早于对照组（P＜0.05）。治疗后，两组患者标准对数视力表值比治疗前明显升高（P＜0.05），且治疗组的视力改善情况明显高于对照组（P＜0.05）。治疗后，两组患者WBV、PV、CMT、SRF指标均明显下降（P＜0.05），且治疗组患者的指标水平明显低于对照组（P＜0.05）。治疗组不良反应发生率（6.67%）明显低于对照组（15.06%，P＜0.05）。结论 甲钴胺联合卵磷脂络合碘治疗中心性浆液性脉络膜视网膜病变效果确切，可改善眼底血液微循环，纠正眼底状态，有效提高患者视力。

Objective To investigate the clinical effect of mecobalamin combined with iodized lecithin in treatment of central serous chorioretinopathy.Methods Patients (120 cases) with central serous chorioretinopathy in Changhai Hospital from May 2019 to May 2022 were randomly divided into control and treatment group,and each group had 60 cases.Patients in the control group were po administered with Iodized Lecithin Tablets,2 tablets/time,three times daily.Patients in the treatment group were po administered with Mecobalamin Tablets on the basis of the control group,0.5 mg/time,three times daily.Patients in two groups were treated for 7 weeks.After treatment,the clinical evaluation was evaluated,the improvement time of symptom,the improvement of visual acuity,the levels of WBV,PV,CMT and SRF,and adverse reaction in two groups before and after treatment were compared.Results After treatment,the clinical effective rate in the treatment group (98.33%) was significantly higher than that in the control group (83.33%,P<0.05).After treatment,the time of symptom relief in the treatment group was significantly earlier than that in the control group (P<0.05).After treatment,the standard logarithmic visual acuity chart of the two groups was significantly higher than that before treatment (P<0.05),and which in the treatment group was significantly higher than that of the control group (P<0.05).After treatment,the indexes of WBV,PV,CMT and SRF in both groups were significantly decreased (P<0.05),and the level of these indexes in the treatment group was significantly lower than that in the control group (P<0.05).The incidence of adverse reactions in the treatment group (6.67%) was significantly lower than that in the control group (15.06%,P<0.05).Conclusion Mecobalamin combined with Iodized Lecithin Tablets is effective in the treatment of central serous chorioretinopathy,which can improve fundus blood microcirculation,correct fundus state and effectively improve patients'visual acuity.

R988.1