目的 探讨重组牛碱性成纤维细胞生长因子滴眼液联合使用更昔洛韦眼用凝胶治疗流行性角结膜炎的临床疗效。方法 2022年12月—2024年12月南京市栖霞区医院收治的流行性角结膜炎患者共计140例，患者按随机数字表法分为对照组和治疗组，每组各70例。对照组结膜囊内涂入更昔洛韦眼用凝胶，每次1滴/眼，4次/d；治疗组在对照组基础上使用重组牛碱性成纤维细胞生长因子滴眼液，每次1滴/眼，4次/d。两组连续治疗2周。比较两组的治疗效果、症状改善时间、病情程度、视力、泪膜四项和泪液实验室指标。结果 对照组的总有效率为85.60%，明显低于治疗组的总有效率94.31%，组间比较差异显著（P＜0.05）。治疗组患者流泪、畏光、疼痛、红肿改善时间均明显短于对照组（P＜0.05）。两组治疗后的眼表疾病指数量表（OSDI）评分降低，视力值升高（P＜0.05）；治疗组治疗后的OSDI评分低于对照组，视力值高于对照组（P＜0.05）。两组治疗后的泪河高度（TMH）、泪膜破裂时间（BUT）明显升高，角膜荧光素染色（FL）、基础泪液分析实验（SⅠT）明显降低（P＜0.05）；治疗组治疗后的TMH、BUT高于对照组，FL、SⅠT低于对照组（P＜0.05）。两组治疗后的泪液乳铁蛋白（LF）、溶菌酶（LZM）明显升高，总蛋白（TP）明显降低（P＜0.05）；治疗组治疗后的泪液LF、LZM高于对照组，TP低于对照组（P＜0.05）。结论 重组牛碱性成纤维细胞生长因子滴眼液联合更昔洛韦眼用凝胶可提高流行性角结膜炎的疗效，改善临床症状、泪膜稳定性和视力，减轻炎症反应。

Objective To explore the clinical efficacy of Recombinant Bovine Basic Fibroblast Growth Factor Eye Drops combined with Ganciclovir Ophthalmic Gel in treatment of epidemic keratoconjunctivitis. Methods A total of 140 patients with epidemic keratoconjunctivitis admitted to Nanjing Qixia District Hospital from December 2022 to December 2024 were selected. The patients were divided into control group and treatment group according to the random number table method, with 70 cases in each group. The control group was administered Ganciclovir Ophthalmic Gel (1 drop per eye, 4 times daily). The treatment group received Recombinant Bovine Basic Fibroblast Growth Factor Eye Drops on the basis of the control group, 1 drop per eye, 4 times daily. Two groups were treated for 2 consecutive weeks. The therapeutic effects, symptom improvement time, disease severity, visual acuity, four tear film parameters, and tear fluid laboratory indicators were compared between two groups. Results The total effective rate of the control was 85.60%, which was significantly lower than the total effective rate of 94.31% in the treatment group, with significant difference between two groups (P < 0.05). The improvement time of tears, photophobia, pain, and redness in the treatment group was significantly shorter than that in the control group (P < 0.05). The OSDI scores of the two groups decreased after treatment, but the visual acuity values increased (P < 0.05). The OSDI score of the treatment group was lower than that of the control group after treatment, but the visual acuity value was higher than that of the control group (P < 0.05). After treatment, the tear height (TMH) and tear film rupture time (BUT) of two groups significantly increased, while corneal fluorescein staining (FL) and basal tear analysis experiment (SIT) significantly decreased (P < 0.05). The TMH and BUT of the treatment group were higher than those of the control group after treatment, while FL and SIT were lower than those of the control group (P < 0.05). After treatments, the levels of lactoferrin (LF) and lysozyme (LZM) in tears significantly increased, while the total protein (TP) significantly decreased (P < 0.05). The tears levels of LF and LZM in the treatment group were higher than those in the control group after treatment, while TP was lower than that in the control group (P < 0.05). Conclusion The combination of Recombinant Bovine Basic Fibroblast Growth Factor Eye Drops and Ganciclovir Ophthalmic Gel can improve the efficacy of epidemic keratoconjunctivitis, improve clinical symptoms, tear film stability and vision, and reduce inflammatory reaction.

R988.1

国家自然科学基金资助项目（81700822）