目的：探讨重组牛碱性成纤维细胞生长因子滴眼液联合玻璃酸钠对白内障超声乳化术后干眼疗效及对泪液氧化应激指标及TNF-α、IL-6水平影响。

方法：选取2016-02/2018-02我院收治的白内障术后出现干眼症的患者112例172眼作为研究对象，按照随机数字法分为两组，每组56例86眼，其中对照组给予玻璃酸钠治疗，观察组给予重组牛碱性成纤维细胞生长因子滴眼液联合玻璃酸钠治疗。对比两组患者疗效、眼表、泪液功能以及泪液中氧化应激指标和炎性因子指标。

结果：观察组治疗4wk后总有效率为96.5%，明显高于对照组总有效率80.2%(P=0.001)。两组患者术前1d的FL、BUT以及SⅠt无差异(P>0.05)，治疗后两组FL均明显降低，术后治疗4、8、28d观察组下降更为明显(P<0.05)； BUT和SⅠt均明显升高，术后治疗4、8、28d观察组升高更为明显(P<0.05)。治疗前两组患者泪液中氧化应激指标丙二醛(MDA)、过氧化物脂质(LPO)、超氧化物岐化酶(SOD)及总抗氧化能力(TAC)无差异(P>0.05)，治疗后两组患者的氧化应激指标均明显改善(P<0.05)，观察组MDA和LPO明显低于对照组(P<0.05)，SOD和TAC明显高于对照组(P<0.05)。治疗前两组患者泪液中炎性因子TNF-α和IL-6无差异(P>0.05)，治疗后两组TNF-α和IL-6均明显下降(P<0.05)，且观察组比对照组下降更为明显(P<0.05)。

结论：重组牛碱性成纤维细胞生长因子滴眼液联合玻璃酸钠治疗白内障超声乳化后干眼效果显著，不仅能促进泪膜稳定性，还能减少泪液分泌和角膜损伤，其作用可能与改善氧化应激指标、调节炎症因子水平有关。

METHODS: From February 2016 to February 2018, 112 patients(172 eyes)of dry eyes were selected as the research objects. According to the law of random numbers, they were divided into two groups, each group with 86 eyes, and the control group was given sodium hyaluronate treatment, while the observation group was given recombinant bovine alkaline fibroblast growth factor eye drops combined with sodium hyaluronate. The efficacy, ocular surface, tear function, oxidative stress and inflammatory factors in tears were compared between the two groups.

RESULTS: After 4wk of treatment, the total effective rate of the observation group was 96.5%, which was significantly higher than that of the control group(P=0.001). Two groups of patients with preoperative fluorescent scores(FL), tear break-up time(BUT)and Schirmer Ⅰ test(SⅠt)had no statistical significance(P>0.05), postoperative medication, two groups of patients of FL were significantly decreased, which in the postoperative treatment, 4d, 8d and 28d, observation group decreased more obvious than control group. The repeatability of variance analysis results showed statistically significant differences between the two groups at different time points(P<0.05). Postoperative drug treatment, BUT and SⅠt in the two groups were significantly increased especially on the 4d, 8d and 28d, observation group increased more obvious than control group. Repeated variance analysis results showed statistically significant differences between the two groups at different time points(P<0.05). Two groups of patients before treatment in tears oxidative stress indicators malondialdehyde(MDA), lipid peroxide(LPO), superoxide disproportionation enzyme(SOD)and total antioxidant capacity(TAC)had no statistical significance(P>0.05), two groups of patients after treatment of oxidative stress indicators were significantly improved(P<0.05), MDA and LPO of observation group were obviously lower than the control group(P<0.05), SOD and TAC were significantly higher than control group(P<0.05). Before the treatment, there was no statistically significant difference between the two groups in terms of TNF-α and IL-6 in their tears(P>0.05). After the treatment, TNF-α and IL-6 in the tears of the two groups decreased significantly(P<0.05), and the decrease was more significant in the observation group than the control group(P<0.05).

CONCLUSION: Recombinant bovine alkaline fibroblast growth factor eye drops combined with sodium hyaluronate have significant effects on dry eyes after phacoemulsification of cataract, which cannot only promote the stability of tear film, but also reduce tear secretion and corneal injury. The effect may be related to the improvement of oxidative stress index and the regulation of inflammatory factors.