目的：探讨短期应用普拉洛芬滴眼液治疗老年干眼症的疗效及安全性。

方法：将2016-06/2017-05于我院接受治疗的100例老年干眼症患者随机均分为两组，每组各50例，均双侧发病，取右眼为观察眼。观察组50眼应用1g/L普拉洛芬滴眼液联合1g/L玻璃酸钠滴眼液治疗； 对照组50眼应用1g/L玻璃酸钠滴眼液治疗。分别于用药前、用药2wk时，进行泪液分泌试验Ⅰ(Schirmer Ⅰ)，检测眼表疾病指数(OSDI)、泪膜破裂时间(BUT)、眼表染色(OSS)评分、球结膜上皮细胞中人类白细胞DR抗原(HLA-DR)、CD11b表达水平，同时观察不良反应与并发症情况。

结果：两组治疗前Schirmer Ⅰ实验结果、OSDI、BUT、OSS、HLA-DR及CD11b表达均接近，差异无统计学意义(P>0.05)； 经治疗后OSDI、OSS、CD11b均明显下降，BUT均明显上升，组内差异有统计学意义(P<0.01)； 治疗后观察组OSDI、OSS、HLA-DR明显低于对照组，BUT明显高于对照组，差异有统计学意义(P<0.05)。HLA-DR表达与OSDI、OSS呈正相关，与BUT呈负相关。两组均未见明显不良反应及并发症。

结论：短期应用普拉洛芬能够有效提升老年干眼症疗效，改善患者临床症状，且普拉洛芬治疗机制可能与其对HLA-DR的抑制作用有关。

METHODS: Totally 100 elderly patients with dry eyes treated in our hospital from June 2016 to May 2017 were randomly divided into 2 groups. All cases were bilateral onset, and the right eyes were marked as the observation eyes. The 50 eyes in the observation group were treated with 1g/L pranoprofen eye drops combined with 1g/L sodium hyaluronate eye drops, while 50 in the control group were treated with 1g/L sodium hyaluronate eye drops. The results of Schirmer Ⅰ, ocular surface disease index(OSDI), break-up time(BUT), ocular surface staining(OSS), human leukocyte antigen-DR(HLA-DR)and CD11b in conjunctival epithelial cells before and at 2wk after treatment, and adverse reactions in 2 groups were observed.

RESULTS: Before treatment, results of Schirmer I, OSDI, BUT, OSS, HLA-DR and CD11b in the two groups were similar, there were no statistically significant differences(P>0.05). After treatment, OSDI, OSS, HLA-DR, CD11b significantly decreased, BUT significantly increased in both groups, the differences were statistically significant(P<0.05). After treatment, OSDI, OSS and HLA-DR in the observation group were significantly lower than those in the control group, BUT in the observation group was significantly higher than those in the control group, the differences were statistically significant(P<0.01). The expression of HLA-DR was positively correlated with OSDI and OSS, and negatively correlated with BUT, and the correlations were statistically significant(P<0.05).

CONCLUSION: Short term application of pranoprofen eye drops can effectively enhance the efficacy in treating elderly patients with dry eyes, release clinical symptoms, and the therapeutic mechanism may be related to the inhibitory effect on HLA-DR.