[1]何丽琴,邹晶,邵毅,等.春季角结膜炎活动期眼表和泪液蛋白的临床研究[J].眼科新进展,2015,35(12):1137-1140.[doi:10.13389/j.cnki.rao.2015.0311]
　HE Li-Qin,ZOU Jing,SHAO Yi,et al.Clinical research on ocular surface condition and tear protein alteration in active vernal keratoconjunctivitis patients[J].Recent Advances in Ophthalmology,2015,35(12):1137-1140.[doi:10.13389/j.cnki.rao.2015.0311]
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春季角结膜炎活动期眼表和泪液蛋白的临床研究
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
35卷
期数:
2015年12期
页码:
1137-1140
栏目:
应用研究
出版日期:
2015-12-05

文章信息/Info

Title:
Clinical research on ocular surface condition and tear protein alteration in active vernal keratoconjunctivitis patients
作者:
何丽琴; 邹晶; 邵毅; 胡佩宏; 李云燕; 裴重刚; 张颖; 高桂平
330006　江西省南昌市，南昌大学第一附属医院眼科
Author(s):
HE Li-Qin ;  ZOU Jing;  SHAO Yi ;  HU Pei-Hong;  LI Yun-Yan;  PEI Chong-Gang ; ZHANG Ying ;  GAO Gui-Ping
Department of Ophthalmology , the First Affiliated Hospital of Nanchang University , Nanchang 330006 , Jiangxi Province , China
关键词:
春季角结膜炎; 泪膜; 泪液蛋白; 角膜知觉; 角膜共聚焦显微镜
Keywords:
vemal keratoconjunctivitis ;  tear film ;  tear protein ;  comeal perception ;  corneal confocal microscopy
DOI:
10.13389/j.cnki.rao.2015.0311
文献标志码:
A
摘要:
目的　对比观察春季角结膜炎（ｖｅｒｎａｌｋｅｒａｔｏｃｏｎｊｕｎｃｔｉｖｉｔｉｓ，ＶＫＣ）活动期患者眼表症状、泪膜、泪液蛋白以及角膜神经改变的特点。方法　收集南昌大学第一附属医院２０１０年８月至２０１４年３月眼科门诊确诊为ＶＫＣ活动期患者２０例（４０眼），分别对患者行眼表症状评分、泪膜四项检查、泪液蛋白测定、角膜知觉检查与中央角膜共聚焦显微镜检查，并与２０例４０眼健康对照组研究对象的检查结果进行对比分析。结果　ＶＫＣ活动期患者左右两眼间和正常对照组研究对象的左右两眼间的眼表症状评分、泪膜四项、泪液蛋白、乳铁蛋白、溶菌酶、神经纤维密度及角膜敏感度差异均无统计学意义（均为Ｐ＞０．０５）；ＶＫＣ活动期患者右眼较对照组右眼干眼症状眼数增多，眼表疾病指数评分增高、泪膜破裂时间减短、基础泪液分泌试验结果增高、泪河高度降低、角膜荧光素染色增强，泪液总蛋白、乳铁蛋白、溶菌酶、角膜神经纤维密度及角膜敏感度值较对照组均明显降低，且差异均有统计学意义（均为Ｐ＜０．０５）；ＶＫＣ活动期患者左眼检查结果较对照组改变与右眼改变一致，差异也均有统计学意义（均为Ｐ＜０．０５）。共聚焦显微镜检查结果发现，ＶＫＣ活动期患者中央角膜可见角膜上皮细胞部分结膜化，其上皮层存在大量炎症细胞浸润并伴有少量朗格汉斯细胞浸润，角膜上皮下有大量非成熟型朗格汉斯细胞浸润；角膜上皮下神经纤维纤细，呈盘旋、弯曲异常分布。结论　ＶＫＣ活动期患者眼表及泪液改变明显，多表现为泪膜稳定性降低，泪液蛋白含量降低，角膜敏感度降低且角膜神经纤维密度下降、纤细及走形异常等特点。
Abstract:
Objective To observe the symptom of ocular surface. tcharacteristics of tear film, tear protein and corneal nerve fiber alteration in active vernal keratoconjunctivitis ( VKC ) patients. Methods Between August 2010 and March 2014.20 cases with active VKC and 20 control people were collected in the first Affrliated Hospital of Nanchang University. The results of tear film .tear protein and corneal nerve fiber which studied with ocular surface disease index , examination for tear film . tests for tear proteins , corneal perception check and corneal confocal microscopy examination were compared between active vernal keratoconjunctivitis group and control group. Results There was no difference in ocular surface disease index, break-up time , Schirmer I test . tears meruscus height , fluorescein stairung , tear proteins , lactoferrin,lysozyme, density of nerve fibers and corneal sensitivity between left eyes and right eyes of VKC group and control group ( all P > 0. 05 ) . But the results of these examination of right eyes in VKC group were different from right eyes in control group ( all P < 0. 05 ) . And the analysis in left eyes between these two groups was consistent with right eyes ( P < 0. 05 ) . The results of VKC group with confocal microscope showed the size of corneal epithelial cells increased , glance of unclear enhanced , part of the corneal epithelium got the features of conjunctiva,the number of high reflective surface cells and inflammatory cells with a small amount of langerhans cell increased on and under the surface of corneal epithelium. Besides, slender and the abnormal distributing nerve fibers under cornea could be found in VKC group. Coriclrisiori Stability of tear film reduce and tear protein content decrease in most of active VKC patients. Also .corneal susceptibility weaken as well the slender and the abnormal distributing nerve fibers which is under and on cornea should be the main feature of active vernal keratoconjunctivitis patients.

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备注/Memo

备注/Memo:
国家自然科学基金资助（编号： ８１１６０１１８、８１４００３７２）；全国临床医药研究专项基金（编号：Ｌ２０１２０５２）；江西省远航工程（编号：２０１４０２２）；江西省学位与研究生教育教学改革研究项目（编号：２０１５）；江西省科技平台建设项目（编号：２０１３１１６）；江西省青年科学基金（编号：２０１５１ＢＡＢ２１５０１６）；江西省科技支撑计划项目（编号：２０１５１ＢＢＧ７０２２３）；江西省教育厅科技计划项目（编号：ＧＪＪ１４１７０）；江西省卫计委科技计划项目（编号：２０１５５１５４）；赣江学者计划（编号：２０１５）
更新日期/Last Update: 2015-12-07