[1]项敏泓,贾元玲,周欢明,等.结膜松弛症患者泪膜稳定性、杯状细胞及黏蛋白5AC表达的变化[J].眼科新进展,2017,37(8):759-763.[doi:10.13389/j.cnki.rao.2017.0192]
　XIANG Min-Hong,JIA Yuan-Ling,ZHOU Huan-Ming,et al.Changes of tear film stability,goblet cell and mucin 5AC expression in conjunctivochalasis patients[J].Recent Advances in Ophthalmology,2017,37(8):759-763.[doi:10.13389/j.cnki.rao.2017.0192]
点击复制

结膜松弛症患者泪膜稳定性、杯状细胞及黏蛋白5AC表达的变化/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
37卷
期数:
2017年8期
页码:
759-763
栏目:
应用研究
出版日期:
2017-08-05

文章信息/Info

Title:
Changes of tear film stability,goblet cell and mucin 5AC expression in conjunctivochalasis patients
作者:
项敏泓; 贾元玲; 周欢明; 李青松; 王晗敏; 张兴儒; 陈星星
200062　上海市，上海中医药大学附属普陀医院眼科
Author(s):
XIANG Min-Hong; JIA Yuan-Ling; ZHOU Huan-Ming; LI Qing-Song; WANG Han-Min; ZHANG Xing-Ru; CHEN Xing-Xing
Department of Ophthalmology,Putuo Hospital Affiliated to Shanghai Traditional Chinese Medicine University,Shanghai 200062，China
关键词:
结膜松弛症; 黏蛋白5AC; 泪膜稳定性; 结膜; 杯状细胞
Keywords:
conjunctivochalasis; mucin 5AC; tear film stability; conjunctiva; goblet cell
分类号:
R777.3
DOI:
10.13389/j.cnki.rao.2017.0192
文献标志码:
A
摘要:
目的　检测和观察结膜松弛症患者泪膜稳定性、杯状细胞变化及黏蛋白5AC的表达情况，探讨结膜松弛症的发病机制。方法　收集在我院就诊的结膜松弛症患者30例（30眼）为结膜松弛症组，另选取单纯老年性白内障手术患者15例（15眼）为正常对照组，对所有入选者进行眼部症状评价［国际眼表面疾病指数(ocular surface disease index，OSDI)积分法］、泪膜破裂时间检测、Schirmer I试验、泪液羊齿状结晶试验，分别对结膜松弛症组和正常对照组的结膜组织标本行HE染色、AB染色、黏蛋白5AC免疫组织化学染色观察，行统计学分析。结果　结膜松弛症组OSDI评分为(37.80±8.94)，高于正常对照组(11.40±4.08)(P<0.01)。结膜松弛症组泪膜破裂时间为(6.70±2.76)s，低于正常对照组(13.67±3.48)s(P<0.01)。Schirmer Ⅰ试验结膜松弛症组为(6.23±3.13)mm，明显低于正常对照组(13.40±3.74)mm (P<0.01)。结膜松弛症组患者泪液中羊齿状结晶较正常对照组明显减少（χ2=14.309，P=0.003）。光镜下结膜松弛症组较正常对照组球结膜厚度变薄，胶原纤维少，弹力纤维缺失，固有层间质淤血水肿，杯状细胞减少，黏蛋白5AC染色阳性细胞数低于正常对照组(χ2=9.499，P=0.023)。结论　结膜松弛症患者泪膜功能受到影响，杯状细胞减少，泪液中羊齿状结晶减少，黏蛋白5AC含量减少，最终导致球结膜过度松弛，出现眼表泪液学异常。
Abstract:
Objective　To observe the changes of tear film stability,goblet cell and mucin 5AC expression in conjunctivochalasis patients,and explore the mechanism of conjunctivochalasis.Methods　Conjunctivochalasis patients (30 cases) and single age-related cataract patients (15 cases) were collected as conjunctivochalasis group and normal control group.Eye symptom assessment (OSDI score),tear break-up time(BUT),Schirmer Ⅰ test,tear fern crystallization tests were performed for all the selected persons.Conjunctival rescent-shaped resections were made for all the conjunctivochalasis patients.Conjunctival tissue samples were stained by HE staining,AB staining,mucin 5AC immunohistochemical staining from the conjunctivochalasis group and normal control group respectively,and then statistical analysis was made.Results　The OSDI score in the conjunctivochalasis group (37.80±8.94) was significantly higher than that in the normal control group (11.40±4.08) (P<0.01).BUT in the conjunctivochalasis group (6.70±2.76)s was significantly lower than that in the normal control group (13.67±3.48)s (P<0.01).Schirmer Ⅰ test in the conjunctivochalasis group (6.23±3.13)mm was significantly lower than the normal control group (13.40±3.74)mm (P<0.01).Tear ferning crystallization of the conjunctivochalasis group was decreased significantly compared with the normal control group (χ2=14.309,P=0.003).Light microscopic showed that conjunctival thickness was thinned,collagen fibers were less,elastic fiber was reduced,the lamina propria and interstitial were congestion and edema,the number of goblet cells was significantly reduced,and the positive staining of mucin 5AC staining was significantly lower in the conjunctivochalasis group than in normal control group (χ2=9.499，P=0.023).Conclusion　For patients with conjunctivochalasis,the tear film function is affected,goblet cells are decreased,tear fern crystallization is decreased,mucin 5AC content is decreased,which finally leads the excessive conjunctival relaxation and abnormal ocular surface and tear.

参考文献/References:

［1］　张兴儒，李青松，项敏泓.结膜松弛症的诊断与治疗［J］.中华眼科杂志,2010,46(1):88-91.
ZHANG XR,LI QS,XIANG MH.Diagnosis and treatment of conjunctivochalasis［J］.Chin J Ophthalmol,2010,46(1):88-91.
［2］　ZHANG XR,ZOU HD,LI QS,ZHOU HM,LIU B,HAN ZM,et al.Comparison study of two diagnostic and grading systems for conjunctivochalasis［J］.Chin Med J,2013,126(16)：3118-3123.
［3］　ZHAO H,JUMBLATT JE,WOOD TO,JUMBLATT MM.Quantification of MUC5 AC protein in human tear［J］.Cornea,2001,20(8):873-877.
［4］　WARD SK,WAKAMATSU TH,DOGRU M,IBRAHIM OM,KAIDO M,OGAWA Y,et al.The role of oxidative stress and inflammation in conjunctivochalasis［J］.Invest Ophthalmol Vis Sci,2010,51(4):1994-2002.
［5］　OZEURA F，AYITIN S，HELVAEI MR.Ocular surface disease index for the diagnosis of dry eye syndrome［J］.Ocul Immunol Inflamm,2007,15(5):389-393.
［6］　李青松，张兴儒，邹海东，彭金娟，史才财，周欢明，等.上海市曹杨新村街道60岁以上人群结膜松弛症流行病学调查［J］.中华眼科杂志，2009，45(9)：793-798.
LI QS,ZHANG XR,ZOU HD,PENG JJ,SHI CC,ZHOU HM,et al.Epidemiologic study of conjunctivochaiasis in populations equal or over 60 years old in Caoyangxincun community of Shanghai，China［J］.Chin J Ophthalmol,2009,45(9):793-798.
［7］　项敏泓，张兴儒，李青松，蔡瑞霞，饶娅敏.结膜松弛症泪液功能改变的观察［J］.中华眼科杂志，2009，45（6）：556-557.
XIANG MH,ZHANG XR,LI QS,CAI RX,RAO YM.The observation of tear functional changes of conjunctivochalasis［J］.Chin J Ophthalmol,2009,45(6):556-557.
［8］　张兴儒，梁丽琼，吴在丽，柯发勇.结膜松弛症致溢泪临床疗效观察［J］.中华眼科杂志，1999，35(1):57.
ZHANG XR,LIANG LQ,WU ZL,KE FY.The clinical observation of conjunctivochalasis due to epiphora［J］.Chin J Ophthalmol,1999,35(1):57.
［9］　MIMURA T,YAMAGAMI S,UANI T,FUNATSU H,MIMURA Y,NOMA H,et al.Changes of conjunctivochalasis with age in a hospital based study［J］.Am J Ophthalmol,2009,147(1):171-l77.
［10］　ZHANG X,LI Q,ZOU H,PENG J,SHI C,ZHOU H,et al.Assessing the severity of conjunctivochalasis in a senile population:a community-based epidemiology study in Shanghai,China［J］.BMC Public Health,2011,11（1）:1-6.
［11］　傅东红，谢田华，朱靖，殷丽，禹倩倩，孙尉，等.无锡市滨湖区50岁及以上人群结膜松弛症流行病学调查［J］.中华实验眼科杂志，2014，32(9):838-843.
FU DH,XIE TH,ZHU J,YIN L,YU QQ,SUN W,et al.Epidemiologic study of conjunctivochalasis in population 50 years old or more in Binhu district of Wuxi city,China［J］.Chin J Exp Ophthalmol,2014,32(9):838-843.
［12］　GIPSON IK.Distribution of mucin at the ocular surface［J］.Exp Eye Res,2004,78（3）:379-388.
［13］　ZHANG XR,LI QS,XIANG MH,CAI RX,YU Z.Analysis of tear mucin and goblet cells in patients with conjunctivochalasis［J］.Spektrum Der Augenheilkd,2010,24(4):206-213.
［14］　ZHAO H,JUMBLATT JE,WOOD TO,JUMBLATT MM.Quantification of MUC5AC protein in human tears［J］.Cornea,2001,20(8):873-877.
［15］　王晓春，杨家千，张前卫，贾延磊.结膜松弛症眼表和泪液的改变［J］.中国眼耳鼻喉科杂志，2010,10(2):87-89.
WANG XC,YANG JQ,ZHANG QW,JIA YL.The changes of ocular surface and tear in patients with conjunctivochalasis［J］.Chin J Ophthalmol Otorhinolar,2010,10(2):87-89.
［16］　PISELLA PJ,BRIGNOLE F,DEBBASCH C,LOZATO PA,CREUZOT-GARCHER C,BARA J,et al.Flow cytometric analysis of conjunctival epithelium in ocular rosacea and keratoconjunctivitis sicca［J］.Ophthalmology,2000,107(10):1841-1849.
［17］　ARGESO P,BALARAM M,SPURR-MICHAUD S,KEUTMANN HT,DANA MR,GIPSON IK.Decreased levels of the goblet cell mucin MUC5AC in tears of patients with Sjgren syndrome［J］.Invest Ophthalmol Vis Sci,2002,43(4):1004-1011.
［18］　ZHANG J,YAN X,LI H.Analysis of the correlations of mucins,inflammatory markers and clinical tests in dry eye［J］.Cornea，2013，32(7)：928-932.
［19］　ERDOGAN-POYRAZ C,MOCAN MC,BOZKURT B,GARIBOGLU S,IRKEC M,ORHAN M.Elevated tear interleukin-6 and interleukin-8 levels in patients with conjunctivochalasis［J］.Cornea,2009,28(2):189-193.
［20］　FODOR E,KOSINA-HAGY K,BAUSZ M,NMETH J.Increased tear osmolarity in patients with severe cases of conjunctivochalasis［J］.Curr Eye Res,2012,37(1):80-84.
［21］　IMBERT Y,JUMBLATT MM,FOULKS GN,COUZIN EG,STEELE PS,YOUNG WW JR.Expression in human ocular surface tissues of the GalNAc transferases that initiate mucin-type O-glycosylation［J］.Cornea，2006，25(10)：1193-1199.

相似文献/References:

[1]项敏泓 饶娅敏 李青松 张兴儒 周欢明 韩竹梅 符之瑄.精杞明目汤治疗结膜松弛症的泪液功能改变[J].眼科新进展,2012,32(8):000.
[2]贾元玲,项敏泓,文杭,等.杞精明目汤颗粒剂对肿瘤坏死因子-α刺激下结膜松弛症成纤维细胞MAPK信号通路的影响[J].眼科新进展,2018,38(4):319.[doi:10.13389/j.cnki.rao.2018.0075]
　JIA Yuan-Ling,XIANG Min-Hong,WEN Hang,et al.Effect of Qijingmingmu decoction granule on MAPK signal pathway in fibroblasts of conjunctivochalasis stimulated by TNF-α[J].Recent Advances in Ophthalmology,2018,38(8):319.[doi:10.13389/j.cnki.rao.2018.0075]

备注/Memo

备注/Memo:
上海市卫生及计划生育委员会资助项目(编号：20124108)；上海市普陀区自主创新科研基金（编号：2013PTKW009）;上海中医药大学预算内项目（编号：2015YSN50）
更新日期/Last Update: 2017-08-14