LASIK手术前后泪液中肝细胞生长因子含量的变化
发布时间：2018-08-16 07:26
【摘要】：目的：激光角膜切削术在全世界已有三十余年的发展历程，准分子激光原位角膜磨镶术(LASIK)在我国也有近二十年的发展，LASIK手术由于手术时间短、恢复时间快、术后疼痛轻、术后反应少、术后安全及稳定性强等优点，在眼科医师中被公认为矫正各种屈光不正理想的，在临床工作中应用前景最广的一种手术。而LASIK手术后角膜创伤愈合反应机制是研究预测术后临床效果的重要环节。角膜创伤修复是一个极其复杂而又高度协调的过程，此过程基本上可以分为局部的炎症反应、细胞的增殖分化和组织的修复重建三个互不相同而又相互交错的阶段。在这一过程中涉及了多种生长因子和细胞因子之间的相互作用及相互影响，它们共同参与调控细胞的迁移、增生、分化、基质沉积以及组织塑形等多个反应。各种细胞因子与生长因子的作用贯穿了整个角膜的创伤愈合的全过程形成一个有机的网络体系。深入探讨了解各种细胞因子和生长因子在LASIK术后角膜伤口愈合中的作用，对于理解LASIK术后角膜伤口愈合反应的调控机制，获得LASIK术后更好的临床预后效果具有重大的指导意义。 本试验通过对LASIK手术前后泪液中与角膜关系密切的肝细胞生长因子（HGF）含量的定量分析，，探讨肝细胞生长因子在LASIK手术前后患者泪液中短期内浓度变化规律及它在LASIK术后角膜伤口愈合中的作用。 方法：随机收集2011年4月至2011年7月于我院行LASIK手术患者30人60眼(男：女比例1：1)的泪液标本，用双抗体夹心酶联免疫吸附法（ELISA法）检测LASIK术前、术后1天、3天、1周、2周、1个月患者泪液标本中HGF表达量的变化，用统计学方法对不同时间泪液中细胞因子平均浓度进行相关性分析。 结果：所有患者60只眼在LASIK手术术前至术后1个月的随访期间，术后1天（775.42±96.96）pg/ml、3天（612.38±80.72）pg/ml、1周（390.25±121.68）pg/ml、2周（253.52±45.69）pg/ml泪液中的HGF表达量均较术前HGF表达量（199.12±25.46）pg/ml明显提高(P0．05），特别是术后1天和3天较术前提高显著（P0．01）。但术后1个月（200.75±31.46）pg/ml与术前比较无统计学差异(P0．05）。 结论：LASIK术后泪液中HGF含量存在着一个由升高到降至术前水平的短期动态变化过程，这一结果提示在LASIK术后泪液中由泪腺和角膜成纤维细胞分泌的HGF含量增加，可能发挥了对角膜损伤反应中的上调作用，促进细胞分裂增殖及迁移等生物学效应作用，参与了LASIK术后角膜伤口愈合的早期过程。
[Abstract]:Objective: laser keratectomy has been developed for more than 30 years in the world. Excimer laser in situ keratomileusis (LASIK) has been developed in China for nearly 20 years. It has the advantages of less reaction, better safety and stability after operation. It is recognized as the most widely used surgery in clinical work for the correction of all kinds of ametropia among ophthalmologists. The mechanism of corneal wound healing after LASIK is an important link in predicting the clinical effect. Corneal wound repair is an extremely complex and highly coordinated process, which can be divided into three stages: local inflammatory response, cell proliferation and differentiation, and tissue repair and reconstruction. The interaction and interaction of various growth factors and cytokines are involved in this process, and they are involved in the regulation of cell migration, proliferation, differentiation, matrix deposition and tissue remodeling. The effects of cytokines and growth factors throughout the corneal wound healing process form an organic network system. To understand the role of cytokines and growth factors in corneal wound healing after LASIK is of great significance in understanding the mechanism of corneal wound healing response after LASIK and obtaining a better clinical prognosis after LASIK. The content of hepatocyte growth factor (HGF), which is closely related to cornea, was determined by quantitative analysis before and after LASIK operation. Objective: to investigate the changes of hepatocyte growth factor (HGF) concentration in tear before and after LASIK operation and its role in corneal wound healing after LASIK. Methods: from April 2011 to July 2011, 60 eyes (60 eyes) of 30 patients undergoing LASIK operation in our hospital were randomly collected. Double antibody sandwich enzyme linked immunosorbent assay (ELISA) was used to detect LASIK before operation. The changes of HGF expression in tear samples were analyzed by statistical method. The mean concentrations of cytokines in tears at different times were analyzed by statistical method. Results: 60 eyes of all patients were followed up for 1 month after LASIK operation. The expression of HGF in tears of (775.42 卤96.96) PG / ml (612.38 卤80.72) PG / ml for 1 week (390.25 卤121.68) PG / ml for 2 weeks (253.52 卤45.69) pg/ml was significantly higher than that for preoperative (199.12 卤25.46) pg/ml (P0.05), especially on the 1st and 3rd day after operation (P0.01). But 1 month after operation (200.75 卤31.46) pg/ml had no statistical difference compared with preoperative (P0.05). Conclusion there is a short period of dynamic change of HGF content in tear after W1 LASIK, which indicates that the content of HGF secreted by lacrimal gland and corneal fibroblasts in tear after LASIK is increased. It may play a role in the up-regulation of corneal injury response, promote cell division, proliferation and migration, and participate in the early process of corneal wound healing after LASIK.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R779.63
本文编号：2185235
[Abstract]:Objective: laser keratectomy has been developed for more than 30 years in the world. Excimer laser in situ keratomileusis (LASIK) has been developed in China for nearly 20 years. It has the advantages of less reaction, better safety and stability after operation. It is recognized as the most widely used surgery in clinical work for the correction of all kinds of ametropia among ophthalmologists. The mechanism of corneal wound healing after LASIK is an important link in predicting the clinical effect. Corneal wound repair is an extremely complex and highly coordinated process, which can be divided into three stages: local inflammatory response, cell proliferation and differentiation, and tissue repair and reconstruction. The interaction and interaction of various growth factors and cytokines are involved in this process, and they are involved in the regulation of cell migration, proliferation, differentiation, matrix deposition and tissue remodeling. The effects of cytokines and growth factors throughout the corneal wound healing process form an organic network system. To understand the role of cytokines and growth factors in corneal wound healing after LASIK is of great significance in understanding the mechanism of corneal wound healing response after LASIK and obtaining a better clinical prognosis after LASIK. The content of hepatocyte growth factor (HGF), which is closely related to cornea, was determined by quantitative analysis before and after LASIK operation. Objective: to investigate the changes of hepatocyte growth factor (HGF) concentration in tear before and after LASIK operation and its role in corneal wound healing after LASIK. Methods: from April 2011 to July 2011, 60 eyes (60 eyes) of 30 patients undergoing LASIK operation in our hospital were randomly collected. Double antibody sandwich enzyme linked immunosorbent assay (ELISA) was used to detect LASIK before operation. The changes of HGF expression in tear samples were analyzed by statistical method. The mean concentrations of cytokines in tears at different times were analyzed by statistical method. Results: 60 eyes of all patients were followed up for 1 month after LASIK operation. The expression of HGF in tears of (775.42 卤96.96) PG / ml (612.38 卤80.72) PG / ml for 1 week (390.25 卤121.68) PG / ml for 2 weeks (253.52 卤45.69) pg/ml was significantly higher than that for preoperative (199.12 卤25.46) pg/ml (P0.05), especially on the 1st and 3rd day after operation (P0.01). But 1 month after operation (200.75 卤31.46) pg/ml had no statistical difference compared with preoperative (P0.05). Conclusion there is a short period of dynamic change of HGF content in tear after W1 LASIK, which indicates that the content of HGF secreted by lacrimal gland and corneal fibroblasts in tear after LASIK is increased. It may play a role in the up-regulation of corneal injury response, promote cell division, proliferation and migration, and participate in the early process of corneal wound healing after LASIK.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R779.63
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