乌鲁木齐市干眼患者眼表CXCR3及CXCL10的表达及干预的研究

发布时间：2019-04-09 16:50

【摘要】：目的:通过检测在不同干预措施下眼表CXCR3及CXCL10的表达水平,分析眼表趋化因子及其受体表达的特征与干眼临床特点的相关性,为提出预防和治疗干眼提供科学依据。方法:评估正常人及干眼患者不同方法(单纯玻璃酸钠治疗和玻璃酸钠联合普拉洛芬治疗)治疗前后的标准干眼症状评估(SPEED)问卷评分调查结果,了解泪膜破裂时间(BUT),泪液分泌功能(SchirmerI试验)及角膜荧光染色(FLS评分)情况;用Elisa方法检测泪液中TNF-α及CXCL10的含量;流式细胞术检测外周血中T淋巴细胞亚群、结膜上皮细胞中T淋巴细胞浸润情况及CCR5、CXCR3的表达水平。对结果进行比较。结果:干眼患者用药前症状评分及角膜荧光染色评、泪膜破裂时间及泪液分泌功能差异均有统计学意义(p0.05)。干眼患者外周血中T淋巴细胞亚群与正常人无显著差异(p0.05),泪液中TNF-α的含量及结膜上皮细胞中CD3+比例、CXCR3及CCR5显著高于正常人(p0.05),泪液中CXCL10高于正常人,但差异无统计学意义(p0.05);玻璃酸钠单独用药后干眼患者TNF-α及CXCL10含量均低于治疗前,CD3+、CXCR3及CCR5较治疗前降低,但差异无明显统计学意义(p0.05);普拉洛芬与玻璃酸钠联合用药后干眼患者TNF-α、结膜上皮细胞中CD3+、CXCR3及CCR5含量均显著低于用药前(p0.05),用药后泪液中CXCL10虽低于用药前,但差异无统计学意义(p0.05);联合用药1个月后CXCR3、CCR5、CD3+及TNF-α表达水平与BUT呈负相关(p0.05),与角膜荧光染色评分及SPEED评分均呈正相关(p0.05)。结论:干眼是一种局部炎性疾病,普拉洛芬联合玻璃酸钠可有效缓解干眼患者症状及体征,其作用机制可能与降低眼表炎性因子及趋化因子水平有关。
[Abstract]:Aim: to detect the expression of CXCR3 and CXCL10 in ocular surface under different intervention measures, and to analyze the correlation between the expression characteristics of chemokine and its receptor and clinical characteristics of dry eye, so as to provide scientific basis for prevention and treatment of dry eye. Methods: to evaluate the standard dry eye symptoms before and after treatment with sodium hyaluronate and sodium hyaluronate combined with Praprofen in normal subjects and dry eyes before and after treatment, and to evaluate the time of lacrimal film rupture (BUT),) by (SPEED) questionnaire. Lacrimal secretion function (SchirmerI test) and corneal fluorescent staining (FLS score); The contents of TNF- 伪 and CXCL10 in lacrimal fluid were measured by Elisa, and T lymphocyte subsets in peripheral blood, T lymphocyte infiltration in conjunctival epithelial cells and expression of CCR5,CXCR3 in peripheral blood were detected by flow cytometry. Compare the results. Results: there were significant differences in symptom score, corneal fluorescent staining, lacrimal film rupture time and lacrimal secretion function in dry eyes before treatment (p0.05). There was no significant difference in peripheral blood T lymphocyte subsets between dry eyes and normal subjects (p0.05). The content of TNF- 伪 in tear fluid and the proportion of CD3 in conjunctival epithelial cells were significantly higher than those in normal controls (p0.05). The levels of CXCR3 and CCR5 in tears were significantly higher than those in normal subjects (p0.05), and the CXCL10 in tear fluid was higher than that in normal persons. But there was no significant difference (p0.05). After treatment with sodium hyaluronate alone, the contents of TNF- 伪 and CXCL10 in dry eyes were lower than those before treatment, while the levels of CD3, CXCR3 and CCR5 were lower than those before treatment, but there was no significant difference (p0.05). The contents of TNF- 伪, CD3, CXCR3 and CCR5 in conjunctival epithelial cells of dry eye patients treated with Praprofen and sodium hyaluronate were significantly lower than those before treatment (p0.05), and the CXCL10 in tear fluid after treatment was lower than that before administration. But there was no significant difference (p0.05). There was a negative correlation between the expression of CXCR3,CCR5,CD3 and TNF- 伪 and BUT (p0.05), and a positive correlation with corneal fluorescent staining score and SPEED score (p0.05). Conclusion: dry eye is a local inflammatory disease. Praprofen combined with sodium hyaluronate can effectively relieve the symptoms and signs of dry eyes, and its mechanism may be related to the reduction of inflammatory and chemokine levels on the surface of the eyes.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R777.34

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