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

发布时间：2019-07-23 05:41

【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)(P0.01)。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(P0.01)。SchirmerⅠ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(P0.01)。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 detect and observe the stability of tear film, the changes of goblet cells and the expression of mucin 5AC in patients with conjunctival relaxation, and to explore the pathogenesis of conjunctival relaxation. Methods 30 patients (30 eyes) with conjunctival relaxation in our hospital were collected as conjunctival relaxation group, and 15 patients (15 eyes) with simple age-related cataract surgery were selected as normal control group. All the selected patients were evaluated by international eye surface disease index (ocular surface disease index,OSDI) integral method, tear film rupture time was measured by, Schirmer I test, lacrimal goat tooth crystallization test. The conjunctival tissue specimens of conjunctival relaxation group and normal control group were observed by HE staining, AB staining and mucin 5AC immunohistochemical staining, and statistical analysis was performed. Results the OSDI score of conjunctival relaxation group was (37.80 卤8.94), which was higher than that of normal control group (11.40 卤4.08) (P 0.01). The rupture time of tear film in conjunctival relaxation group was (6.70 卤2.76) s, which was lower than that in normal control group (13.67 卤3.48) s (/ P 0.01). The mm, in Schirmer I test conjunctival relaxation group was (6.23 卤3.13) mm, significantly lower than that in normal control group (13.40 卤3.74) mm (/ P 0.01). The dentate crystallization in tears of conjunctival relaxation group was significantly lower than that of normal control group (蠂 ~ 2 鈮，

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