准分子激光原位角膜磨镶术前后泪液中转化生长因子α（TGF-α）的表达

发布时间：2018-08-03 09:59

【摘要】： 目的：角膜创伤是临床上极为常见的眼外伤,无论是医源性或是外伤性,完善的角膜创伤修复对于维持正常的视功能和屈光手术的矫正效果具有重要影响。准分子激光原位角膜磨镶术(LASIK)因其矫治范围广、可预测性好、安全性及稳定性强的优势,成为目前世界范围内矫正各种屈光不正的理想方法。LASIK手术效果受多种因素的影响,角膜愈合反应的个体差异是重要因素之一。LASIK术后角膜伤口愈合是一复杂过程,近年来发现泪液中具有多种细胞因子,尽管含量很低,但在维持眼表正常功能、损伤修复中发挥重要作用。LASIK术后角膜伤口愈合是由多种细胞及细胞因子在时间与空间的高度协调作用下完成的。深入的研究与理解LASIK术后角膜愈合反应的调控机制,对于获得LASIK术后更好的临床效果有重大意义。本试验通过收集2009年6-10月在我院行LASIK手术患者术前术后的泪液,通过采用双抗体夹心酶联免疫吸附分析法检测泪液中转化生长因子α(TGF-α)的浓度,寻求TGF-α在LASIK手术前后泪液中的的变化规律,以探讨其在LASIK术前术后泪液中浓度变化及其对角膜愈合的作用。方法：LASIK术前及术后1天、3天、7天及15天在患者眼结膜囊内抽取泪液标本,采用双抗体夹心酶联免疫吸附法检测30名(60眼,男性13例26眼,女性17例34眼)18-33岁患者泪液中TGF-α含量,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：在LASIK术前及术后半个月随访期间,术前TGF-α平均含量为(175.19±61.22)pg/ml,术后1天,3天,7天含量分别为(606.01.±128.69)pg/ml,(439.38±90.57)pg/ml,(243.27±75.51)pg/ml,与术前比较TGF-α在泪液中的浓度差异有显著统计学意义(P0.05),术后15天TGF-α平均含量为(191.63±20.51)pg/ml,与术前比较TGF-α在泪液中的浓度差异无显著统计学意义(P0.05)。结论：LASIK术后泪液中TGF-α的含量存在一个由增高到恢复术前水平的动态变化过程,这一结果提示LASIK术后TGF-α可促进角膜细胞增殖、分裂、趋化及移行等一系列生物学过程,从而有利于伤口愈合,为获得LASIK术后更好的临床效果提供理论依据。
[Abstract]:Objective: corneal trauma is a common ocular trauma in clinic. Whether iatrogenic or traumatic, perfect corneal wound repair has an important effect on maintaining normal visual function and correcting effect of refractive surgery. Excimer laser in situ keratomileusis (LASIK) is an ideal method for correction of various refractive errors in the world because of its wide range of correction, good predictability, safety and stability. The effect of laser in situ keratomileusis is affected by many factors. The individual difference of corneal healing response is one of the important factors. Corneal wound healing after LASIK is a complicated process. In recent years, it has been found that there are many cytokines in the tear, although the content is very low, it maintains the normal function of the eye surface. Corneal wound healing after LASIK is accomplished by a variety of cells and cytokines in high coordination of time and space. It is of great significance to study and understand the mechanism of corneal healing response after LASIK. In this study, tear samples were collected from patients undergoing LASIK operation in our hospital from June to October 2009. The concentrations of transforming growth factor 伪 (TGF- 伪) in tears were detected by double antibody sandwich enzyme-linked immunosorbent assay (Elisa). To explore the changes of TGF- 伪 in tear before and after LASIK operation, and to explore the effect of TGF- 伪 on corneal healing after LASIK. Methods tear samples were collected from conjunctival sac of 30 patients (60 eyes, 13 cases, 26 eyes) by double antibody sandwich enzyme-linked immunosorbent assay (Elisa). The content of TGF- 伪 in tear of 17 cases (34 eyes) of female patients aged 18 to 33 years was analyzed. The mean concentration of cytokines in tear at different time was analyzed. Results: during the follow-up period of half a month before and after LASIK, The mean level of TGF- 伪 was (175.19 卤61.22) PG / ml before operation, (606.01 卤128.69) PG / ml, (439.38 卤90.57) PG / ml, (243.27 卤75.51) PG / ml on day 1 and day 3 after operation, respectively. There was significant difference in the concentration of TGF- 伪 in tear between before and after operation (P0.05), and the mean content of TGF- 伪 in tear was (191.63 卤20.51) pgml. the concentration of TGF- 伪 in tear was (191.63 卤20.51) pgml-1 / ml on the 15th day after operation, compared with that before operation (439.38 卤90.57) PG / ml, (243.27 卤75.51) PG / ml respectively (P0.05). There was no significant difference in degree (P0.05). Conclusion there is a dynamic change process of TGF- 伪 content in tears after LASIK. The results suggest that TGF- 伪 can promote corneal cell proliferation, division, chemotaxis and migration after LASIK. It is beneficial to wound healing and provides theoretical basis for obtaining better clinical effect 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】：2010
【分类号】：R779.63

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