LASIK术后杯状细胞、黏蛋白MUC5AC的变化及与泪膜变化的关系
发布时间：2019-03-17 19:06
【摘要】： 目的研究准分子激光原位磨镶术(LASIK)负压吸引环对结膜杯状细胞密度(GCD),黏蛋白MUC5AC量的影响以及GCD、MUC5AC和泪膜变化的相关性。为探讨LASIK术后干眼症状发病机制提供可能的依据,为临床上寻找有效的预防和治疗LASIK术后干眼的方法提供参考依据。 方法选30位做LASIK近视矫正术的病人(60只眼),每只眼的球结膜选取两个位点采用印迹细胞学取样。取样时间分别是术前、术后1周、术后1月、术后3月,过碘酸-希夫试剂染色(PAS)后计算GCD。记录负压吸引环吸引时间(ST),观察术前、术后1周、术后1月、术后3月患者的泪膜破裂时间(BUT)、schirmer实验Ⅰ的值、角膜荧光素染色评分(FLU)。检测术前术后泪液总蛋白的量,黏蛋白MUC5AC的吸光度值(OD)。对ST、术后不同时间的BUT、schirmer值、FLU与GCD做相关性分析,对术后不同时间的GCD、BUT、schirmer值、FLU与OD值做相关性分析。 结果ST为10~26 s。术后GCD、BUT、shirmer值、FLU、OD值与术前相比下降,差异有统计学意义(P0.01)。术后泪液总蛋白量与术前相比无统计学差异。术后1周、1月GCD和ST成负相关,术后3月GCD和ST无相关性。术后1周、1月、3月BUT和GCD成正相关。术后1周、1月schirmer值与GCD呈正相关,术后3月的schirmer值与GCD无相关性。术后1周、1月FLU与GCD呈负相关,术后3月FLU与GCD无相关性。术后1周、1月、3月GCD、BUT和OD值成正相关。术后1周schirmer值与OD值成正相关,术后1月、3月schirmer值与OD值无相关性。术后1周、1月、3月FLU与GCD无相关性。术后1周、1月、3月GCD、BUT和OD值成正相关。术后1周schirmer值与OD值成正相关,术后1月、3月schirmer值与OD值无相关性。术后1周、1月、3月FLU与GCD无相关性。 结论术后泪膜稳定性下降。结膜印迹细胞学提示LASIK术后负压吸引环施压处结膜杯状细胞密度降低,下降程度可能与施压时间长短有关。术后黏蛋白MUC5AC的OD值下降。泪膜稳定性的改变可能与杯状细胞的减少,黏蛋白MUC5AC的量下降有关。
[Abstract]:Aim to study the effect of (LASIK) suction ring on the density of conjunctival goblet cells (GCD), mucin MUC5AC and the correlation between GCD,MUC5AC and lacrimal film changes after excimer laser in situ grinding. In order to explore the pathogenesis of dry eye symptoms after LASIK, and to provide a reference for the effective prevention and treatment of LASIK postoperative dry eyes. Methods A total of 30 LASIK myopia correction patients (60 eyes) were selected. Two sites of bulbar conjunctiva were selected from each eye and were sampled by imprinted cytology. The sampling time was pre-operation, 1 week after operation, 1 month after operation, 3 months after operation, and GCD. was calculated after (PAS) staining with periodate-Schiff reagent. The time of lacrimal film rupture before operation, 1 week after operation, 1 month after operation and 3 months after operation was recorded by (ST), and the corneal fluorescein staining score (FLU).) was used to evaluate the time of lacrimal film rupture. The amount of total lacrimal protein and the absorbance value of mucin MUC5AC (OD).) were measured before and after operation. The BUT, Schirmer value, FLU and GCD at different time after ST, were analyzed, and the GCD,BUT, Schirmer value, FLU and OD value at different time after operation were analyzed. The results showed that the ST was 10? 26s. The values of GCD,BUT, shirmer and FLU, OD after operation were significantly lower than those before operation (P0.01). There was no significant difference in the total amount of lacrimal protein between the two groups before and after operation. One week after operation, there was a negative correlation between GCD and ST, but there was no correlation between GCD and ST at 3 months after operation. 1 week, 1 month and 3 months after operation, there was a positive correlation between BUT and GCD. One week after operation, Schirmer value was positively correlated with GCD, but there was no correlation between Schirmer value and GCD at 3 months after operation. One week after operation, there was a negative correlation between FLU and GCD, but there was no correlation between FLU and GCD at 3 months after operation. 1 week, 1 month and 3 months after operation, there was a positive correlation between GCD,BUT and OD. Schirmer value was positively correlated with OD value one week after operation, but there was no correlation between Schirmer value and OD value 1 month and 3 months after operation. 1 week, 1 month and 3 months after operation, there was no correlation between FLU and GCD. 1 week, 1 month and 3 months after operation, there was a positive correlation between GCD,BUT and OD. Schirmer value was positively correlated with OD value one week after operation, but there was no correlation between Schirmer value and OD value 1 month and 3 months after operation. 1 week, 1 month and 3 months after operation, there was no correlation between FLU and GCD. Conclusion the stability of lacrimal film decreased after operation. Conjunctival imprinting cytology showed that the density of conjunctival goblet cells decreased at negative pressure suction ring after LASIK, and the degree of decrease might be related to the duration of pressure. The OD value of mucin MUC5AC decreased after operation. The change of tear film stability may be related to the decrease of goblet cells and the decrease of mucin MUC5AC.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.63
本文编号：2442607
[Abstract]:Aim to study the effect of (LASIK) suction ring on the density of conjunctival goblet cells (GCD), mucin MUC5AC and the correlation between GCD,MUC5AC and lacrimal film changes after excimer laser in situ grinding. In order to explore the pathogenesis of dry eye symptoms after LASIK, and to provide a reference for the effective prevention and treatment of LASIK postoperative dry eyes. Methods A total of 30 LASIK myopia correction patients (60 eyes) were selected. Two sites of bulbar conjunctiva were selected from each eye and were sampled by imprinted cytology. The sampling time was pre-operation, 1 week after operation, 1 month after operation, 3 months after operation, and GCD. was calculated after (PAS) staining with periodate-Schiff reagent. The time of lacrimal film rupture before operation, 1 week after operation, 1 month after operation and 3 months after operation was recorded by (ST), and the corneal fluorescein staining score (FLU).) was used to evaluate the time of lacrimal film rupture. The amount of total lacrimal protein and the absorbance value of mucin MUC5AC (OD).) were measured before and after operation. The BUT, Schirmer value, FLU and GCD at different time after ST, were analyzed, and the GCD,BUT, Schirmer value, FLU and OD value at different time after operation were analyzed. The results showed that the ST was 10? 26s. The values of GCD,BUT, shirmer and FLU, OD after operation were significantly lower than those before operation (P0.01). There was no significant difference in the total amount of lacrimal protein between the two groups before and after operation. One week after operation, there was a negative correlation between GCD and ST, but there was no correlation between GCD and ST at 3 months after operation. 1 week, 1 month and 3 months after operation, there was a positive correlation between BUT and GCD. One week after operation, Schirmer value was positively correlated with GCD, but there was no correlation between Schirmer value and GCD at 3 months after operation. One week after operation, there was a negative correlation between FLU and GCD, but there was no correlation between FLU and GCD at 3 months after operation. 1 week, 1 month and 3 months after operation, there was a positive correlation between GCD,BUT and OD. Schirmer value was positively correlated with OD value one week after operation, but there was no correlation between Schirmer value and OD value 1 month and 3 months after operation. 1 week, 1 month and 3 months after operation, there was no correlation between FLU and GCD. 1 week, 1 month and 3 months after operation, there was a positive correlation between GCD,BUT and OD. Schirmer value was positively correlated with OD value one week after operation, but there was no correlation between Schirmer value and OD value 1 month and 3 months after operation. 1 week, 1 month and 3 months after operation, there was no correlation between FLU and GCD. Conclusion the stability of lacrimal film decreased after operation. Conjunctival imprinting cytology showed that the density of conjunctival goblet cells decreased at negative pressure suction ring after LASIK, and the degree of decrease might be related to the duration of pressure. The OD value of mucin MUC5AC decreased after operation. The change of tear film stability may be related to the decrease of goblet cells and the decrease of mucin MUC5AC.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.63
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相关期刊论文 前2条
1 刘祖国;彭娟;;干眼的诊断与治疗规范[J];眼科研究;2008年03期
2 杨斌,陈家祺,王铮;准分子激光屈光性角膜手术后角膜知觉的改变[J];中华眼科杂志;1998年01期
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