结膜松弛症的发病机理研究  

Pathogenesis of conjunctivochalasis

作　　者：张兴儒[1] 项敏泓[1] 李青松[1] 许琰[1] 

机构地区：[1]上海中医药大学附属普陀医院眼科,中国上海市200062

出　　处：《国际眼科杂志》2008年第5期1001-1005,共5页International Eye Science

基　　金：中国上海市高等学校科学技术发展基金资助项目(No05CZ14)~~

摘　　要：结膜松弛症的发病机理是出现了球结膜、泪液和睑缘三者平衡失调,眼表自动反馈调节系统失灵。球结膜组织发生以弹力纤维减少为主要的组织病理改变,泪液中出现蛋白质及酶的异常表达,在瞬目或闭眼时下睑缘张力增高向上推压已经过度变薄、弹性下降、张力降低、与其下方组织结合疏松的球结膜,松弛结膜就会明显堆积在下睑缘上、内、外眦部之间,形成皱褶,突出于眼表曲面,影响泪液的流动、分布、排泄,在松弛结膜上不能形成正常泪膜,而发生干燥、充血、水肿、上皮角化、泪河变窄或残缺不全,泪液不能正常流动到泪湖区,泪湖不能聚泪,泪液不能进入泪点,使泪液排泄出现障碍,泪液清除延缓又可导致大量降解酶的堆积,可能使胶原纤维溶解,弹力纤维变性,引起眼表泪液学异常的病理循环,而发生结膜松弛症。The mechanism of conjunctivochalasis is imbalance among bulbar conjunctiva, tear and eyelid. The ocular surface automatic feedback regulation system is abnormal. The major histopathological change is decrease of elastic fiber of bulbar conjunctiva tissue. The proteins and enzymes have abnormal expressions in tear. The lower eyelid tension is increased when the eye winkes or closes, which will push the excessively thinning, elasticity descending, tension decreasing and loosely combining bulbar conjunctiva. The slack bulbar conjunctiva is obviously piled on the lower eyelid between the internal and external canthus and forms goffers. The goffers protrude out of the ocular surface, which affects the tear flowing, distributing and drainage. The normal tear film cannot exist on the slack bulbar conjunctiva, which will cause dryness, congestion, edema, epithelial keratinization, tear river narrowing or deformity. The facts that tear is not able to flow normally into the tear lake, tear lake is unable to assemble the tear and tear is not able to flow into the lacrimal puncta cause the obstacle of the lacrimal drainage. The delay of tear elimination will cause lots of degrading enzymes accumulated, which may result in lysis of collagenous fibers, degeneration of elastic fibers and abnormal pathological circulation of tear on ocular surface. All these above may induce conjunctivochalasis.

关 键 词：结膜松弛症 发病机理 文献综述 

分 类 号：R777.3[医药卫生—眼科] R259.952[医药卫生—临床医学]