颌下腺移植治疗重症干眼远期泪液生化分析  

Long-term biochemical analysis of salivary tears after submandibular gland transplantation for severe dry eye

作　　者：王海璐[1] 接英[1] 邹留河[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科学与视觉科学重点实验室,100730

出　　处：《眼科》2010年第3期161-165,共5页Ophthalmology in China

基　　金：科技部国家"十一五"科技支撑计划资助项目(2007BAI18B11)

摘　　要：目的了解自体颌下腺移植治疗重症干眼术后远期的唾液泪液成分特点,分析唾液泪液成分对角膜移植成败的影响。设计病例系列研究。研究对象19例因干眼行颌下腺移植手术成功患者。方法收集颌下腺移植手术成功患者的唾液泪液,其中7例在颌下腺移植后接受了板层角膜移植,采用实验室常规检测方法对19例样本进行生化检测。检测项目包括免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、钠(Na)、钾(K)、葡萄糖(Glu)、血尿素氮(BUN)、淀粉酶(Amy)、溶菌酶(Lz)及酸碱度(pH)。19例样本按采集泪液距颌下腺移植术后时间3年为界,分为术后近期及远期两组,比较颌下腺移植术后近期及远期唾液泪液的成分。7例颌下腺移植并角膜移植患者中2例成功,5例失败,比较两者唾液泪液的成分。主要指标唾液泪液的成分及含量。结果所有检测项目在自体颌下腺移植术后的唾液泪液中均能检出,与正常泪液相比,唾液泪液的钠、溶菌酶含量低,钾、葡萄糖、淀粉酶含量高,免疫球蛋白含量及酸碱度与正常泪液相近。颌下腺移植术后近期及远期唾液泪液成分比较差异无统计学意义(P>0.05)。所有测定的泪液成分在角膜移植成功与失败病例中比较差异均无统计学意义(P>0.05)。结论自体颌下腺移植治疗重症干眼术后远期唾液泪液成分稳定,唾液泪液与正常泪液的成分存在一定差异,这种差异对角膜移植手术成败无明显影响。Objective To characterize the composition of salivary-tears after transplantation of the autologous submandibular gland （SMG） for patients with severe dry eye. To investigate the effects of salivary-tears on keratoplasty. Design Cases series. Partici- pants Nineteen patients with transplantation of the autologous SMG for severe dry eye. Methods Salivary-tears from 19 patients （7 of them underwent lamellar keratoplasty after SMG transplantation） with a viable SMG were sampled. The analysis included immunoglobu- lin G（IgG）, immunoglobulin A （IgA）, immunoglobulin M （IgM）, sodium, potassium, glucose, blood urea nitrogen, amylase, lysozyme and hydrogen ion concentration （pH）. 19 samples were divided into two groups, according to the time, whether it was more than 3 years be- tween salivary-tear collection and SMG transplantation. Seven patients who had accepted both SMG transplantation and lamellar ker- atoplasty were divided into two groups, according to the corneal graft survival. Main Outcom Measures The composition and quantity of salivary-tears. Results All items could be detected in the salivary-tears. After transplantation, sodium and lysozyme were lower, potassium, glucose and amylase were higher, immunoglobulin and power of hydrogen were similar, as compared with normal tears. The difference of salivary-tears between near and long term group was not significant. So was the samples after lamellar keratoplasty. Con- clusion Long-term salivary-tears＇ composition after SMG transplantation for patients with severe dry eye is stable. The composition of salivary-tears differs from normal tears to a certain extent. The effects of salivary-tears on keratoplasty are not significant.

关 键 词：干眼 颌下腺移植 泪液 板层角膜移植 

分 类 号：R777[医药卫生—眼科]