全身化疗对实体恶性肿瘤患者眼表的影响  

Changes to Malignant Tumor Patient's Ocular Surface before and after Initial Chemotherapy

作　　者：潘旭斌[1] 张晓峰[1] 孙正太[1] 周丹虹[2] 张雪彤[2] 

机构地区：[1]苏州大学附属第一医院,江苏苏州215001 [2]苏州大学附属第四医院,江苏无锡214062

出　　处：《现代生物医学进展》2013年第6期1090-1092,1145,共4页Progress in Modern Biomedicine

摘　　要：目的:研究初次全身化疗对恶性实体肿瘤患者眼表状态的影响。方法:选取首次化疗的恶性实体肿瘤的患者60例,年龄在50-75岁之间,在化疗前及化疗结束后1周分别进行眼表评估。检查内容包括:干眼相关症状问卷调查,泪膜破裂时间、基础泪液分泌试验、角膜荧光素染色、泪液羊齿状结晶、结膜丽丝胺绿染色、结膜印迹细胞学检查。结果:1)问卷调查提示全身化疗后,患者眼部出现视力波动、干涩、眼部不适等症状是最常见的;2)患者全身化疗后,眼表出现泪膜破裂时间缩短,基础泪液分泌量减少,结膜杯状细胞减少,角膜荧光素染色与结膜丽丝胺绿染色评分增加,泪液羊齿状结晶评级下降(P<0.05)。结论:全身化疗可对恶性肿瘤患者的眼表产生影响,能导致干眼病的发生和发展,因此在化疗的同时要关注患者眼表的健康,及时予以干预,提高患者的生存质量。Objective： To investigate the changes of the ocular surface of patients with malignant tumors before and after initial chemotherapy. Methods： Sixty patients were diagnosed of malignant tumors. The status of their ocular surface was evaluated in an obser-vational case series, with the help of dry eye questionnaire （DEQ）, breakup time （BUT）, Schirmer I test （Sit）, fluorescein staining （FL）, tear ferning test （TFT）, lissamine green staining （LG）, impression cytology of conjunctiva （IC）, one week before and after initial chemotherapy. Results： 1）After initial chemotherapy, most common symptoms after initial chemotherapy were vision blur, dryness and discomfort. 2）BUT and Sit were shorter, scores of FL and LG were increased, grades of TFT were lower and conjunctival goblet cells were less （all P〈0.05）. Conclusions： Chemotherapy could impose toxic or side effects on the ocular surface of patients with malignant tu-mors, which might lead to dry eye or worsen the progression of dry eye. Attention should be paid to the health of ocular surface during chemotherapy, in order to strengthen the quality of life of patients with malignant tumors.

关 键 词：眼表 结膜杯状细胞 恶性肿瘤 化疗 

分 类 号：R730.53[医药卫生—肿瘤]