翼状胬肉术后复发的临床危险因素分析  

Analysis of the risk factors for post operative relapse following pterygium excision

作　　者：郑兰育 Zheng Lanyu(Department of Ophthalmology, the Second Hospital of Wuxi, Wuxi 214000, China)

机构地区：[1]无锡第二人民医院眼科,江苏省214000

出　　处：《中国实用眼科杂志》2017年第1期45-49,共5页Chinese Journal of Practical Ophthalmology

基　　金：南京医科大学科技发展基金面上项目（2015NJMUl36）

摘　　要：目的探讨翼状胬肉患者行翼状胬肉切除＋结膜移植术后，导致其复发的临床相关危险因素。方法回顾性临床研究。对2010年3月29日至2016年3月8日期间在无锡第二人民医院眼科住院接受治疗的93例翼状胬肉患者，通过临床病例回顾及随访记录患者发病年龄、发病时间、胬肉类型、HE染色病理切缘淋巴细胞数量，血浆淋巴细胞计数、免疫组化染色胬肉组织上界、下界及鼻侧切缘SDF-1表达情况，对纳入研究的患者通过病例回顾性分析及随访了解患者愈后情况，随访截止时间2016年8月18日，比较治愈组与复发组相关指标的差异性，并对翼状胬肉患者复发可能的相关影响因素进行logistic回归分析，探讨引起翼状胬肉复发的主要危险因素。结果不同预后的翼状胬肉患者鼻侧病理切缘SDF-1表达水平、鼻侧病理切缘淋巴细胞数方面存在差异，复发组患者2N指标皆高于治愈组，其差异均有统计学意义（P〈0．05）；logistic回归分析显示翼状胬肉患者鼻侧切缘SDF-1高表达是翼状胬肉术后复发的主要危险因素（OR=6．317，95％CI为5．82-6．849，P=0．00）；而患者年龄、翼状胬肉发病时间、血液中淋巴细胞数量、胬肉类型、胬肉组织上界、下界、鼻侧切缘淋巴细胞数量与患者的术后复发无明显相关性。结论SDF-1在翼状胬肉组织鼻侧切缘的高表达与是翼状胬肉术后复发的主要影响因素。Objective To investigate the risk factors for relapse after pterygium excision and con- junctival autografl surgery. Methods From March 2010 to March 2016, 93 pterygium patients from the Second Hospital of Wuxi were collected through reviewing analysis and observed the major clini- cal typing, age and examined the expression of sdf-1 in pterygium by immunohistochemistry which were divided into two groups according to the different surgery effect, 72 patients with healing group pterygium and 21 patients with relapse group pterygium. The pterygium patient＇s age, process, the number of inflammatory cells and the expression of sdf-1 in the lower bound upper bound and nasal bound edge of pterygium were observed. Results The expression of sdf-1 in the nasal bound edge of pterygium was the risk factor of postoperative relapse （OR=6.317, 95% CI5.82-6.849, P = 0.00）, logistic regression analysis showed that excess expression of sdf-1 in the nasal bound edge of pterygium was the most important risk factor of postoperative relapse. Conclusions The abnormal ex- pression of sdf-1 in the nasal bound edge of pterygium may be associated with the pterygium re- lapse after surgery.

关 键 词：翼状胬肉 复发 危险因素 SDF-1 炎性细胞 

分 类 号：R777.33[医药卫生—眼科]