红斑痤疮患者眼表、泪膜、泪液蛋白以及角膜神经纤维的改变  

Changes in ocular surface,tear film,tear protein and corneal nerve fibers in patients with rosacea

作　　者：张厚检 李清海 刘康成 张雨晴 林启 石文卿 林志荣[2] 葛倩敏 李秋玉 梁荣斌 邵毅[1] ZHANG Hou-Jian;LI Qing-Hai;LIU Kang-Cheng;ZHANG Yu-Qing;LIN Qi;SHI Wen-Qing;LIN Zhi-Rong;GE Qian-Min;LI Qiu-Yu;LIANG Rong-Bin;SHAO Yi(Department of Ophthalmology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China;Department of Keratology,Xiamen Ophthalmology Center,Xiamen 361102,Fujian Province,China)

机构地区：[1]南昌大学第一附属医院眼科,江西省南昌市330006 [2]厦门眼科中心角膜病科,福建省厦门市361102

出　　处：《眼科新进展》2019年第12期1145-1148,1152,共5页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:81660158、81160118、81460092、81400372、81400424);江西省自然科学基金重大项目(编号:20161ACB21017)~~

摘　　要：目的对比分析红斑痤疮患者眼表、泪膜、泪液蛋白以及角膜神经纤维的改变情况。方法选取南昌大学第一附属医院和厦门眼科中心已确诊为红斑痤疮患者24例(48眼)作为红斑痤疮组;另选年龄、月收入等重要非试验因素匹配的24例(48眼)健康志愿者(门诊体检者,无眼部相关疾病)作为正常对照组。对比分析两组受试者眼表疾病指数、泪膜四项、泪液蛋白以及共聚焦显微镜等检查结果。结果红斑痤疮组相比于正常对照组右眼的干眼症状眼数增多、眼表疾病指数评分增高、泪膜破裂时间缩短、基础泪液分泌试验长度减少、泪河高度降低及角膜荧光素染色评分增高,差异均有统计学意义(均为P<0.05);左眼的干眼症状眼数、眼表疾病指数和泪膜四项与右眼改变一致,差异亦均有统计学意义(均为P<0.05)。红斑痤疮组相比于正常对照组右眼泪液中泪液总蛋白、乳铁蛋白及溶菌酶含量均明显降低,差异亦均有统计学意义(均为P<0.05);左眼的泪液蛋白改变与右眼一致,差异均有统计学意义(均为P<0.05)。红斑痤疮组共聚焦显微镜图像可见角膜上皮基底细胞部分膨胀、变形,有光亮的炎症细胞浸润;角膜前基质细胞增多,形态与正常对照组差别不大;红斑痤疮组相比于正常对照组角膜上皮下神经丛出现弯曲且数量增多;角膜基质内神经丛出现弯曲。红斑痤疮组相比于正常对照组左右眼的角膜上皮下神经纤维密度均明显增大,分支增多且曲率评分增高,差异均有统计学意义(均为P<0.05)。结论红斑痤疮患者眼表发生明显改变,主要表现为泪膜稳定性降低,泪液蛋白含量降低,角膜荧光素染色评分增高和角膜神经纤维密度升高及走形异常等特点。Objective To compare and analyze the changes in ocular surface,tear film,tear protein and corneal nerve fibers in patients with rosacea.Methods Totally 24 patients(48 eyes) with rosacea from the First Affiliated Hospital of Nanchang University and Xiamen Ophthalmology Center were selected as the rosacea group.In addition,totally 24 healthy volunteers(48 eyes)(outpatients with no ocular diseases) matched with age,monthly income and other important non-experimental factors were selected as the normal control group.The indexes of ocular surface disease,four items of tear film,tear protein and confocal microscopy of the two groups of subjects were compared and analyzed.Results Compared with the normal control group,the rosacea group showed increased number of eyes with dry eye symptoms,increased index of ocular surface disease,shortened tear rupture time,decreased length of basic tear secretion,lowered lacrimal river height and increased score of fluorescence staining in the right eyes,and the differences were statistically significant(all P<0.05).The changes in the number of eyes with dry eye symptoms,the index of ocular surface disease and four items of tear film in the left eye were consistent with the changes in the right eye,and the differences were statistically significant(all P<0.05).Compared with the normal control group,the content of total protein,lactoferrin and lysozyme in tear of the right eyes significantly decreased,and the differences were statistically significant(all P<0.05).The changes in tear protein in the left eye were consistent with those in the right eye,and the differences were statistically significant(all P<0.05).Confocal microscopic images showed that the basal cells of the corneal epithelium were partially swollen and deformed,with bright inflammatory cells infiltrating.Confocal microscopic images showed precorneal stromal cell proliferation,whose morphology was not different from that of normal control group.Compared with the normal control group,the corneal subepithelial plexus of the

关 键 词：红斑痤疮 眼表泪液 角膜神经纤维 临床研究 

分 类 号：R777.2[医药卫生—眼科]