自体角膜缘上皮移植术治疗翼状胬肉的临床研究  

Clinical study of autologous limbal epithelial transplantation in the treatment of pterygium

作　　者：徐着华 卢会秦 许丽萍 刘辉鸿 XU Zhuo-hua;LU Hui-qin;XU Li-ping(Fengshun County People's Hospital,Meizhou 514300,China)

机构地区：[1]丰顺县人民医院眼耳鼻喉科,514300

出　　处：《中国实用医药》2022年第17期1-5,共5页China Practical Medicine

基　　金：梅州市科技计划(项目编号:201120092050581)。

摘　　要：目的 研究自体角膜缘上皮移植术在翼状胬肉中的应用效果。方法 60例翼状胬肉患者作为研究对象,根据治疗方式的差异分为观察组和对照组,各30例。对照组实施单纯翼状胬肉切除术进行治疗,观察组采用自体角膜缘上皮移植术进行治疗。对比两组患者的临床治疗效果,治疗前后的血清免疫学指标[免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)]及血管内皮生长因子(VEGF)、内皮抑素(Endostatin)水平,症状缓解时间(眼球刺激症状缓解时间、结膜上皮恢复时间),治疗前后的泪膜功能指标(泪液分泌试验滤纸湿长、泪膜破裂时间)及视觉质量指标(角膜散光度、屈光度)。结果 观察组的临床治疗总有效率为90.00%,高于对照组的53.33%,差异具有统计学意义(P<0.05)。治疗后,观察组患者的IgA、IgM、IgG分别为(1.61±0.30)、(1.34±0.30)、(9.23±1.20)g/L,均低于对照组的(2.34±0.42)、(1.93±0.33)、(13.24±1.61)g/L,差异具有统计学意义(P<0.05)。治疗后,观察组患者的VEGF(153.23±54.73)ng/L低于对照组的(230.35±45.67)ng/L、Endostatin(302.13±23.53)ng/ml高于对照组的(258.34±33.46)ng/ml,差异具有统计学意义(P<0.05)。观察组患者的眼球刺激症状缓解时间(12.74±5.23)d、结膜上皮恢复时间(11.21±2.09)d均短于对照组的(16.39±5.67)、(14.77±2.17)d,差异具有统计学意义(P<0.05)。治疗后,观察组患者的泪液分泌试验滤纸湿长(13.58±0.09)mm/5 min、泪膜破裂时间(12.75±0.27)s均长于对照组的(13.26±0.14)mm/5 min、(11.83±0.06)s,差异具有统计学意义(P<0.05)。治疗后,观察组患者的屈光度(0.51±0.03)D、角膜散光度(0.77±0.69)D均低于对照组的(0.90±0.09)、(1.20±0.93)D,差异具有统计学意义(P<0.05)。结论 翼状胬肉患者实施自体角膜缘上皮移植术治疗可以提高治疗效果,改善患者的血清免疫学指标,加快恢复速度,改善泪膜功能和视觉质量,值得研究和借鉴。Objective To study the application effect of autologous limbal epithelial transplantation in the treatment of pterygium.Methods A total of 60 patients with pterygium were selected as the research suobjects,and they were divided into observation group and control group according to the different treatment methods,with 30 cases in each group.Patients in the control group were treated with simple pterygium excision,and patients in the observation group were treated with autologous limbal epithelial transplantation.Both groups were compared in terms of clinical therapeutic effects,and the serum immunological indexes[immunoglobulin A(IgA),immunoglobulin M(IgM),immunoglobulin G(IgG)]and vascular endothelial growth factor(VEGF)before and after treatment,Endostatin level,symptom relief time(relief time of eye irritation symptom,recovery time of conjunctival epithelium),tear film function indicators(wet length of filter paper in Schirmer's tear test,tear film breakup time)and visual quality indicators(corneal astigmatism,diopter)before and after treatment.Results The total effective rate of clinical treatment in the observation group was 90.00%,which was higher than 53.33%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of IgA,IgM and IgG in the observation group were(1.61±0.30),(1.34±0.30)and(9.23±1.20)g/L,which were lower than(2.34±0.42),(1.93±0.33)and(13.24±1.61)g/L in the control group,and the differences were statistically significant(P<0.05).After treatment,the VEGF(153.23±54.73)ng/L in observation group was lower than(230.35±45.67)ng/L in control group,and the Endostatin(302.13±23.53)ng/ml was higher than(258.34±33.46)ng/ml in control group.All the differences were statistically significant(P<0.05).The relief time of eye irritation symptoms(12.74±5.23)d and the recovery time of conjunctival epithelium(11.21±2.09)d in the observation group were shorter than(16.39±5.67)and(14.77±2.17)d in the control group,and the differences were statistically sig

关 键 词：自体角膜缘上皮移植术 单纯翼状胬肉切除术 翼状胬肉 免疫学指标 

分 类 号：R779.6[医药卫生—眼科]