改良Parks切口斜视手术后干眼症患者炎症因子与眼表功能的关系研究  

Relationship Between Inflammatory Factors and Ocular Surface Function in Patients with Xerophthalmia After Modified Parks Incision Strabismus Surgery

作　　者：程靖倩 王爽 覃冬[1] CHENG Jingqian;WANG Shuang;QIN Dong(The Third People's Hospital of Chengdu,Sichuan Chengdu 610014,China)

机构地区：[1]四川省成都市第三人民医院眼科,四川成都610014

出　　处：《河北医学》2025年第1期127-132,共6页Hebei Medicine

基　　金：四川省成都市医学科研课题,(编号:2022014)。

摘　　要：目的:探析改良Parks切口斜视手术后干眼症患者血清炎症因子水平变化情况,并分析其与眼表功能的关联性。方法:纳入2021年3月至2024年3月本院收治的斜视患者122例,所有患者接受改良Parks切口手术,观察术后发生干眼症患者炎症因子水平变化,并分析其水平变化与眼表功能的关系。结果:改良Parks切口斜视手术后干眼症发生率为21.31%(26/122),术后干眼症患者血清IL-6、MMP-2、TNF-α、TLR4水平明显高于非干眼症患者,差异均有统计学意义(P<0.05);干眼症患者与非干眼症患者OSDI评分比较差异有统计学意义(P<0.05),Pearson相关性分析显示:IL-6、MMP-2、TNF-α、TLR4水平与眼表功能障碍程度成正相关性,相关性均有统计学意义(r=0.482、0.510、0.351、0.333,P<0.05);线性回归显示:IL-6、MMP-2、TNF-α、TLR4是影响眼表功能的危险因素,差异均有统计学意义(P<0.05);ROC曲线分析显示:血清IL-6、MMP-2、TNF-α、TLR4评估眼表功能障碍的AUC分别为0.668、0.752、0.743、0.766,而IL-6+MMP-2+TNF-α+TLR4四项联合评估眼表功能障碍的AUC为0.873,最大约登指数下的敏感度和特异度分别为0.769、0.854。结论:改良Parks切口斜视手术后干眼症患者血清IL-6、MMP-2、TNF-α、TLR4等因子水平异常升高,并与眼表功能障碍程度相关,对眼表功能障碍有较高的评估价值。Objective:To analyze the changes in serum inflammatory factors in patients with xerophthalmia after modified Parks incision strabismus surgery and to investigate their association with ocular surface function.Methods:A total of 122 patients with strabismus who underwent modified Parks incision surgery at our hospital from March 2021 to March 2024 were included in this study.The changes in inflammatory factors among patients with xerophthalmia after surgery were observed,and the relationship between these changes and ocular surface function was analyzed.Results:The incidence rate of xerophthalmia after modified Parks incision strabismus surgery was 21.31%(26/122).The serum levels of IL-6,MMP-2,TNF-α,and TLR4 in patients with xerophthalmia were significantly higher than those in patients without xerophthalmia(P<0.05).There was a statistically significant difference in OSDI scores between patients with and without xerophthalmia(P<0.05).Pearson correlation analysis indicated that IL-6,MMP-2,TNF-α,and TLR4 were positively correlated with the degree of ocular surface dysfunction,with statistically significant correlations(r=0.482,0.510,0.351,0.333,P<0.05).Linear regression analysis showed that IL-6,MMP-2,TNF-α,and TLR4 were risk factors affecting ocular surface function(P<0.05).ROC curve analysis revealed that the AUCs of serum IL-6,MMP-2,TNF-α,and TLR4 in evaluating ocular surface dysfunction were 0.668,0.752,0.743,and 0.766,respectively.The combined AUC of IL-6+MMP-2+TNF-α+TLR4 was 0.873,with a sensitivity and specificity of 0.769 and 0.854,respectively,under the maximum Youden index.Conclusion:The serum levels of IL-6,MMP-2,TNF-α,and TLR4 in patients with xerophthalmia after modified Parks incision strabismus surgery are abnormally increased and are related to the degree of ocular surface dysfunction.These levels have a high evaluative value for ocular surface dysfunction.

关 键 词：斜视 改良Parks切口手术 干眼症 炎症因子 眼表功能 

分 类 号：R779.6[医药卫生—眼科] R777.34[医药卫生—临床医学]