【摘要】：目的:通過檢測在不同干預(yù)措施下眼表CXCR3及CXCL10的表達水平,分析眼表趨化因子及其受體表達的特征與干眼臨床特點的相關(guān)性,為提出預(yù)防和治療干眼提供科學依據(jù)。方法:評估正常人及干眼患者不同方法(單純玻璃酸鈉治療和玻璃酸鈉聯(lián)合普拉洛芬治療)治療前后的標準干眼癥狀評估(SPEED)問卷評分調(diào)查結(jié)果,了解淚膜破裂時間(BUT),淚液分泌功能(SchirmerI試驗)及角膜熒光染色(FLS評分)情況;用Elisa方法檢測淚液中TNF-α及CXCL10的含量;流式細胞術(shù)檢測外周血中T淋巴細胞亞群、結(jié)膜上皮細胞中T淋巴細胞浸潤情況及CCR5、CXCR3的表達水平。對結(jié)果進行比較。結(jié)果:干眼患者用藥前癥狀評分及角膜熒光染色評、淚膜破裂時間及淚液分泌功能差異均有統(tǒng)計學意義(p0.05)。干眼患者外周血中T淋巴細胞亞群與正常人無顯著差異(p0.05),淚液中TNF-α的含量及結(jié)膜上皮細胞中CD3+比例、CXCR3及CCR5顯著高于正常人(p0.05),淚液中CXCL10高于正常人,但差異無統(tǒng)計學意義(p0.05);玻璃酸鈉單獨用藥后干眼患者TNF-α及CXCL10含量均低于治療前,CD3+、CXCR3及CCR5較治療前降低,但差異無明顯統(tǒng)計學意義(p0.05);普拉洛芬與玻璃酸鈉聯(lián)合用藥后干眼患者TNF-α、結(jié)膜上皮細胞中CD3+、CXCR3及CCR5含量均顯著低于用藥前(p0.05),用藥后淚液中CXCL10雖低于用藥前,但差異無統(tǒng)計學意義(p0.05);聯(lián)合用藥1個月后CXCR3、CCR5、CD3+及TNF-α表達水平與BUT呈負相關(guān)(p0.05),與角膜熒光染色評分及SPEED評分均呈正相關(guān)(p0.05)。結(jié)論:干眼是一種局部炎性疾病,普拉洛芬聯(lián)合玻璃酸鈉可有效緩解干眼患者癥狀及體征,其作用機制可能與降低眼表炎性因子及趨化因子水平有關(guān)。
[Abstract]:Aim: to detect the expression of CXCR3 and CXCL10 in ocular surface under different intervention measures, and to analyze the correlation between the expression characteristics of chemokine and its receptor and clinical characteristics of dry eye, so as to provide scientific basis for prevention and treatment of dry eye. Methods: to evaluate the standard dry eye symptoms before and after treatment with sodium hyaluronate and sodium hyaluronate combined with Praprofen in normal subjects and dry eyes before and after treatment, and to evaluate the time of lacrimal film rupture (BUT),) by (SPEED) questionnaire. Lacrimal secretion function (SchirmerI test) and corneal fluorescent staining (FLS score); The contents of TNF- 偽 and CXCL10 in lacrimal fluid were measured by Elisa, and T lymphocyte subsets in peripheral blood, T lymphocyte infiltration in conjunctival epithelial cells and expression of CCR5,CXCR3 in peripheral blood were detected by flow cytometry. Compare the results. Results: there were significant differences in symptom score, corneal fluorescent staining, lacrimal film rupture time and lacrimal secretion function in dry eyes before treatment (p0.05). There was no significant difference in peripheral blood T lymphocyte subsets between dry eyes and normal subjects (p0.05). The content of TNF- 偽 in tear fluid and the proportion of CD3 in conjunctival epithelial cells were significantly higher than those in normal controls (p0.05). The levels of CXCR3 and CCR5 in tears were significantly higher than those in normal subjects (p0.05), and the CXCL10 in tear fluid was higher than that in normal persons. But there was no significant difference (p0.05). After treatment with sodium hyaluronate alone, the contents of TNF- 偽 and CXCL10 in dry eyes were lower than those before treatment, while the levels of CD3, CXCR3 and CCR5 were lower than those before treatment, but there was no significant difference (p0.05). The contents of TNF- 偽, CD3, CXCR3 and CCR5 in conjunctival epithelial cells of dry eye patients treated with Praprofen and sodium hyaluronate were significantly lower than those before treatment (p0.05), and the CXCL10 in tear fluid after treatment was lower than that before administration. But there was no significant difference (p0.05). There was a negative correlation between the expression of CXCR3,CCR5,CD3 and TNF- 偽 and BUT (p0.05), and a positive correlation with corneal fluorescent staining score and SPEED score (p0.05). Conclusion: dry eye is a local inflammatory disease. Praprofen combined with sodium hyaluronate can effectively relieve the symptoms and signs of dry eyes, and its mechanism may be related to the reduction of inflammatory and chemokine levels on the surface of the eyes.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R777.34

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