本文選題：白內(nèi)障超聲乳化術(shù)　切入點(diǎn)：淚膜穩(wěn)定性　出處：《中南大學(xué)》2011年碩士論文

【摘要】：目的：通過檢測(cè)淚液中細(xì)胞因子白細(xì)胞介素-2(IL-2)在白內(nèi)障超聲乳化手術(shù)(Phaco)術(shù)后含量的變化規(guī)律,探討IL-2與Phaco術(shù)后干眼的關(guān)系。 方法：收集2010年1月至2010年6月期間于長(zhǎng)治醫(yī)學(xué)院附屬和濟(jì)醫(yī)院行白內(nèi)障超聲乳化手術(shù)患者78例,所有患者均由同一人行白內(nèi)障超聲乳化術(shù)聯(lián)合人工晶體植入術(shù)(Phaco+IOL),術(shù)后均常規(guī)給予妥布霉素／地塞米松(典必舒)滴眼液。根據(jù)干眼診斷標(biāo)準(zhǔn),所有患者于術(shù)后2周時(shí)分為兩組：干眼組；非干眼組。 所有患者分別于術(shù)前、術(shù)后2周、4周依次行淚膜破裂時(shí)間(break-up time BUT)、淚液分泌試驗(yàn)(Schirmer test I)、角膜熒光素染色試驗(yàn)(Fluorescein staining of cornea, CFL)。三項(xiàng)檢查術(shù)眼均測(cè)量3次,取平均值作為最終結(jié)果。全部檢查均由同一醫(yī)師在同一暗室內(nèi)進(jìn)行,暗室內(nèi)保持安靜無風(fēng)、恒溫恒濕的條件。分別于術(shù)前、術(shù)后2周、術(shù)后4周取患者淚液,用雙抗體夾心酶聯(lián)免疫吸附法(ELISA)檢測(cè)淚液中IL-2濃度,采用SPSS13.0統(tǒng)計(jì)軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。 結(jié)果： 干眼組在術(shù)后2周、4周時(shí)與術(shù)前比較,淚膜破裂時(shí)間縮短、基礎(chǔ)淚液分泌量降低、角膜熒光染色積分增加,差異具有統(tǒng)計(jì)學(xué)意義(所有P0.01)。干眼組在術(shù)后4周時(shí)與術(shù)后2周相比,淚膜破裂時(shí)間增加、基礎(chǔ)淚液分泌量升高、角膜熒光染色積分降低,差異具有統(tǒng)計(jì)學(xué)意義(所有P0.01)。非干眼組在術(shù)后2周時(shí)與術(shù)前比較,淚膜破裂時(shí)間、基礎(chǔ)淚液分泌量、角膜熒光染色積分均恢復(fù)到術(shù)前水平,差異無統(tǒng)計(jì)學(xué)意義(所有P0.05)。兩組間術(shù)后2周、4周比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.01)。 干眼組在術(shù)后2周、術(shù)后4周時(shí)與術(shù)前比較,淚液中IL-2含量升高,有顯著差異,其差異具有統(tǒng)計(jì)學(xué)意義(P0.01)；術(shù)后2周與4周比較,差異具有統(tǒng)計(jì)學(xué)意義。非干眼組術(shù)后2周、4周時(shí)術(shù)前相比,淚液中IL-2含量恢復(fù)到術(shù)前水平,其差異無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組間術(shù)后2周、4周比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.01)。 結(jié)論： 1、Phaco術(shù)后早期部分患者出現(xiàn)干眼癥狀。 2、IL-2在干眼患者中表達(dá)增高,提示IL-2在干眼發(fā)病機(jī)制中起一定的作用。
[Abstract]:Aim: to investigate the relationship between IL-2 and dry eye after phacoemulsification by detecting the content of interleukin-2 (IL-2) in lacrimal fluid after phacoemulsification.Methods: a total of 78 patients underwent phacoemulsification from January 2010 to June 2010 in Heji Hospital of Changzhi Medical College.All the patients were treated with phaco IOL after cataract phacoemulsification and intraocular lens implantation and were given tobramycin / dexamethasone eye drops.According to the criteria of dry eye diagnosis, all patients were divided into two groups at 2 weeks after operation: dry eye group and non dry eye group.All the patients were treated with tear film break-up time UTT, tear secretion test with Schirmer test I, corneal fluorescein staining of cornea, and CFL with fluorescein staining before operation and 2 weeks and 4 weeks after operation respectively.All eyes were measured 3 times, and the mean value was taken as the final result.All examinations were performed by the same physician in the same dark room, which kept quiet and windless, constant temperature and humidity.Tear samples were collected from patients before, 2 weeks and 4 weeks after operation respectively. The concentration of IL-2 in tears was detected by double antibody sandwich enzyme-linked immunosorbent assay (Elisa). The data were statistically analyzed by SPSS13.0 software.Results:In the dry eye group, the time of lacrimal film rupture was shortened, the amount of basal tear secretion was decreased, and the fluorescent staining score of cornea was increased at 2 weeks and 4 weeks after operation. The difference was statistically significant (all P 0.01).In the dry eye group, the tear film rupture time increased, the basal tear secretion increased and the corneal fluorescent staining score decreased at 4 weeks after operation compared with 2 weeks after operation, the difference was statistically significant (all P 0.01).In the non-dry eye group, the time of tear film rupture, the amount of basal tear secretion and the score of corneal fluorescence staining all returned to the preoperative level at 2 weeks after operation, and there was no significant difference between the two groups (all P 0.05).There were significant differences between the two groups at 2 weeks and 4 weeks after operation (P 0.01).In the dry eye group, the content of IL-2 in tears increased significantly at 2 weeks and 4 weeks after operation, and the difference was statistically significant (P 0.01), and the difference was statistically significant 2 weeks after operation and 4 weeks after operation.In the non-dry eye group, the content of IL-2 in tears returned to the preoperative level at 2 weeks and 4 weeks after operation, but the difference was not statistically significant (P 0.05).There were significant differences between the two groups at 2 weeks and 4 weeks after operation (P 0.01).Conclusion:1 dry eye symptoms were found in some patients early after Phaco operation.2the increased expression of IL-2 in dry eye patients suggests that IL-2 may play a role in the pathogenesis of dry eye.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R779.66

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