LASIK術(shù)后杯狀細胞、黏蛋白MUC5AC的變化及與淚膜變化的關(guān)系
發(fā)布時間：2019-03-17 19:06
【摘要】： 目的研究準分子激光原位磨鑲術(shù)(LASIK)負壓吸引環(huán)對結(jié)膜杯狀細胞密度(GCD),黏蛋白MUC5AC量的影響以及GCD、MUC5AC和淚膜變化的相關(guān)性。為探討LASIK術(shù)后干眼癥狀發(fā)病機制提供可能的依據(jù),為臨床上尋找有效的預防和治療LASIK術(shù)后干眼的方法提供參考依據(jù)。 方法選30位做LASIK近視矯正術(shù)的病人(60只眼),每只眼的球結(jié)膜選取兩個位點采用印跡細胞學取樣。取樣時間分別是術(shù)前、術(shù)后1周、術(shù)后1月、術(shù)后3月,過碘酸-希夫試劑染色(PAS)后計算GCD。記錄負壓吸引環(huán)吸引時間(ST),觀察術(shù)前、術(shù)后1周、術(shù)后1月、術(shù)后3月患者的淚膜破裂時間(BUT)、schirmer實驗Ⅰ的值、角膜熒光素染色評分(FLU)。檢測術(shù)前術(shù)后淚液總蛋白的量,黏蛋白MUC5AC的吸光度值(OD)。對ST、術(shù)后不同時間的BUT、schirmer值、FLU與GCD做相關(guān)性分析,對術(shù)后不同時間的GCD、BUT、schirmer值、FLU與OD值做相關(guān)性分析。 結(jié)果ST為10~26 s。術(shù)后GCD、BUT、shirmer值、FLU、OD值與術(shù)前相比下降,差異有統(tǒng)計學意義(P0.01)。術(shù)后淚液總蛋白量與術(shù)前相比無統(tǒng)計學差異。術(shù)后1周、1月GCD和ST成負相關(guān),術(shù)后3月GCD和ST無相關(guān)性。術(shù)后1周、1月、3月BUT和GCD成正相關(guān)。術(shù)后1周、1月schirmer值與GCD呈正相關(guān),術(shù)后3月的schirmer值與GCD無相關(guān)性。術(shù)后1周、1月FLU與GCD呈負相關(guān),術(shù)后3月FLU與GCD無相關(guān)性。術(shù)后1周、1月、3月GCD、BUT和OD值成正相關(guān)。術(shù)后1周schirmer值與OD值成正相關(guān),術(shù)后1月、3月schirmer值與OD值無相關(guān)性。術(shù)后1周、1月、3月FLU與GCD無相關(guān)性。術(shù)后1周、1月、3月GCD、BUT和OD值成正相關(guān)。術(shù)后1周schirmer值與OD值成正相關(guān),術(shù)后1月、3月schirmer值與OD值無相關(guān)性。術(shù)后1周、1月、3月FLU與GCD無相關(guān)性。 結(jié)論術(shù)后淚膜穩(wěn)定性下降。結(jié)膜印跡細胞學提示LASIK術(shù)后負壓吸引環(huán)施壓處結(jié)膜杯狀細胞密度降低,下降程度可能與施壓時間長短有關(guān)。術(shù)后黏蛋白MUC5AC的OD值下降。淚膜穩(wěn)定性的改變可能與杯狀細胞的減少,黏蛋白MUC5AC的量下降有關(guān)。
[Abstract]:Aim to study the effect of (LASIK) suction ring on the density of conjunctival goblet cells (GCD), mucin MUC5AC and the correlation between GCD,MUC5AC and lacrimal film changes after excimer laser in situ grinding. In order to explore the pathogenesis of dry eye symptoms after LASIK, and to provide a reference for the effective prevention and treatment of LASIK postoperative dry eyes. Methods A total of 30 LASIK myopia correction patients (60 eyes) were selected. Two sites of bulbar conjunctiva were selected from each eye and were sampled by imprinted cytology. The sampling time was pre-operation, 1 week after operation, 1 month after operation, 3 months after operation, and GCD. was calculated after (PAS) staining with periodate-Schiff reagent. The time of lacrimal film rupture before operation, 1 week after operation, 1 month after operation and 3 months after operation was recorded by (ST), and the corneal fluorescein staining score (FLU).) was used to evaluate the time of lacrimal film rupture. The amount of total lacrimal protein and the absorbance value of mucin MUC5AC (OD).) were measured before and after operation. The BUT, Schirmer value, FLU and GCD at different time after ST, were analyzed, and the GCD,BUT, Schirmer value, FLU and OD value at different time after operation were analyzed. The results showed that the ST was 10? 26s. The values of GCD,BUT, shirmer and FLU, OD after operation were significantly lower than those before operation (P0.01). There was no significant difference in the total amount of lacrimal protein between the two groups before and after operation. One week after operation, there was a negative correlation between GCD and ST, but there was no correlation between GCD and ST at 3 months after operation. 1 week, 1 month and 3 months after operation, there was a positive correlation between BUT and GCD. One week after operation, Schirmer value was positively correlated with GCD, but there was no correlation between Schirmer value and GCD at 3 months after operation. One week after operation, there was a negative correlation between FLU and GCD, but there was no correlation between FLU and GCD at 3 months after operation. 1 week, 1 month and 3 months after operation, there was a positive correlation between GCD,BUT and OD. Schirmer value was positively correlated with OD value one week after operation, but there was no correlation between Schirmer value and OD value 1 month and 3 months after operation. 1 week, 1 month and 3 months after operation, there was no correlation between FLU and GCD. 1 week, 1 month and 3 months after operation, there was a positive correlation between GCD,BUT and OD. Schirmer value was positively correlated with OD value one week after operation, but there was no correlation between Schirmer value and OD value 1 month and 3 months after operation. 1 week, 1 month and 3 months after operation, there was no correlation between FLU and GCD. Conclusion the stability of lacrimal film decreased after operation. Conjunctival imprinting cytology showed that the density of conjunctival goblet cells decreased at negative pressure suction ring after LASIK, and the degree of decrease might be related to the duration of pressure. The OD value of mucin MUC5AC decreased after operation. The change of tear film stability may be related to the decrease of goblet cells and the decrease of mucin MUC5AC.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R779.63
本文編號：2442607
[Abstract]:Aim to study the effect of (LASIK) suction ring on the density of conjunctival goblet cells (GCD), mucin MUC5AC and the correlation between GCD,MUC5AC and lacrimal film changes after excimer laser in situ grinding. In order to explore the pathogenesis of dry eye symptoms after LASIK, and to provide a reference for the effective prevention and treatment of LASIK postoperative dry eyes. Methods A total of 30 LASIK myopia correction patients (60 eyes) were selected. Two sites of bulbar conjunctiva were selected from each eye and were sampled by imprinted cytology. The sampling time was pre-operation, 1 week after operation, 1 month after operation, 3 months after operation, and GCD. was calculated after (PAS) staining with periodate-Schiff reagent. The time of lacrimal film rupture before operation, 1 week after operation, 1 month after operation and 3 months after operation was recorded by (ST), and the corneal fluorescein staining score (FLU).) was used to evaluate the time of lacrimal film rupture. The amount of total lacrimal protein and the absorbance value of mucin MUC5AC (OD).) were measured before and after operation. The BUT, Schirmer value, FLU and GCD at different time after ST, were analyzed, and the GCD,BUT, Schirmer value, FLU and OD value at different time after operation were analyzed. The results showed that the ST was 10? 26s. The values of GCD,BUT, shirmer and FLU, OD after operation were significantly lower than those before operation (P0.01). There was no significant difference in the total amount of lacrimal protein between the two groups before and after operation. One week after operation, there was a negative correlation between GCD and ST, but there was no correlation between GCD and ST at 3 months after operation. 1 week, 1 month and 3 months after operation, there was a positive correlation between BUT and GCD. One week after operation, Schirmer value was positively correlated with GCD, but there was no correlation between Schirmer value and GCD at 3 months after operation. One week after operation, there was a negative correlation between FLU and GCD, but there was no correlation between FLU and GCD at 3 months after operation. 1 week, 1 month and 3 months after operation, there was a positive correlation between GCD,BUT and OD. Schirmer value was positively correlated with OD value one week after operation, but there was no correlation between Schirmer value and OD value 1 month and 3 months after operation. 1 week, 1 month and 3 months after operation, there was no correlation between FLU and GCD. 1 week, 1 month and 3 months after operation, there was a positive correlation between GCD,BUT and OD. Schirmer value was positively correlated with OD value one week after operation, but there was no correlation between Schirmer value and OD value 1 month and 3 months after operation. 1 week, 1 month and 3 months after operation, there was no correlation between FLU and GCD. Conclusion the stability of lacrimal film decreased after operation. Conjunctival imprinting cytology showed that the density of conjunctival goblet cells decreased at negative pressure suction ring after LASIK, and the degree of decrease might be related to the duration of pressure. The OD value of mucin MUC5AC decreased after operation. The change of tear film stability may be related to the decrease of goblet cells and the decrease of mucin MUC5AC.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R779.63
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相關(guān)期刊論文 前2條
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