PCBP1在原发性干燥综合征干眼患者泪液中的表达及其相关性

Study on the Expression and Correlation of PCBP1 in Tears of Dry Eye Induced by Primary Sjögren's Syndrome

目的:研究原发性干燥综合征(PSS)相关干眼患者泪液中多聚胞嘧啶结合蛋白1(PCBP1)的表达水平及其与临床干眼指标之间的相关性。方法:病例对照研究。选取2023年7—10月在浙江中医药大学附属第二医院眼科确诊为PSS伴干眼的患者6例(12眼)为SS干眼组,同期选取健康人6例(12眼)为正常组,选取同家医院非SS干眼患者6例(12眼)为非SS干眼组,分别完成3组研究对象的眼表疾病指数问卷(OSDI)、泪河高度(TMH)、非侵入式泪膜破裂时间(NIBUT)、角膜荧光素染色(CFS)、睑板腺缺失度评分(MGL)、眼红指数(ORI)、Schirmer试验(SIt)和泪液采集。ELISA检测3组泪液中PCBP1的表达水平,并分析其与临床干眼指标的相关性,采用单因素方差分析、Pearson相关分析、受试者工作特征曲线进行数据分析。结果:OSDI评分:正常组<非SS干眼组<SS干眼组,TMH、NIBUT(f)、NIBUT(av)、MGL、SIt指标:正常组>非SS干眼组>SS干眼组,差异均有统计学意义(均P<0.05)。CFS:正常组<非SS干眼组<SS干眼组,但差异无统计学意义(P>0.05)。ORI:正常组<SS干眼组,非SS干眼组<SS干眼组,差异均有统计学意义(均P<0.05);正常组<非SS干眼组,差异无统计学意义(P>0.05)。受试者工作特征曲线分析显示,泪液PCBP1表达水平诊断PSS干眼症的曲线下面积为0.944,得到最大约登指数为0.817,最大阈值为1.201,此时灵敏度和特异度分别为0.956和0.861。ELISA定量测定泪液PCBP1结果显示正常组<非SS干眼组<SS干眼组,差异有统计学意义(P<0.05)。相关性分析显示,PCBP1表达水平与NIBUT(f)、NIBUT(av)、TMH、SIt呈负相关(r=-0.88、-0.91、-0.78、-0.82,P<0.001);PCBP1表达水平与OSDI评分、ORI、MGL呈正相关(r=0.84、0.88、0.86,P<0.001)。结论:PSS干眼患者泪液中PCBP1高表达,与OSDI评分、TMH、NIBUT(f)、NIBUT(av)、MGL、SIt、ORI具有强相关性。

Objective:To study the expression level of Poly(rC)-binding protein 1(PCBP1)in tears of patients with dry eye induced by primary Sjögren's syndrome(PSS)and the correlation between which and the clinical dry eye indexes.Methods:This was a case-control study.Six cases(12 eyes)of patients with PSS and dry eye diagnosed in our hospital were selected prospectively as the group SS-DED.During the same period,6 cases(12 eyes)of healthy people were selected as the group Normal.Six cases(12 eyes)of patients with non-SS and dry eye were selected as the group Non-SS DED.The three groups of research object completed the ocular surface disease index(OSDI),tear meniscus height(TMH)measurement,noninvasive tear break-up time(NIBUT),corneal fluerescein staining(CFS),meibomian gland loss(MGL),ocular redness index(ORI),Schirmer I test(SIt)and the collection of tears.Detect the expression level of PCBP1 in the tears of three groups by ELISA and analyze the correlation between which and the clinical dry eye indexes.One-way analysis of variance,Pearson correlation analysis,and receiver operating characteristic curve were used for data analysis.Results:Compared with the three groups,the OSDI of three groups were Normal<Non-SS DED<SS-DED,and the TMH,NIBUT(f),NIBUT(av),MGL,and SIt of three groups were Normal>Non-SS DED>SS-DED,the differences were statistically significant(P<0.05).CFS:Normal<Non-SS DED<SS-DED,the difference was not statistically significant(P>0.05).The ORI of the study group was Normal<SS-DED,Non-SS DED<SS-DED,the difference was statistically significant(P<0.05);Normal<Non-SS DED,the difference was not statistically significant(P>0.05).The analysis of receiver operating characteristic curve showed that the area under the curve of the diagnosis of dry eye induced by PSS which rely on the expression level of PCBP1 in tears was 0.944,and the maximal Youden index was 0.817,and the maximal threshold was 1.201.At this time,the sensitivity and specificity were 0.956 and 0.861.The results of quantitative determination of PCBP1 in tears by ELISA showed that the expression level of PCBP1 in three groups were Normal<Non-SS DED<SS-DED,the difference was statistically significant(P<0.05).Correlation analysis results showed that the expression level of PCBP1 was negatively correlated with NIBUT(f),NIBUT(av),TMH,and SIt(r=-0.88,-0.91,-0.78,-0.82,P<0.001);the expression level of PCBP1 was positively correlated with OSDI score,ORI,and MGL(r=0.84,0.88,0.86,P<0.01).Conclusion:PCBP1 was highly expressed in tears of patients with dry eye induced by PSS and was strong correlated with OSDI score,TMH,NIBUT(f),NIBUT(av),MGL,SIt,and ORI.