干眼症的发病机制及治疗现状

New progress in the pathogenesis and treatment of dry eyes

干眼症是泪液和眼表的一种多因素疾病,由于各种原因导致的泪液质或量的异常,或泪液流体动力学异常引起的泪膜不稳定和眼表损害。可引起患者眼部不适、视力障碍和泪膜不稳定。虽然干眼症的临床表现不同,但其病理生理改变是相似的。引起干眼症的起始病因很多,这些因素均可造成眼表面的病理生理改变。炎症是干眼症发病机制中最关键的因素,而细胞凋亡和性激素等也共同影响了干眼症的发病过程。干眼症治疗的常规方法是提供润滑的滴眼液或泪液替代品,而新的治疗方法则是针对干眼症潜在的病因,而不是单纯的缓解症状。尽管近年来在阐述干眼症病理生理、发病机制及治疗方面的研究已取得了一定进展,但目前尚无统一的标准。笔者就近年来干眼症的发病机制及治疗现状进行综述。

Dry eye is a condition characterized by either decreased tear production or increased tear film evaporation.Significant advances ahve been made in the physiopathology and therapy of dry eye disease in recent years.This paper aims to review these advances with a particular focus on the role for inflammatory cytokines,cell apoptosis and sex hormones in the development of dry eye and on the importance of addressing underlying causes in the treatment of the disease.