前葡萄膜炎患者房水闪辉和炎性细胞的定量测量

Quantitative determination of aqueous flare and cells in the eyes of patients with inflammation of anterior uvea

目的 探讨激光蛋白细胞检测仪定量测定前葡萄膜炎患者房水闪辉和炎性细胞的临床应用价值。方法 采用FC-2000型激光蛋白细胞检测仪(laser flare cell meter,LFCM)非接触性定量检测2001年12月至2002年4月于中山眼科中心就诊、复查的110例前葡萄膜炎患者(194只眼)和52例正常人(52只跟)的房水闪辉和炎性细胞出现情况,检测前所有患者均在裂隙灯显微镜下详细检查,并进行房水闪辉分级和定量检测细胞。结果 LFCM检测前葡萄膜炎患者0～2级房水闪辉的平均值分别为7.9、29.5和189.0 pc/ms;3-4级房水闪辉由于背景干扰大,检测结果显示为警告或无法检测。前葡萄膜炎患者的0～2级房水闪辉的裂隙灯显微镜检查与激光蛋白测定结果呈正相关性(r=0.75,P<0.001);与正常人房水闪辉值(5.3 pc/ms)比较,均显著增高(t=5.872,P<0.05)。LFCM检测前葡萄膜炎患者(0-4级房水闪辉)房水中炎性细胞的平均值分别为1.5、12.1、33.9、84.9和193.1个/0.5 mm3;裂隙灯显微镜检查与激光蛋白细胞计数结果呈正相关性(r=0.72,P<0.001);与正常人房水中炎性细胞值(0.9个/0.5 mm3)比较,均显著增高(t=7.35l,P<0.05)。结论LFCM检测可确切判断轻、中度的血房水屏障破坏和炎性反应改变,此项检查对判断眼前段炎性反应和指导临床用药有重要价值。

Objective To quantify aqueous flare and cells in the eyes of patients with inflammation of anterior uvea by FC-2000 laser flare cell meter (LFCM) , and to compare these results with those obtained with slit lamp microscopy. Methods Aqueous flare and cells of 194 eyes of 110 patients with inflammation of anterior uvea and 52 eyes of 52 healthy subjects were graded into 0, 1 + , 2 + , 3 + and 4 + scale based on a previously described system using slit lamp microscopy. LFCM was also used for evaluation of aqueous flare and cells. Results All eyes in normal individuals were graded as '0' scale of both flare and cells by silt lamp microscopy. Flare of grade 0,1+ and 2 + were noted in 74, 98 and 18 eyes, and cell of grade 0, 1 + , 2 + , 3 + and 4 + were noted in 124, 26, 19, 14 and 11 eyes in uveitis patients, respectively. LFCM examination revealed that the mean flare values in uveitis eyes with flare of grade 0,1+ and 2 + were 7. 9, 29. 5 and 189. 0 photon count/ms, respectively. In patients with flare of grade 3 + and 4 + , LFCM readings were unreliable because of increased background noise. There was significant correlation between slit lamp examination and the laser flare measurement for flare of grade 0,1+ and 2 + (r =0. 75 , P <0. 001). The mean flare values were significantly higher in patients with flare of grade 0,1+ and 2 + than that in normal controls (5. 3 pc/ms) ( t = 5. 872, P <0. 05). The mean cell numbers in the eyes with cell of grade 0, 1 + , 2 + , 3 + and 4 + were 1. 5, 12. 1 , 33. 9, 84. 9 and 193. 1 count/0. 5 mm3, respectively. The results of slit lamp examination showed significant correlation with laser cell counts measurement ( r = 0. 72, P < 0.001). The mean cell numbers were significantly higher in uveitis patients than that in normal controls (0. 9 count/0.5 mm3) (t = 1. 351, P < 0. 05). Conclusions Our results indicate that LFCM is able to evaluate precisely the mild and moderate breakdown of blood aqueous barrier and inflammation of the anterior uvea tract, therefore it provides an important parameter for the treatment of anterior uveitis. ( Chin J Ophthalmol, 2004,40:510-513)