结膜松弛症泪液黏蛋白及球结膜杯状细胞的研究

Research on tear mucin and goblet cell of conjunctivochalasis

目的:评价结膜松弛症泪液功能及结膜杯状细胞的组织病理学及超微结构改变。方法:结膜松弛症与正常对照组各30例(60眼)进行泪膜破裂时间(tearbreakup time,BUT)SchirmerⅠ试验、泪液羊齿状试验(tear ferning test,TFT)检查。对10例松弛球结膜组织和10例对照组球结膜对应区组织,采用PAS,AB和HE染色,对照观察组织病理及超微结构改变。结果:结膜松弛症组BUT(7.72±2.90s)较对照组(14.40±3.68s)减少明显(P<0.05)。基础Schirmer试验中结膜松弛症组(13.20±4.07mm)较对照组(16.73±4.41mm)明显降低(P<0.05)。结膜松弛症组泪液中羊齿状结晶明显减少,与对照组间比较差异有显著意义(P<0.05)。结膜松弛症球结膜上皮中的杯状细胞密度为2.75±2.68/100个上皮细胞,对照组为4.64±3.25/100个上皮细胞,两组间差异无显著性(t=1.42,P=0.172)。随着结膜松弛症程度加重,球结膜杯状细胞密度降低。结膜松弛症球结膜杯状细胞组织形态和超微结构有异常。结论:结膜松弛症泪膜稳定性下降、泪液分泌减少,泪液中黏蛋白减少,结膜杯状细胞数量减少,超微结构有异常。

AIM ： To evaluate the variation of tear functions, as well as histopathological and ultrastructural changes in conjunctival goblet cells during conjunctivochalasis. METHODS： Thirty cases （60 eyes） of patients with conjunctivochalasis, as well as the same number of healthy controls were recruited respectively. Tear film breakup time（BUT）, Schirmer I test measurements and tear ferning test（TFT） were performed.The histopathological and ultrastructural changes of 10 tissue cases from two groups were examined and compared after PAS, AB and HE stains. RESULTS： Compared with control group（14.40 ± 3.68s）, the mean tear film BUT of conjunctivochalasis patients （14.40 ± 3.68s） decreased significantly （ P 〈 0.05）, as well as the mean value of Schirmer I test （conjunctivochalasis, 13.20±4.07mm; control group, 16.73 ±4.41mm, P〈0.05）. The amount of tear fern of conjunctivochalasispatients also reduced significantly compared to control group （P 〈0.05）. The goblet cell density of conjunctival epithelium from conjunctivochalasis patients was 2. 75 ± 2. 68/100, while 4. 64 ± 3.25/100 of control group. But there was no significant difference in two groups（ t = 1.42, P = 0. 172）. The conjunctival goblet cell density also decreased significantly with the aggravation of conjunctivochalasis, and the cell could be found with abnormal morphology and ultrastructure. CONCLUSION： In our study, all of tear film stability, tear secretion, tear mucin content and conjunctival goblet cell quantity were found to be decreased during conjunctivochalasis. And abnormal ultrastructure could also be found.