结缔组织病患者结膜印迹细胞凋亡研究

The Research of Apoptosis in Conjunctiva Epithelial Cells with Connective Tissue Disease

目的探讨结膜印迹细胞的流式细胞术凋亡检测在干眼发病机制研究与结缔组织病患者干眼诊断中的应用价值。方法对结缔组织病患者60例(120眼)进行眼科病史询问、泪液分泌实验Ⅰ(S-I-T)、泪膜破裂时间(BUT)及荧光素染色计分(FL)检查,根据检查结果和有无Sjgren综合征分为非干燥综合征无干眼(NSS1)组、非干燥综合征干眼(NSS2)组、干燥综合征无干眼(SS1)组和干燥综合征干眼(SS2)组。并对其行结膜印迹细胞流式细胞术凋亡检测。结果结膜上皮细胞凋亡百分比除NSS1组与SS1组间差异无统计学意义(P=0.998)外,其余各组差异均有统计学意义(P<0.001)。且细胞凋亡百分比与FL成正相关(r=0.926,P<0.001),与S-I-T、BUT结果成负相关(r=–0.712,r=–0.818,P<0.001)。有无干眼和有无干燥均影响结膜上皮细胞凋亡量,且干眼与干燥有交互作用。结论细胞凋亡可能是造成干眼眼表损害的重要因素,凋亡检测有助于结缔组织病患者干眼的诊断。干眼和干燥均可使结膜上皮细胞凋亡增加。印迹细胞流式细胞凋亡检测是一项微创、有效的眼表凋亡检测方法。

Objective To investigate pathogenesis of dry eye and applied value in diagnosis of dry eye with connective tissue disease（CTD）by apoptosis detection,using impression cytology flow cytometry（ICFC）in conjunctiva epithelial cells.Methods A total of 60 patients（120 eyes）with CTD,after asked case history and measured the basal Schirmer s test（S-I-T）,Break-Up Time（BUT）,fluorescent Staining（FL）,were divided into 4 groups：the first group without Sjogren syndrome or dry eye（NSS1）,the second group without Sjogren syndrome but dry eye （NSS2）, the third group with Sjogren syndrome and non-dry-eye （SS1） and the fourth group with Sjogren syndrome and dry eye （SS2）. And apoptosis of conjunctiva epithelial cells was detected by ICFC. Results The apoptosis rate of conjunctiva epithelial cells was statistically significant （P〈0.001） between every two groups, except that between NSS1 group and SS1 group （P=0.998）. And apoptosis rate was a positive correlation with FL （r=0.926, P〈0.001）, but negatively with S-I-T and BUT （r=-0.712, r=-0.818, P〈0.001）. Dye eye and Sjogren-syndrome both affected the apoptosis level of conjunctiva epithelial cell and there was an interaction between them. Conclusion Apoptosis plays an important role of ocular damage and apoptosis detection helps with diagnosis of dry eye with CTD. Dye eye and Sjogren-syndrome increase apoptosis level. Apoptosis detection by ICFC in conjunctiva epithelial cells is a minimally invasive and effective way to detect ocular apoptosis.