原发性进展型翼状胬肉与泪膜的相关性研究

Research of association between the primary progressive type of pterygium and the tear film

目的:研究原发性进展型翼状胬肉与泪膜的相关性。方法:收集我院2012-09/2013-06原发性进展型翼状胬肉患者60例,以患眼为观察组,对侧眼为对照组,比较两组在主观症状、基础泪液分泌试验(SchirmerⅠtest,SⅠt)、泪膜破裂时间(break-up time,BUT)、角膜荧光素染色(fluorescent staining,FL),泪液蕨样结晶试验(tear ferning test,TFT),结膜印迹细胞学(conjunctival impression cytology,CIC)上的差异。结果:观察组平均主观症状评分及FL评分较对照组增高、结膜鳞状上皮化生程度加重、泪液异常蕨样结晶比例增高,BUT及杯状细胞密度较对照组减少,差异具有统计学意义(P<0.05);两组具有相似的SⅠt结果,差异无统计学意义(P>0.05)。结论:进展型翼状胬肉可致泪膜功能稳定性下降,进而引起眼部干涩、烧灼感等干眼症状,其机制可能是其对杯状细胞及泪液流体动力学的影响等多因素综合作用所致。

AIM： To research the association between primary progressive pterygium and tear film. METHODS： Totally 60 cases of primary progressive pterygium from September 2012 to June 2013 in our hospital were enrolled. The pterygium eye was for observation group and the contralateral eye as the control group. The differences of eye symptoms,tear film breakup time（ BUT）, Schirmer Ⅰ test（ S Ⅰ t）, corneal fluorescein staining（ FL）,tear ferning test（ TFT） and the conjunctival impression cytology（ CIC） were compared between two groups.RESULTS： The eyes in observation group had higher symptoms score, FL score, grades of conjunctival squamous metaplasia, percentage of abnormal tear ferning,but had lower BUT and density of goblet cell,the differences had statistically significance（ P〈0.05）; Similar S Ⅰ t results were presented in the two groups, the difference had no statistically significance（ P〈0.05）.CONCLUSION： Primary progressive pterygium can cause a decrease in tear film stability,which in turn lead to some dry eye symptoms such as dry feeling and burning sensation,and its mechanism may be caused by multi-factors,such as density change of goblet cell and the tear fluid dynamics.