功能性泪溢患者泪道泵功能及泪液蛋白成分的初步研究

Preliminary research on lacrimial pump function and tear proteins of patients with functional epiphora

目的:分析功能性泪溢患者泪道泵功能及泪液蛋白成分与正常泪液的异同。方法:功能性泪溢患者100例200眼,正常对照20例40眼。观察指标包括SchirmerⅠ试验、按压泪囊部时SchirmerⅠ试验、泪膜破裂时间,同时采用ELISA测定功能性泪溢患者泪液主要蛋白含量,并与正常人的泪液对比。结果:正常受试者按压泪囊部时与开放泪囊部时的SchirmerⅠ测试值比较,差异有显著意义(t=-4.008,P<0.05),而功能性泪溢患者在不同时间点的SchirmerⅠ试验测试值比较,差异无显著意义(t=-0.811,P>0.05)。功能性泪溢患者泪膜破裂时间缩短(t=-5.382,P<0.01),功能性泪溢组与对照组泪液蛋白含量比较,溶菌酶、白蛋白浓度降低(P<0.05),乳铁蛋白、分泌型免疫球蛋白A含量无明显差异(P>0.05)。结论:泪道泵功能破坏在功能性泪溢中存在重要影响,功能性溢泪患者泪液蛋白质发生变化。

AIM： To study the lacrimial pump functions and tear proteins of patients with functional Epiphora. METHODS： One hundred cases （200 eyes） with functional epiphora and 20 cases （ 40 eyes ） of nonfunctional controls were recruited and under routine ophthalmic examinations, including Schirmer I test, Schirmer I test while pressing the lacrimal sac, tear film break-up time （BUT）. Enzyme linked immunosorbent assay （ELISA） was used to detect main tear proteins, and the results were compared with control group. RESULTS： Compared the result of the Schirmer I test on the normal subjects while pressing the lacrimal sac with that of releasing the lacrimal sac, the difference was significant （t=-4. 008, P〈0.05）. While the result on the functional epiphora group showed no significant difference （t=-0. 811, P〉0.05）. The mean BUT was significantly shorter than that in the normal subjects （ t= -5. 382, P〈 0.01 ）. The concentrations of lactoferrin and albumin in the functional epiphora group decreased significantly （P 〈 0. 05 ）, and the concentrations of Lactoferrin and secretory IgA didn＇t show significant （P〉 0.05）. CONCLUSION： The damage of lacrimal pump function plays a great role in the functional epiphora and the tear proteins of functional epiphora patients changed.