泪囊炎发病相关免疫因素及其作用

Immune factors in the pathogenesis of dacryocystitis and their roles

泪囊炎是眼科的常见病和多发病,临床治疗主要是通过手术摒弃阻塞的鼻泪管,在鼻腔内开放新的泪液引流通路。现阶段,对其发病机制的认识十分有限,目前观点认为有多种因素参与泪囊炎发病,其中阻塞和感染因素发挥重要作用。近年研究发现泪道黏膜内存在泪道相关淋巴组织,在泪囊炎发病过程中发生明显改变,同时检测到泪囊炎患者与正常对照者泪液中细胞因子水平具有显著差别,以及泪道对置入硅胶管存在类似免疫排斥反应,均提示免疫因素参与泪囊炎的发病。因此,本文就泪道相关淋巴组织、细胞因子、泪道置管后局部组织及细胞因子的变化等对泪囊炎发病中免疫组织及大分子物质的改变进行综述,分析免疫因素在泪囊炎病程中发生的变化及其潜在作用和泪囊炎可能的发病机制,以期为泪囊炎的临床诊治提供新的思路。

Dacryocystitis is a common ophthalmic disease,and the main treatment of it is to abandon the obstructed nasolacrimal duct and create a new lacrimal drainage pathway through implanting a tube.For now,its pathogenesis is understood very limitedly.It is widely accepted that many factors take part in its occurrence,among which obstruction and infection play important roles.Recent researches have shown that there is lacrimal drainage-associated lymphoid tissue(LDALT)which changes remarkably in dacryocystitis,and significant differences in cytokines expression levels in tears between dacryocystitis patients and normal control have been found.In addition,the lacrimal duct has reactions similar to immune rejection to the silicone tube.All of these indicate that immune factors participate in the pathogenesis of dacryocystitis.Changes of immune tissue and macromolecular substances including the LDALT,cytokines,local tissue and cytokines after tube implantation were reviewed to analyze the changes and possible roles of immune factors in the pathogenesis of dacryocystitis.