炎症因子在糖尿病性干眼患者中的表达变化及其意义

目的　研究炎症因子在糖尿病性干眼患者中的表达变化及意义。方法　选择符合干眼病诊断标准的糖尿病患者（糖尿病干眼组102例 102眼）及正常对照者（正常对照组84例84眼）。所有受检者均接受干眼症状询问及相关检查如:泪膜破裂时间（tear break-up time，BUT），泪液分泌试验（schirmer Ⅰ test，S Ⅰ T）及角膜荧光素染色（fluoresce in staining，FLS）评分。将两组结膜上皮细胞进行印迹细胞学检查和免疫组织化学染色。采用双抗体夹心酶联免疫吸附试验法（enzyme-linked immunosorbent assay，ELISA）检测所收集的泪液中炎症因子的浓度。结果　免疫组织化学染色结果显示:糖尿病组患者的结膜上皮细胞中转化生长因子β₁（transforming growth factor β₁，TGF-β₁）与转录因子-κB（nuclear factor κB，NF-κB）的阳性表达率均明显高于正常对照组，差异均具有统计学意义（P=0.008、0.016），Spearman相关性分析结果显示，两者之间显著正相关（r=0.654，P=0.005）。ELISA法检测结果显示，糖尿病组患者的泪液中白细胞介素-1β（interleukin 1β，IL-1β）、肿瘤坏死因子-α（tumor necrosis factor α，TNF-α）、趋化因子3（chemokine C-C ligand 3，CCL3）、CCL4、CCL5及血管内皮生长因子（vascular endothelial growth factor，VEGF）的浓度均明显高于正常对照组，差异均有统计学意义（均为P<0.05）。结论　IL-1β、CCL3、TNF-α、TGF-β₁等都在糖尿病性干眼患者的结膜上皮细胞及泪液中高表达，并有临床指导意义。

Expression of inflammatory factors in type 2 diabetic patients with dry eyes and its significance

Objective　To investigate the expression and significance of inflammatory factors in type 2 diabetic patients with dry eyes.Methods　Totally 102 diabetic patients （102 eyes） who met the diagnostic criteria for dry eye were collected as diabetic dry eye group and 84 normal individuals （84 eyes） as control group.All subjects were inquired about dry eye syndrome and received the examination including tear break-up time （BUT），Schirmer I test （SIT） and corneal fluoresce in staining （FLS）.Conjunctival epithelial cells of patients in both groups were examined by imprint cytological test and immunohistochemical staining while double antibody sandwich enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of concentration of inflammatory factors in tears.Results　Immunohistochemical staining results represented that the positive expression rate of transforming growth factor-β1 （TGF-β₁） and nuclear factor-κB （NF-κB） in conjunctival epithelial cells of diabetic dry eye group were higher than those of the control group，and the difference was statistically significant （P=0.008，0.016） and the Spearman correlation analysis showed that there was a significant positive correlation between the two groups （r=0.654，P=0.005）.The levels of interleukin-1β （IL-1β），tumor necrosis factor-α （TNF-α），chemokine C-C ligand 3 （CCL3）,CCL4,CCL5 and vascular endothelial growth factor （VEGF） in the tears of diabetic patients were significantly higher than those of the control group，and the differences were statistically significant （all P<0.05）.Conclusion　IL-1β，CCL3，TNF-α，TGF-β₁ are highly expressed in the epithelial cells and tears of diabetic patients with dry eye and meanwhile play key roles in the clinical diagnosis.