维生素A棕榈酸酯眼用凝胶对抗青光眼药物眼表损伤的防治作用

目的 探讨维生素A棕榈酸酯眼用凝胶预防临床常用抗青光眼药物眼表损伤的作用.方法 正常新西兰大白兔60只采用随机对照方式分为5组,每组12只(12眼).A组单纯使用维生素A棕榈酸酯眼用凝胶,B组单纯使用0.5%噻吗洛尔滴眼液,C组单纯使用0.2%溴莫尼定滴眼液,D组联合使用维生素A棕榈酸酯眼用凝胶及0.5%噻吗洛尔滴眼液,E组则联合使用维生素A棕榈酸酯眼用凝胶及0.2%溴莫尼定滴眼液.用药前及用药1个月后分别进行泪膜破裂时间(tear break-up time,BUT)、基础泪液分泌试验(Schirmer test)及印迹细胞学检查,并通过扫描电镜观察各组角膜上皮形态.结果 用药后B组及C组BUT为(11.6±1.9)s和(10.9±3.1)s,较用药前的(18.6 ±3.9)s和(16.5±4.3)s缩短,并且结膜杯状细胞密度较用药前下降,二者差异有统计学意义(P＜0.05).A,D及E组的BUT及结膜杯状细胞密度用药前后无明显变化.各组用药前后基础泪液分泌的差异均无统计学意义.B组和C组用药后Nelson分级标准评为1级;A,D及E组用药后仍为0级.扫描电镜结果表明B组及C组表现为表面粗糙,细胞失去平整性,卷边、脱落明显增多,细胞间出现裂隙,同时微绒毛密度明显减少.结论 长期使用抗青光眼药物可导致兔角膜及结膜结构变化.维生素A棕榈酸酯通过维持泪膜的稳定性及结膜杯状细胞密度,能够有效地减轻临床常用抗青光眼药造成的眼表损伤.(中国眼耳鼻喉科杂志,2007,7356-358)     

电子烟对小鼠角膜上皮和结膜杯状细胞的影响

目的：研究电子烟对小鼠角膜上皮组织结构及结膜杯状细胞的影响。方法：实验研究。18只雄性c57BL小鼠，5～6周龄，随机分为A、B、C组，每组6只。A组不做任何干预，B组采用0 mg尼古丁电子烟进行干预，C组采用12 mg尼古丁电子烟进行干预。每日2次，每次30 min。干预12周后，行苏木精-伊红染色观察角膜上皮情况，透射电子显微镜下观察小鼠角膜上皮组织超微结构变化，免疫荧光染色观察Mucin 5AC阳性表达的杯状细胞的改变。各组间结果数据采用单因素方差（One-way ANOVA）分析和事后分析。结果：干预12周后，A组上皮细胞层数为5.0±0.7，而B、C组上皮细胞层数分别为7.0±0.7和7.0±0.6，A组与B、C组间差异有统计学意义（F=18.50，P<0.001），而B组和C组间差异无统计学意义。与A组相比，B、C组角膜上皮微绒毛明显减少（F=153.50，P<0.001），长度变短（F=29.54，P<0.001），排列紊乱。在结膜穹隆部的上皮中，B组和C组的Mucin 5AC阳性细胞数目比A组明显减少（F=420.10，P<0.001），但是B组和C组之间Mucin 5AC阳性细胞数目差异无统计学意义。结论：电子烟会损伤小鼠角膜上皮的组织结构，减少结膜杯状细胞的数目。     

维生素A对角膜移植排斥反应后结膜杯状细胞的影响

目的:探讨维生素A对角膜移植排斥反应后结膜杯状细胞的影响。方法:建立大鼠角膜移植排斥反应模型,随机分3组:A、B、C组为SD-Wistar大鼠行同种异体角膜移植术,SD鼠为受体,Wistar鼠为供体,其中A组为空白对照组,B组为(维生素A)诺沛凝胶滴眼液组,C组为0.1%地塞米松滴眼液组,另设D组为正常眼组。术后不同时间裂隙灯显微镜记录及比较各组角膜移植排斥指数(RejectionIndex,RI)。通过结膜组织学切片HE、PAS染色,并运用显微图像分析系统对结膜上皮杯状细胞数量及形态进行分析。结果:观察期间检测结膜杯状细胞发现,A、B、C组杯状细胞数量均少于D组(P<0.01),A、B、C组内部比较,以C组数量为多,其次为B组,有差异有显著性(P<0.05)。结论:维生素A具有保护角膜移植引起的结膜杯状细胞减少的作用。     

圆锥角膜配戴透气性角膜接触镜相关性干眼疗效评价

目的 观察维生素A棕榈酸酯眼用凝胶对圆锥角膜配戴硬性透气性角膜接触镜(RGP)相关性干眼症的临床疗效.方法 将90例透气性角膜接触镜相关性干眼症圆锥角膜患者随机分为3组,每组30例(60眼):A组使用人工泪液滴眼液,6次,d,1滴/次;B组使用维生素A棕榈酸酯眼用凝胶,3次,d,1滴/次;C组在使用人工泪液滴眼液(6次/d,1滴/次)后15min再用维生素A棕榈酸酯眼用凝胶(3次/d,1滴/次).观察各组患者用药前1天与用药后第3、7、14天的眼部症状评分、泪膜破裂时间(BUT)、Schirmer Ⅰ试验(S Ⅰ T)、角膜荧光染色(Fl)评分变化.结果 在用药7天后三组患者的干眼症状、BUT和Fl染色均较治疗前有明显改善(P＜0.05),三组患者SⅠT值治疗前后差异均无统计学意义(P＞0.05).各组患者在治疗14天后和治疗7天时测得的各项指标差异无统计学意义(P＞0.05).A组与B组对眼部症状、BUT和SⅠT的改善作用差异无统计学意义(P＞0.05);B组较A组改善角膜Fl染色作用更明显,差异有统计学意义(P＜0.05).C组对改善干眼症状、BUT和Fl染色作用优于A组(P＜0.05).SⅠT和Fl染色治疗前后比较,C组和B组,差异无统计学意义(P＞0.05),C组对改善干眼症状和BUT作用优于B组(P＜0.05).结论 维生素A棕榈酸酯眼用凝胶能够促进角膜上皮损伤愈合,缓解圆锥角膜患者配戴硬性透气性角膜接触镜所致干眼症状,具有临床应用价值.     

维生素A对角膜移植排斥反应后结膜杯状细胞的影响

目的:探讨维生素A对角膜移植排斥反应后结膜杯状细胞的影响。方法:建立大鼠角膜移植排斥反应模型,随机分3组:A,B,C组为SD-Wistar大鼠行同种异体角膜移植术,SD鼠为受体,Wistar鼠为供体,其中A组为空白对照组,B组为(维生素A)诺沛凝胶滴眼液组,C组为1g/L地塞米松滴眼液组,另设D组为正常眼组。术后不同时间裂隙灯显微镜记录及比较各组角膜移植排斥指数(Rejection Index,RI)。通过结膜组织学切片HE,PAS染色,并运用显微图像分析系统对结膜上皮杯状细胞数量及形态进行分析。结果:观察期间检测结膜杯状细胞发现,A,B,C组杯状细胞数量均少于D组(P<0.01);A,B,C组内部比较,以C组数量为多,其次为B组,有显著性差异(P<0.05)。结论:维生素A具有保护角膜移植引起的结膜杯状细胞减少的作用。     

严重碱烧伤患者眼表形态的共焦显微镜观察

目的 探讨利用激光共焦显微镜观察严重碱烧伤患者眼表的形态结构.方法 系列病例研究.于2008年2月至11月期间在复旦大学附属眼耳鼻喉科医院就诊的眼表碱烧伤患者中,选择39例Roper-Hall分度为Ⅲ度或Ⅳ度的患者,根据眼部受伤时间分组,A组(9例,12只眼)为受伤3个月以内,B组(8例,11只眼)为受伤3～6个月,C组(11例,14只眼)为受伤6～12个月,D组(11例,14只眼)为受伤12个月以上.使用激光共焦显微镜对其受伤角膜、角膜缘以及球结膜进行检查,各层图像均被记录,分析角膜各层细胞形态,角膜缘栅栏结构形态,角膜缘炎性细胞与树突状细胞密度,以及球结膜各层细胞形态.运用单因素方差分析对角膜缘炎性细胞与树突状细胞密度进行统计学分析,运用最小显著性差异分析组间差异.结果 A组的碱烧伤患者角膜上皮细胞体积增大,形态不一,细胞质高反光,细胞核低反光,有时可见部分细胞缺失;表层细胞下见大量高亮小圆的炎性细胞浸润,聚集成团;浅基质层水肿明显,难以分辨细胞形态;深基质层细胞呈激活态;内皮层模糊不清.随着病程的延长,表层上皮细胞仍表现为上述异常结构,D组碱烧伤患者中,此类异常细胞消失;表层细胞下炎性细胞减少,可见部分残存的角膜上皮基底层细胞,存在散在或成团分布的中高亮反光的结模样细胞生长,随着病程的延长,角膜上皮基底层细胞大面积消失,代之以卵圆形,体积较小,排列紧密,细胞核呈点状高反光的结模样细胞;B组碱烧伤患者浅基质层仍难以分辨细胞形态,深基质层细胞呈激活态,C组和D组的碱烧伤患者中,角膜基质被纤维组织所替代;内皮层始终模糊不清.碱烧伤患者角膜缘Vogt栅栏结构始终被破坏;角膜缘血管网密集;A～D组角膜缘炎性细胞密度分别为(4023±343)、(2975±246)、(2652±375)、(2679±299)个/mm~2,经统计学分析差异有统计学意义(F=40.001,P=O.000);角膜缘树突状细胞密度分别为(106±19)、(132±35)、(141±26)、(98±24)个/mm~2,经统计学分析差异有统计学意义(F=8.053,P=0.000).碱烧伤患者的结膜损伤面积较小时,A组与B组碱烧伤患者结膜上皮细胞形态较难分辨,结膜固有层可见大量炎性细胞浸润,杯状细胞难以见到;C组和D组的碱烧伤患者中,结膜上皮形态基本正常,结膜固有层仍有部分炎性细胞与树突状细胞浸润,部分患者可见残存的杯状细胞.而当结膜受到大面积损伤时,各组碱烧伤患者的结膜均表现为上皮大面积缺失,代之以条索状高反光的纤维组织.结论 在激光共焦显微镜下,不同病程的严重碱烧伤患者的眼表组织细胞形态存在一定差异,激光共焦显微镜是观察严重碱烧伤患者眼表形态的有效工具.     

长期使用青光眼药物对眼表的影响

目的 探讨长期使用青光眼药物对患者眼表的影响.方法 收集局部使用青光眼药物3个月以上的患者65例108只眼,分为单种药物使用组(A组)和多种药物使用组(B组);另收集正常对照组(c组)25例25只眼.对所有观察对象进行泪膜破裂时间测定(BUT)、基础泪液分泌试验(ST)、角膜上皮荧光素染色、结膜上皮虎红染色以及结膜印迹细胞(IC)检查.结果 正常对照组BUT(12.25±5.40)s,ST(11.65±4.66)mm,A组BUT(6.97±4.87)8 9ST(7.19±5.36)mm,明显低于正常对照组(BUT P=0.000;STP=0.001). B组BUT(4.81±2.45)s,显著短于正常对照组(P=0.000)和A组(P=0.008);ST(5.20±2.97)mm,显著少于正常对照组(P=0.000)和A组(P=0.026).A组和B组的角膜荧光素染色评分和结膜虎红染色评分显著高于正常对照组.与正常对照组相比,A组和B组IC评分2-3级所占比例明显增高,结膜上皮表现出鳞状上皮化趋势.结论 长期使用青光眼药物会导致患者泪膜稳定性下降、泪液分泌减少,角膜上皮荧光素染色增多,结膜上皮杯状细胞减少、上皮细胞呈鳞状上皮化等泪膜、角膜和结膜的损伤.     

结膜基质环境对杯状细胞分化调控作用的研究

目的 探索结膜基质纤维细胞对结膜上皮杯状细胞分化的调控作用.方法 将实验研究对象分为A、B两组,A组为兔结膜上皮细胞与兔基质纤维细胞共培养组:即先在培养皿内培养兔结膜基质组织块1周.此时可见组织块周围生长直径约1 cm的基质纤维细胞,然后在距该细胞2～3 cm位置培养兔结膜上皮组织块,二者在同一培养皿内共培养1周;B组为单纯结膜上皮细胞培养组:即仅在培养皿内培养兔结膜上皮组织块1周.应用光学倒置相差显微镜观察两组结膜上皮细胞分泌泡的形态,通过免疫组化技术对比两组PAS及Muc5AC染色阳性细胞的数量及分布,并对两组Muc5AC阳性细胞数进行统计学分析及对比.结果 培养1周后,A组见大量顶浆分泌的杯状细胞,队S及Muc5AC染色阳性细胞数A组均明显高于B组,A组Mue5AC染色阳性细胞数量平均为(26.40±4.78)个,B组平均为(15.00±4.31)个,两组相比差异有显著统计学意义(P<0.001).结论 结膜基质纤维细胞具有促进结膜上皮杯状细胞分化和分泌的作用.     

3g/L玻璃酸钠联合角膜绷带镜在翼状胬肉切除术后早期的应用

目的:评价3g/L玻璃酸钠联合角膜绷带镜在翼状胬肉切除术后早期的应用价值。方法:随机双盲对照研究。收集2017-03/2018-03行手术治疗的单眼原发性鼻侧翼状胬肉患者90例90眼,分为A、B、C三组。A组角膜绷带镜+3g/L玻璃酸钠治疗;B组角膜绷带镜+1g/L玻璃酸钠治疗;C组:3g/L玻璃酸钠+包盖治疗。比较三组治疗后眼表刺激症状评分、角膜上皮愈合时间和结膜植片水肿消退时间。结果:术后A组各观察时间点眼表刺激症状评分均低于C组(P<0.001);A组角膜上皮愈合时间(2.08±0.78d)、结膜植片水肿消退时间(4.62±1.17d)均较C组(5.13±2.34、6.42±1.51d)明显缩短(P=0.001、0.002)。A组与B组术后各时间点眼表刺激症状以及结膜植片水肿消退时间均无差异(P>0.05),但A组角膜上皮愈合时间明显缩短(P=0.018)。结论:3g/L玻璃酸钠联合角膜绷带镜在翼状胬肉切除术后早期应用具有协同作用,可以有效缩短角膜上皮愈合时间,缓解刺激症状。     

维生素A对结膜巩膜手术切口所致杯状细胞减少的保护作用

目的 探讨维生素A对结膜巩膜手术切口所致结膜杯状细胞减少的保护作用.方法 建立兔结膜巩膜切口手术模型,随机分2组:A组为空白对照组,B组为维生素A干预组;另设正常对照组C组,未接受手术组.术后不同时间行裂隙灯显微镜检查、手术区结膜组织学切片HE、PAS染色及印迹细胞学检测,并运用显微图像分析系统对结膜上皮杯状细胞数量及形态进行分析.结果 术后各时间点,A、B组结膜杯状细胞数量均少于C组(P<0.05),A、B组比较,B组杯状细胞数量较多,差异有显著性(P<0.05).且B组杯状细胞形态较A组饱满.结论 维生素A对结膜巩膜手术切口所致杯状细胞的减少具有保护作用.     

Effect of vitamin A on the conjunctival goblet cells of rat after corneal transplantation

AIM: To investigate the effect of vitamin A on the conjunctival goblet cells of rat after corneal transplantation. · METHODS: Rat graft rejection models of corneal transplant- ation were established. SD rats were receptor and Wistar rats were donors. After corneal allografts were performed, 48 SD rats were randomly divided into three groups, 16 rats in each group. Group A was blank control group; group B was treated by oculotect gel (containing vitamin A); group C was treated by 1g/L dexamethasone eyedrops. Besides, group D was normal unoperated eyes. Slit-lamp microscope was employed to record and compare rejection index (RI) of corneal transplantation. By HE, PAS staining of conjunctival histological sections and image analysis system, the number and morphology of conjunctival goblet cells were observed and analyzed between operation group and normal group. · RESULTS: The HE, PAS staining detection showed that the number of conjunctival goblet cells in oculotect gel group, 1g/L dexamethasone eyedrops group and control group is lower than that in normal group after surgery (P <0.01). The number of conjunctival goblet cells in oculotect gel group and 1g/L dexamethasone eyedrops group is higher than that in control group (P <0.05). The number of conjunctival goblet cells in 1g/L dexamethasone eyedrops group is higher than that in oculotect gel group (P <0.05). · CONCLUSION: The results indicate that vitamin A may inhibit the decrease of conjunctival goblet cells after corneal allograft rejection in rats.     

Inhibition of conjunctival transdifferentiation by topical retinoids

During the healing of a total corneal epithelial defect extending beyond the limbus, conjunctival transdifferentiation can be inhibited by corneal vascularization as evidenced by the lack of morphological transformation of the conjunctival epithelium into a cornea-like epithelium and the persistence of goblet cells on the corneal surface. We speculated that corneal vascularization might play a causative role in inhibiting conjunctival transdifferentiation, and examined the hypothesis that vitamin A or retinoids might be one of the blood-borne factors in modulating this process. To test this hypothesis, we created total corneal epithelial defects extending 3 mm beyond the limbus in rabbits using n-heptanol, and segregated the resultant corneas into nonvascularized and vascularized groups. After re-epithelialization, both groups received topical 0.1% Etretinate (Roche-Hoffmann, Nutley, NJ) or 13-cis retinoic acid in corn oil three times a day for 8 weeks. Controls received corn oil only. The extent of transdifferentiation was analyzed by assaying goblet cell density and distribution using flat-mount preparations and Alcian blue and periodic acid-Schiff stains (Fischer Scientific Co., Fair Lawn, NJ) and by conventional histology. Topical retinoid application inhibited conjunctival transdifferentiation in nonvascularized corneas to the same extent as that caused by corneal vascularization, suggesting that vitamin A is an important blood-borne factor for goblet cell maintenance. Its relative deficiency in the normal avascular cornea may explain why conjunctival transdifferentiation occurs.     

Conjunctival transdifferentiation induced by systemic vitamin A deficiency in vascularized rabbit corneas

Conjunctival transdifferentiation, the process in which conjunctival epithelium transforms into a cornea-like epithelium with the loss of goblet cells during the healing of a total corneal epithelial defect, can be retarded or reversed by corneal neovascularization. We have previously shown that this process normally occurring on non-vascularized corneas can be retarded or reversed by topical retinoids, suggesting that vitamin A may be one of the factors from blood circulation which is responsible for modulating transdifferentiation. Herein, we have examined the effect of systemic vitamin A deficiency on vascularized corneas starting 4 months after epithelial denudation, and compared this deficient group with their vascularized and non-vascularized controls. Mean serum retinol level (microgram/dl) (n = 4) measured by HPLC was gradually reduced from 83 of the controls to 20 in a 10 month follow-up. Topographical analysis disclosed a centrifugal loss of goblet cell density with time. Histology showed complete transdifferentiation in vascularized areas at 9 months, initiated by the loss of mucin contents from receding zones first noted at 2 months. Using impression cytology, all corneas were not keratinized and all conjunctivas maintained a normal goblet cell density at 10 months. These results indicate that conjunctival epithelium on corneal surface is more sensitive to the decrease of serum vitamin A levels than that on conjunctiva, and support the hypothesis that the relative vitamin A deficiency on vascularized corneas can also result in the conjunctival transdifferentiation.     

Reversal of conjunctival transdifferentiation by topical retinoic acid

After resurfacing a total corneal epithelial defect extending 2-3 mm beyond the limbus, conjunctival epithelium gradually loses goblet cells and transforms into a corneal-like epithelium. We examined the effect of topical retinoic acid on the reversal of transdifferentiation on nonvascularized corneas. Four months after total denudation of corneal epithelium using n-heptanol, rabbit corneas without vascularization received topical drops of 0.1% (wt/vol) all-trans retinoic acid in corn oil 3 times a day. Before treatment, the transdifferentiation was complete, as evidenced by the absence of goblet cells on the corneal surface using a topographical assay and routine histology. After treatment for 15 days, goblet cells reappeared 3 mm into the peripheral cornea, and extended in a centripetal density to 4.5 mm after 32 days. To prove that retinoic acid was not angiogenic, retinoid-bearing Elvax-40 pellets were implanted into normal corneal stroma. Taken together, these data indicate that vitamin A or retinoids may be an important factor in the modulation of conjunctival epithelial transdifferentiation.     

持续性角膜上皮缺损对骨髓间充质干细胞增殖能力的影响

目的建立持续性角膜上皮缺损模型,观察不同时相的角膜上皮缺损对骨髓间充质干细胞增殖能力的影响。方法取健康雄性Wistar大鼠40只,随机平均分为8组,按每天处死1组大鼠的先后顺序分别命名为缺损组(A、B、C、D、E、F、G)和空白对照组。对全部缺损组大鼠建立持续性角膜上皮缺损模型,每天对缺损组大鼠左眼行角膜上皮刮除术,第1次术后1d处死缺损组A组大鼠,然后对剩余缺损组大鼠左眼行角膜上皮刮除术;第2次术后1d处死缺损组B组大鼠,然后对剩余缺损组大鼠左眼行角膜上皮刮除术,依此类推连续7d,并在无菌条件下获取各组骨髓间充质干细胞,流式细胞技术检测各组细胞周期。结果骨髓间充质干细胞细胞周期检测结果显示:B、D组S期细胞百分数分别为16.76%±4.49%、17.95%±2.77%,明显高于其他缺损组和对照组(均为P<0.05),B、D组G1期细胞百分数分别为72.26%±8.81%、71.33%±5.30%,均低于其他缺损组和对照组(均为P<0.05);但B、D组S期细胞及G1期细胞百分数差异无统计学意义(均为P>0.05),A、C、E、F、G组及对照组间的S期细胞及G1期细胞百分数差异亦无统计学意义(均为P>0.05)。结论持续性角膜上皮缺损模型,在缺损持续的第3天和第5天骨髓间充质干细胞的增殖能力明显提高。     

Vitamin E prevents changes in the cornea and conjunctiva due to vitamin A deficiency

PURPOSE: To determine whether vitamin E can prevent changes in the cornea and conjunctiva due to vitamin A deficiency. METHODS: Male infant rats from normal mothers were weaned at 20 days of age and divided into three groups: in group 1, A(-), rats were fed a vitamin A-deficient diet; in group 2, A(-)E(+), rats were fed a vitamin A-deficient diet and injected intraperitoneally with 15 mg of vitamin E per week; group 3 rats were normal controls. At 13 weeks of age, the corneal and conjunctival changes were examined by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). RESULTS: SEM showed more fine microvilli and clear cells in the most superficial epithelial layer of the cornea and conjunctiva in A(-)E(+) rats than in that of A(-) rats. Numerous secretory granules were seen in the goblet cells of the conjunctiva of A(-)E(+) rats, but in A(-) rats there was a total absence of conjunctival goblet cells. TEM showed a severely keratinized corneal surface in A(-) rats. On the other hand, the corneas of A(-)E(+) rats were almost normal in appearance. The conjunctivae of A(-) rats had superficial epithelial keratinization, scarce goblet cells, and many keratohyalin granules in the epithelium and dark cells, while in the conjunctivae of A(-)E(+) rats there were numerous secretory granules in goblet cells and some dark cells. CONCLUSION: The present study suggests that vitamin E has a protective effect against the corneal and conjunctival damage caused by vitamin A deficiency.     

维生素A治疗苯扎氯铵诱导的小鼠干眼的实验研究

目的通过随机对照实验探讨维生素A对苯扎氯铵诱导的小鼠干眼的治疗作用。方法实验研究。选用BALB＆小鼠50只,使用0．25％的苯扎氯铵溶液局部点眼以诱导干眼。在第21天时根据泪膜破裂时间（BUT）、角膜荧光素钠染色、炎症指数等参数选择干眼表现程度相近的小鼠30只（60眼）并随机分为A、B、C三组,每组10只（20眼）。A、B组分别使用5000IU／（g·mD维生素A微乳剂和空白微乳剂滴眼,C组为空白对照组。在治疗的第0、1、3、5、7天检测BUT和角膜上皮荧光素钠染色、眼表炎症程度及基础泪液分泌量。7d治疗结束后取出小鼠眼球,进行HE及过碘酸．希夫（PAS）染色,角蛋白10（K10）免疫荧光标记,以及WesternBlot检测角膜组织中K10表达水平。对数据采用单因素方差分析。结果在药物治疗的第0、1、3、5天各项临床指标差异无统计学意义。治疗第7天时,A、B、C组BUT值分别为（4．20±0．89）s、（3．32±1．01）s和（3．28±0．74）s;其中A组的BUT值较B组和C组长,差异有统计学意义（F=6．825,P=-0．002）。A、B、C组角膜荧光素钠染色评分分别为3．74±1．31、5．47±1．81和5．83±1．54,其中维生素A微乳组较空白微乳组和空白对照组角膜荧光素钠染色分级轻．差异具有统计学意义（F=8．853,P〈0．01）。各组间的角膜炎症指数评分、基础泪液分泌量差异均无统计学意义。组织病理检查示维生素A组与空白微乳组和空白对照组比较,其角膜上皮形态较规整;PAS染色示维生素A组杯状细胞数量更接近正常小鼠。维生素A组的角膜上皮层几乎均不表达K10．而空白微乳组及空白对照组呈阳性表达。Westem Blot检测示维生素A组角膜中的K10水平低于空白微乳组和空白对照组。结论维生素A可以延长苯扎氯铵诱导的干眼小鼠的BUT,降低角膜上皮染色程度,抑制角膜上皮鳞状化生,并能增加结膜杯状细胞数量,有望用于干眼治疗。