激光蛋白细胞检测仪在葡萄膜炎中的应用价值

目的:探讨激光蛋白细胞检测仪(laser flare cell meter,LFCM)定量测定葡萄膜炎患者房水闪辉的临床应用价值。方法:选择2009-07/2010-07在我院就诊、复查的葡萄膜炎患者129例171眼,根据其临床特点将其分为前葡萄膜炎组87例87眼,中间葡萄膜炎组10例20眼,后葡萄膜炎组32例64眼;正常对照组50例100眼。应用LFCM(FM-600型)检测各期患者房水闪辉情况,检查前所有患者均经裂隙灯显微镜检查,并进行房水闪辉分级。结果:前葡萄膜炎患者裂隙灯检查前房闪辉48眼(1+),35眼(2+),2眼(3+),2眼(4+);LFCM检测1～2级房水闪辉的平均值分别为28.6±6.7pc/ms,144.3±28.1pc/ms,3～4级房水闪辉由于背景干扰大,检测结果显示警告或无法检测;前葡萄膜炎患者1～2级房水闪辉的裂隙灯显微镜检查与LFCM测定结果呈正相关(r=0.901,P<0.01);与对照组房水闪辉值比较(5.1±1.8pc/ms),差异具有统计学意义(P<0.05)。中间葡萄膜炎患者裂隙灯检查前房闪辉10眼(1+),10眼(2+),LFCM检测1～2级房水闪辉的平均值分别为31.7±5.0pc/ms,130.7±12.9pc/ms;中间葡萄膜炎患者1～2级房水闪辉的裂隙灯显微镜检查与LFCM测定结果呈正相关(r=0.867,P<0.01);与对照组房水闪辉值比较,差异具有统计学意义(P<0.05)。后葡萄膜炎患者裂隙灯检查前房闪辉均为0级,LFCM检测房水闪辉的平均值为9.8±3.1pc/ms,高于对照组,差异具有统计学意义(P<0.05)。结论:LFCM(FM-600型)可确切判断葡萄膜炎患者轻、中度的血-房水屏障破坏,对判断眼前段炎性反应和指导临床治疗有重要意义。

Application value of laser flare cell meter in uveitis

AIM: To explore the clinical value of quantitative determination of aqueous flare in patients with uveitis by FM-600 laser flare cell meter(LFCM).

METHODS:According to clinical manifestation, 129 patients(171 eyes)with uveitis were divided into 3 groups in our hospital from July 2009 to July 2010: 87 cases(87 eyes)in anterior uveitis group, 10 cases(20 eyes)in intermediate uveitis group, 32 cases(64 eyes)in posterior uveitis group. The other 50 cases(100 normal eyes)were in the control group. Flare in patients with uveitis at different stages was graded and measured by LFCM(FM-600)and slit-lamp microscope.

RESULTS: Flare of grade 1+, 2+, 3+ and 4+ were noted in 48, 35, 2 and 2 eyes in anterior uveitis patients, respectively. LFCM examination revealed that the mean flare values in anterior uveitis eyes with flare of grade 1+ and 2+ were 28.6±6.7pc/ms and 144.3±28.1pc/ms, and 5.1±1.8pc/ms in the control group. In patients with flare of grade 3+ and 4+, LFCM readings were unreliable because of increased background noise. The differences between the two groups were statistically significant(P<0.05). There was significant correlation between slit lamp examination and LFCM measurement for flare of grade 1+ and 2+(r=0.901, P<0.01). Flare of grade 1+ and 2+ were noted in 10 and 10 eyes in intermediate uveitis patients, respectively. LFCM examination revealed that the mean flare values were 31.7±5.0pc/ms and 130.7±12.9pc/ms, and 5.1±1.8pc/ms in the control group. The differences between the two groups were statistically significant(P<0.05). There was significant correlation between slit lamp examination and LFCM measurement for flare of grade 1+ and 2+(r=0.867, P<0.01). Flare of grade 0 was noted in 64 eyes in posterior uveitis patients. LFCM examination revealed that the mean flare value was 9.8±3.1pc/ms which was higher than that in the control group(P<0.05).

CONCLUSION:LFCM(FM-600)is able to evaluate precisely the mild and moderate breakdown of blood aqueous barrier in uveitis, therefore it provides an important parameter for the determination of inflammatory response in anterior segment and the clinical treatment of uveitis.