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《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

卷:

期数:

2022年7期

页码:

84-88

栏目:

出版日期:

2022-07-10

文章信息/Info

Title:

Efficacy Analysis of Autologous Limbal Stem Cell Transplantation in the Treatment of Patients with Pterygium

文章编号:

1008-6455（2022）07-0084-04

作者:

晋红敏

(襄阳爱尔眼科医院眼科 湖北 襄阳 441000)

Author(s):

JIN Hongmin

(Department of Ophthalmology,Aier Eye Hospital of Xiangyang,Xiangyang 441000,Hubei,China)

关键词:

翼状胬肉; 自体角膜缘干细胞; 移植; 泪膜; 角膜上皮功能; 复发

Keywords:

pterygium;  autologous limbal stem cell;  transplantation;  tear film;  corneal epithelial function;  recurrence

分类号:

R777.83

文献标志码:

A

摘要:

目的：探讨自体角膜缘干细胞移植术治疗翼状胬肉的效果及对眼表泪液系统及角膜上皮功能的影响。方法：选取2018年1月-2019年1月笔者医院就诊的80例（共110眼）翼状胬肉患者为研究对象，采用简单随机数字表法分为单一组（n=40，56眼）、联合组（n=40，54眼）。单一组采用翼状胬肉单纯切除术治疗，联合组在单一组基础上联合自体角膜缘干细胞移植术治疗。比较两组手术效果，酶联免疫吸附法检测两组白介素-6（Interleukin-6，IL-6）、肿瘤坏死因子-α（Umor necrosis factor-α，TNF-α）、血管内皮生长因子（Vascular endothelial growth factor，VEGF）水平，采用泪膜破裂时间（Tear film rupture time，BUT）、基础泪液分泌试验（Schirmer I test，SIT）评估两组眼表泪液系统变化情况，采用角膜上皮荧光素染色评分（Corneal epithelial fluorescein staining score，FL）评估两组角膜上皮功能，同时比较两组并发症发生率和复发率。结果：联合组角膜上皮修复时间较单一组明显短，美学效果优良率明显高于单一组，差异有统计学意义（P＜0.05）。与治疗前比较，治疗后两组IL-6、TNF-α、VEGF水平明显降低，且联合组明显低于单一组（P＜0.05）。与治疗前比较，治疗后两组BUT、SIT明显增大，且联合组明显大于单一组（P＜0.05）。与治疗前比较，治疗后2、4、6个月两组FL评分明显降低，且联合组明显低于单一组（P＜0.05）。Pearson参数分析提示BUT、SIT与IL-6、TNF-α、VEGF水平呈明显负相关（P＜0.05），而FL评分与IL-6、TNF-α、VEGF水平呈明显正相关（P＜0.05）。联合组并发 症发生率与对照组比较，差异无统计学意义（P＞0.05）；但联合组术后1年复发率明显低于单一组（P＜0.05）。结论：自体角膜缘干细胞移植术应用于翼状胬肉患者中可获得更理想的美学效果，且有效抑制机体炎症反应，对改善患者眼表泪液系统和角膜上皮功能以及降低复发率方面有明确优势，有临床推广应用优势。

Abstract:

Objective This research aims to investigate the effects of autologous limbal stem cell transplantation in the treatment of pterygium, and the influence on ocular surface tear system and corneal epithelium function. Methods Totally 80 patients (110 eyes) with pterygium treated in the hospital were selected as the research subjects between January 2018 and January 2019. They were divided into single group (n=40, 56 eyes) and combined group (n=40, 54 eyes) by random number table method. Patients in the single group were treated with simple pterygium excision, while on this basis, patients in the combined group were treated with autologous limbal stem cell transplantation. Surgical results of the two groups were compared. Detect the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and vascular endothelial growth factor (VEGF) by enzyme linked immunosorbent assay. Tear film stability and corneal epithelium function were evaluated with break-up time (BUT) and fluorescein staining (FL). The incidence of complications and postoperative recurrence rate were compared between the two groups. Results The corneal epithelial repair time was significantly shorter, and the excellent and good rate of cosmetic effect was significantly higher in the combined group than in the single group (P＜0.05).Compared with before treatment, the levels of IL-6, TNF-α and VEGF in the two groups after treatment were significantly reduced, and the combined group was significantly lower than that of the single group (P＜0.05). After treatment, BUT and SIT were significantly increased in the two groups, and the two were significantly longer in the combined group than in the single group (P＜0.05). FL scores of the two groups were significantly reduced at 2, 4 and 6 months after treatment, and the combined group had significantly lower FL scores than the single group (P＜0.05). Pearson analysis showed that BUT and SIT were significantly negatively correlated with IL-6, TNF-α, and VEGF levels (P＜0.05), while FL score was significantly positively correlated with IL-6, TNF-α, and VEGF levels (P＜0.05). There was no significant difference in incidence of complications between the two groups (P＞0.05). However, the postoperative 1-year recurrence rate in the combined group was significantly lower than that in the single group. Conclusion The application of autologous limbal stem cell transplantation to patients with pterygium can achieve more ideal cosmetic effect. It has definite advantages in improving ocular surface tear system and corneal epithelial function, and reducing recurrence rate.

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更新日期/Last Update: 2022-07-26