Ma X, Lu Y
泪膜 角膜炎 单侧
摘要：目的：评价单侧静止性单纯疱疹性角膜炎(HSK)患者双边眼泪的作用和角膜敏感性，并确定双眼中角膜敏感性和泪液分泌的关系。方法：这项研究包括35个HSK患者和35个健康者。每个参与者测量双边眼泪渗透性，分泌测试，眼泪中断时间(TBUT)和角膜敏感性。结果：HSK组中，两只眼眼泪渗透性明显增加，分泌测试和TBUT相比于正常组减少(p<0.001)。双边眼泪渗透性和分泌测试结果相同，TBUT (4.9±2.1与7.4±2.0秒；p<0.001)和角膜敏感性(35.1±1.9与54.3±0.8mm; p<0.001)在病眼中明显降低。双边眼泪渗透性，分泌测试和TBUT与角膜敏感性显著相关(p<0.001)。未受影响眼的角膜敏感性作为控制变量，其眼泪渗透性(R=-0.626，p<0.001)，分泌测试(R=0.739，p<0.001)和TBUT (R=0.691，p<0.001)与受影响眼的角膜敏感性显著相关。结论：由于缺乏角膜敏感性，HSK引起双侧眼泪损伤。受影响的眼睛伴随严重的角膜敏感性缺失和干眼症的发生。
PURPOSE:To evaluate bilateral tear function and corneal sensitivity in patients with unilateral quiescent herpes simplex keratitis (HSK) and determine the correlation between corneal sensitivity and tear secretion in both eyes.METHODS:Thirty-five patients diagnosed with unilateral quiescent HSK and 35 heathy controls were included in this study. Bilateral tear osmolarity, Schirmer's test, the tear break-up time (TBUT) and corneal sensitivity were measured in all participants.RESULTS:In the HSK group, both eyes demonstrated a significant increase in tear osmolarity, and a decrease in Schirmer's test and the TBUT compared with healthy controls (All p<0.001). The bilateral tear osmolarity and Schirmer's test were similar, but the TBUT (4.9±2.1 versus 7.4±2.0second; p<0.001) and corneal sensitivity (35.1±1.9 versus 54.3±0.8mm; p<0.001) were significantly lower in the affected eyes. The bilateral tear osmolarity, Schirmer's test and the TBUT were significantly correlated with corneal sensitivity of the affected eye (All p<0.001). When corneal sensitivity of the unaffected eye was treated as a control variable, tear osmolarity (R=-0.626, p<0.001), Schirmer's test (R=0.739, p<0.001) and the TBUT (R=0.691, p<0.001) of the unaffected eyes were still significantly correlated with the corneal sensitivity of the affected eyes.CONCLUSIONS:Unilateral quiescent HSK causes bilateral tear impairment, which depends on the loss of corneal sensitivity in the affected eye. In the affected eye with severe corneal sensitivity loss, bilateral dry eye occurred.