中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
Chinese Journal of Optometry Ophthalmology and Visual Science
2015年
11期
662-667
,共6页
覃冬菊%刘辉%高黎黎%张鹏%徐建江
覃鼕菊%劉輝%高黎黎%張鵬%徐建江
담동국%류휘%고려려%장붕%서건강
睑板腺功能障碍%睑脂%磷脂%液相色谱-串联质谱
瞼闆腺功能障礙%瞼脂%燐脂%液相色譜-串聯質譜
검판선공능장애%검지%린지%액상색보-천련질보
Meibomian gland dysfunction%Meibum%Phospholipids%Liquid chromatography/tandem mass spectrometry method
目的 用液相色谱-串联质谱联用技术(LC-MS/MS)检测睑板腺功能障碍(meibomian glanddysfunction, MGD)患者睑板腺分泌物磷脂的3种主要成分卵磷脂(溶血磷脂酰胆碱)、脑磷脂(磷脂酰乙醇胺)、神经鞘磷脂与正常人的区别;并分析其相对浓度水平与MGD临床客观体征检测指标的相关性.方法 前瞻性配伍组设计.MGD患者22例(22眼)为MGD组,年龄相匹配的正常人30例(30眼)为对照组.MGD组患者选择症状体征较重的眼作为观察对象.用无菌棉签棒按压睑缘后,用无菌的不锈钢刮匙收集睑缘的睑板腺分泌物.所有样本使用LC-MS/MS定性定量分析MGD组睑脂磷脂的主要成分(卵磷脂、脑磷脂、神经鞘磷脂)与正常对照组的区别.2组之间比较采用独立样本￡检验,Pearson相关分析MGD组3种磷脂相对浓度水平与睑板腺分泌物性状评分、泪膜破裂时间(BUT)、角膜荧光素染色评分(CFS)、基础泪液分泌试验(S Ⅰ T)、裂隙灯显微镜下睑缘评分5项指标的关系.结果 ①睑板腺分泌物3种主要磷脂成分在MGD组与正常对照组间有明显差异,MGD组的睑脂卵磷脂上调(t=-2.45,P＜0.05),脑磷脂、神经鞘磷脂下调(t=16.73、18.59,P＜0.05).②卵磷脂相对浓度水平与睑板腺分泌物性状评分、CFS、裂隙灯显微镜下睑缘评分呈正相关(r=0.602、0.716、0.710,P＜0.01),与BUT、SⅠT呈负相关(r=-0.628、-0.477, P＜0.05).脑磷脂与睑板腺分泌物性状评分、CFS、裂隙灯显微镜下睑缘评分呈负相关(r=-0.565、-0.724、-0.702,P＜0.01),与BUT、SⅠT呈正相关(r=0.659、0.498,P＜0.05).神经鞘磷脂相对浓度水平与睑板腺分泌物性状评分、CFS、裂隙灯显微镜下睑缘评分呈负相关(r=-0.597、-0.719、-0.698,P＜0.01);与BUT、S Ⅰ T呈正相关(r=0.631、0.468,P＜0.05).结论 MGD患者较正常人有较高水平的卵磷脂,较低水平的脑磷脂和神经鞘磷脂.睑脂磷脂成分的变化可能是MGD发生发展的一个重要标志.
目的 用液相色譜-串聯質譜聯用技術(LC-MS/MS)檢測瞼闆腺功能障礙(meibomian glanddysfunction, MGD)患者瞼闆腺分泌物燐脂的3種主要成分卵燐脂(溶血燐脂酰膽堿)、腦燐脂(燐脂酰乙醇胺)、神經鞘燐脂與正常人的區彆;併分析其相對濃度水平與MGD臨床客觀體徵檢測指標的相關性.方法 前瞻性配伍組設計.MGD患者22例(22眼)為MGD組,年齡相匹配的正常人30例(30眼)為對照組.MGD組患者選擇癥狀體徵較重的眼作為觀察對象.用無菌棉籤棒按壓瞼緣後,用無菌的不鏽鋼颳匙收集瞼緣的瞼闆腺分泌物.所有樣本使用LC-MS/MS定性定量分析MGD組瞼脂燐脂的主要成分(卵燐脂、腦燐脂、神經鞘燐脂)與正常對照組的區彆.2組之間比較採用獨立樣本￡檢驗,Pearson相關分析MGD組3種燐脂相對濃度水平與瞼闆腺分泌物性狀評分、淚膜破裂時間(BUT)、角膜熒光素染色評分(CFS)、基礎淚液分泌試驗(S Ⅰ T)、裂隙燈顯微鏡下瞼緣評分5項指標的關繫.結果 ①瞼闆腺分泌物3種主要燐脂成分在MGD組與正常對照組間有明顯差異,MGD組的瞼脂卵燐脂上調(t=-2.45,P＜0.05),腦燐脂、神經鞘燐脂下調(t=16.73、18.59,P＜0.05).②卵燐脂相對濃度水平與瞼闆腺分泌物性狀評分、CFS、裂隙燈顯微鏡下瞼緣評分呈正相關(r=0.602、0.716、0.710,P＜0.01),與BUT、SⅠT呈負相關(r=-0.628、-0.477, P＜0.05).腦燐脂與瞼闆腺分泌物性狀評分、CFS、裂隙燈顯微鏡下瞼緣評分呈負相關(r=-0.565、-0.724、-0.702,P＜0.01),與BUT、SⅠT呈正相關(r=0.659、0.498,P＜0.05).神經鞘燐脂相對濃度水平與瞼闆腺分泌物性狀評分、CFS、裂隙燈顯微鏡下瞼緣評分呈負相關(r=-0.597、-0.719、-0.698,P＜0.01);與BUT、S Ⅰ T呈正相關(r=0.631、0.468,P＜0.05).結論 MGD患者較正常人有較高水平的卵燐脂,較低水平的腦燐脂和神經鞘燐脂.瞼脂燐脂成分的變化可能是MGD髮生髮展的一箇重要標誌.
목적 용액상색보-천련질보련용기술(LC-MS/MS)검측검판선공능장애(meibomian glanddysfunction, MGD)환자검판선분비물린지적3충주요성분란린지(용혈린지선담감)、뇌린지(린지선을순알)、신경초린지여정상인적구별;병분석기상대농도수평여MGD림상객관체정검측지표적상관성.방법 전첨성배오조설계.MGD환자22례(22안)위MGD조,년령상필배적정상인30례(30안)위대조조.MGD조환자선택증상체정교중적안작위관찰대상.용무균면첨봉안압검연후,용무균적불수강괄시수집검연적검판선분비물.소유양본사용LC-MS/MS정성정량분석MGD조검지린지적주요성분(란린지、뇌린지、신경초린지)여정상대조조적구별.2조지간비교채용독립양본￡검험,Pearson상관분석MGD조3충린지상대농도수평여검판선분비물성상평분、루막파렬시간(BUT)、각막형광소염색평분(CFS)、기출루액분비시험(S Ⅰ T)、렬극등현미경하검연평분5항지표적관계.결과 ①검판선분비물3충주요린지성분재MGD조여정상대조조간유명현차이,MGD조적검지란린지상조(t=-2.45,P＜0.05),뇌린지、신경초린지하조(t=16.73、18.59,P＜0.05).②란린지상대농도수평여검판선분비물성상평분、CFS、렬극등현미경하검연평분정정상관(r=0.602、0.716、0.710,P＜0.01),여BUT、SⅠT정부상관(r=-0.628、-0.477, P＜0.05).뇌린지여검판선분비물성상평분、CFS、렬극등현미경하검연평분정부상관(r=-0.565、-0.724、-0.702,P＜0.01),여BUT、SⅠT정정상관(r=0.659、0.498,P＜0.05).신경초린지상대농도수평여검판선분비물성상평분、CFS、렬극등현미경하검연평분정부상관(r=-0.597、-0.719、-0.698,P＜0.01);여BUT、S Ⅰ T정정상관(r=0.631、0.468,P＜0.05).결론 MGD환자교정상인유교고수평적란린지,교저수평적뇌린지화신경초린지.검지린지성분적변화가능시MGD발생발전적일개중요표지.
Objective To evaluate the differences in three kinds of meibomian phospholipid composition in healthy subjects and in patients suffering from meibomian gland dysfunction (MGD).Methods In this prospective study, 22 MGD patients (MGD group) and 30 age and sex matched heahhy individuals (control group) were enrolled.One eye of each subject was included in the study.MGD patients underwent sequential examinations as follows: the property of meibomian secretion, tear film break-up time (BUT), corneal fluorescein staining (CFS), Schirmer Ⅰ test and lid margin and ocular surface examinations by slit lamp.Meibomian gland secretions were collected using sterile stainless steel curettes in the healthy control group and MGD group after gentle massage of the lid margin with sterile cotton swabs.The meibomian phospholipids, mainly lysophosphatidylcholine,phosphatidylethanolamine, and sphingomyelin, were detected using liquid chromatography/tandem mass spectrometry (LC-MS/MS), and comparisons were made between the MGD group and the healthy control group.The data from the two groups were compared by an independent-samples t test and a Pearson correlation analysis was used to assess the correlation between the relative composition concentrations of the three kinds of phospholipids with the clinical parameters of the objective signs of MGD.Results The relative concentration level of lysophosphatidylcholine in the MGD group was significantly higher than that in the healthy controls (t=-2.45, P＜0.05), while phosphatidylethanolamine and sphingomyelin levels were lower in the MGD group than in healthy controls (t=16.73, P＜0.01 and t=18.59, P＜0.01, respectively).The relative concentration of lysophosphatidylcholine was positively correlated with the property of meibomian secretion, CFS, lid margin and ocular surface examination by slit lamp (r=0.602, 0.716, 0.710, P＜0.01, respectively);while a negative correlation was found with the BUT and Schirmer Ⅰ test (-0.628,-0.477, P＜0.05, respectively).The relative concentrations of phosphatidylethanolamine and sphingomyelin were negatively correlated with the properties of the meibomian secretion, CFS, lid margin and ocular surface examination (r=-0.565,-0.724,-0.702;r=-0.597,-0.719,-0.698, P＜0.01, respectively).However, a positive correlation was detected with the BUT and Schirmer Ⅰ test (r=0.659, 0.498, P＜0.05;r=0.631, 0.468, P＜0.05, respectively).Conclusion The profile of the three kinds of meibomian phospholipids (lysophosphatidylcholine, phosphatidylethanolamine and sphingomyelin) in MGD patients is dramatically different from healthy subjects.Its significant correlation with the clinical parameters of the signs of meibomian gland dysfunction suggest that a change in phospholipids composition in meibomian gland secretions is a probable reason for the development of MGD.
