【摘要】  目的 探讨内源性神经生长因子（nerve growth factor，NGF）在准分子激光原位角膜磨镶术（laser in situ keratomileusis，LASIK）后干眼中的作用机制。方法 LASIK术前及术后1天、2天、10天及30天在17例患者（34眼）下睑结膜囊内抽取泪液标本，采用双抗体夹心酶联免疫吸附分析法检测泪液中NGF含量，同时行泪膜稳定性的检查，并对两者行相关性分析。结果 NGF含量在术前平均值为（21.96±8.22）μg/ml，术后1天、2天、10天含量分别为(12.76±3.55)μg/ml、(11.01±4.66)μg/ml、(13.55±4.93)μg/ml，与术前比较差异有统计学意义（P<0.05）；术后30天含量(19.16±8.79)μg/ml，与术前比较差异无统计学意义(P>0.05)。术前泪膜破裂时间（breaking-up time，BUT）均值为(12.62±1.99)s，术后1天、2天、10天和30天分别为(4.68±1.77)s、(4.84±1.92)s、(7.36±1.53)s和(8.82±3.08)s，与术前比较差异有统计学意义(P<0.05)；术后1天与2天比较差异无统计学意义(P>0.05)，术后1天（2天）、10天、30天比较差异均有统计学意义(P<0.05）。泪液中NGF含量与泪膜稳定性具有正相关（r=0.484，P<0.01）。结论 LASIK术后泪液NGF的含量存在一个由降低到正常的动态变化过程，NGF含量变化是泪膜稳定性下降的相关因素之一。

【关键词】  准分子激光角膜切削术；神经生长因子；泪膜稳定性；干眼

     Relationship between the levels of nerve growth factor in tears and tear film stability after LASIK

    CAO Yu-jin，TANG Ren-hong.Department of Ophthalmology，The Third Hospital of Xiangya of Center South University，Changsha 410013，China

    ［Abstract］  Objective  To study the mechanism of endogenous nerve growth factor(NGF) in the dry eye after LASIK.Methods  Nerve growth factor levels in the tears of 34 eyes before and after LASIK were studied with a monoclonal antibody based ELISA before LASIK and 1 day，2 days，10 days，and 30 days after LASIK.Tear film stability was examined during the same visits.And then the relationship between the levels of NGF in tears and tear film stability in the eyes of pre and postoperative LASIK patients was studied.Results  Mean value of NGF before LASIK was (21.96±8.22)μg/ml and mean values at 1 day，2 days，10 days and 30 days after LASIK were(12.76±3.55)μg/ml，(11.01±4.66)μg/ml，(13.55±4.93)μg/ml，(19.16±8.79)μg/ml，respectively.The NGF levels in tears at the first three visits post-operation were significantly different from levels in the pre-operative group.(P<0.05).However，There was no significant difference between the pre-surgical level and the level at the 30 days visit post-operation(P>0.05).Tear film stability before LASIK was(12.62±1.99)seconds，and at 1 day，2 days，10 days and 30days after LASIK，it was(4.68±1.77) seconds，(4.84±1.92) seconds，(7.36±1.53)seconds，and (8.82±3.08)seconds，respectively.Tear film stability at the time of the four visits after surgery was significantly different from the preoperative level (P<0.05).There was a positive correlation between tear film content and changes in tear film stability after LASIK(r=0.484，P<0.01).Conclusion  The decrease of BUT is the cause of dry eye and the changes in tear film stability and the onset of dry eye after LASIK are related to the level of NGF.

    ［Key words］  LASIK;nerve growth factor;tear film stability;dry eye

    近年来，准分子激光原位角膜磨镶术(laser in situ keratomileusis，LASIK)成为屈光手术的主流手术。除了视力的上升，视觉质量以及舒适度也成为患者追求的目标。然而术后患者常常出现眼干涩、异物感、易疲劳等干眼症状，在一定程度上影响了视觉质量。有研究表明局部应用含神经生长因子（nerve growth factor，NGF）滴眼液可以改善LASIK术后患者的干眼症状。神经生长因子存在于角膜组织［1，2］，其含量的稳定性是维持正常角膜上皮完整和角膜感觉的重要因素。LASIK术后角膜NGF含量变化国内外文献鲜有报道。本研究采用双抗体夹心酶联免疫吸附法（avidin-biotin peroxidase complex enzyme-liked immunosorbent assay，ABC ELISA ）测定LASIK手术前后泪液中NGF水平的变化，结合泪膜稳定性检测，对NGF与干眼关系进行探讨。

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