【作者】 钟彬武；

【导师】 贾卉；

【作者基本信息】 吉林大学 ， 临床医学， 2012， 硕士

【摘要】 慢性结膜炎是眼科的常见病、多发病。慢性结膜炎根据主要致病因素可分为感染性结膜炎（细菌、病毒、衣原体等）和非感染性结膜炎（机械性刺激、药品等化学性刺激、眼部其他疾病、不良卫生环境刺激、不良的生活习惯等）。在临床上由病毒感染导致的慢性结膜炎呈逐渐增多趋势，部分报道由病毒感染导致的慢性结膜炎其重要体征为下睑的滤泡。为探讨慢性结膜炎中单纯疱疹病毒1型（Herpes simplex virus-1，HSV-1）及腺病毒(Adenovirus，ADV)的感染比例及在有下睑滤泡体征的慢性结膜炎患者中两者的感染情况，本实验以临床诊断为慢性结膜炎患者（分为有下睑滤泡体征的慢性结膜炎患者、无下睑滤泡体征的慢性结膜炎两组）及正常人群为研究对象，采集患者眼部泪液标本，应用实时荧光定量PCR (Real-time fluorescence quantification PCR,FQ-PCR)技术检测有下睑滤泡体征的慢性结膜炎患者中单纯疱疹病毒1型及腺病毒的感染比例。目的:通过实时荧光定量PCR技术检测单纯疱疹病毒（主要是HSV-1）及腺病毒在慢性结膜炎和正常人群中的泪液标本感染比例，及在有下睑滤泡体征的慢性结膜炎、无下睑滤泡为体征的慢性结膜炎患者中的表达情况。方法:采集临床诊断为慢性结膜炎患者的结膜囊泪液标本102例，正常人群结膜囊泪液标本30例。通过实时荧光定量PCR检测单纯疱疹病病毒1型（单纯疱疹病毒性结膜炎主要由HSV-1引起）及腺病毒在有下睑滤泡体征的慢性结膜炎组、无下睑滤泡的慢性结膜炎组及正常人群组中的表达。分析病毒感染在慢性结膜炎致病因素中所占比例，并将慢性结膜炎患者分为有下睑滤泡体征的慢性结膜炎组(n=59)和无下睑滤泡的慢性结膜炎组(n=43)。应用实时荧光定量PCR技术检测单纯性疱疹病毒1型及腺病毒在两组中的表达情况。分析单纯疱疹病毒-1型与腺病毒在两组中表达的水平差异及与下睑滤泡体征的相关性。所得数据用SPSS l3.0统计软件进行相应统计学分析。结果:①单纯疱疹病毒1型在慢性结膜炎患者中的阳性表达率为23.53%(24/102),在正常人群组中阳性表达率为3.33%(1/30)；在有下睑滤泡体征的慢性结膜炎中的阳性表达率为32.2%(19/59)；在无下睑滤泡体征的慢性结膜炎中的阳性表达率为11.63%(5/43)；单纯疱疹病毒1型在有下睑滤泡体征的慢性结膜炎组的表达与无下睑滤泡体征的慢性结膜炎组的表达差异具有统计学意义(P<0.05)。②腺病毒在慢性结膜炎患者中的阳性表达率为27.45%（28/102）,在正常人群组中阳性表达率为6.67%(2/30)；在有下睑滤泡体征的慢性结膜炎中的阳性表达率为35.6%(21/59)；在无下睑滤泡体征的慢性结膜炎中的阳性表达率为16.28%(7/43)；腺病毒在有下睑滤泡体征的慢性结膜炎组的表达与无下睑滤泡体征的慢性结膜炎组的表达差异具有统计学意义(P<0.05)。③单纯疱疹病毒1型及腺病毒在慢性结膜炎患者中的感染比例为50.98%（52/102）。单纯疱疹病毒1型及腺病毒在有下睑滤泡体征的慢性结膜炎患者中的感染比例67.8%（40/59）。结论：①在慢性结膜炎中由单纯疱疹病毒-1型和腺病毒感染引起的病毒性结膜炎占有较大的比例。②慢性结膜炎下睑滤泡的产生与病毒感染（单纯疱疹病毒1型、腺病毒）有关。更多还原

【Abstract】 Chronic conjunctivitis is a common disorder in ophthalmology. The causes includeinfection (bacteria, virus, chlamydiaetc)and non-infection(mechanical, chemical,personal hygiene and other eye disease stimulants). The incidence of viral chronicconjunctivitis increased recently as a result of antibiotics and hormone abuse. It is reportedthat the major sign of viral chronic conjunctivitis is inferior pleural follicles. In order toexplore the percentage of （herpes simplex virus-1，HSV-1）and (Adenovirus, ADV)infection in chronic conjunctivitis in patients presents inferior pleural follicles. Wecompared normal patients with chronic conjunctivitis patients, which categorized into twosubgroups by the sign of inferior pleural follicles. Samples were collected, and PCR（Real-time fluorescence quantification PCR, FQ-PCR) were used to detect the infectionpercentage of HSV-1and ADV.Purpose: To detect the infection percentage of HSV-1and ADV with real-timefluorescence quantification PCR between normal population and chronic conjunctivitispatients. And study the present rate of HSV-1and ADV in chronic conjunctivitis patientswhich manifested inferior pleural follicles and not manifest.Methods: Conjunctiva swab was collected from102patients diagnosed chronicconjunctivitis, another30swab were collected from normal population. FQ-PCR was usedto detect the infection percentage of HSV-1and ADV in the above groups.Viral infectionproportion was studied in chronic conjunctivitis. We categorized viral chronicconjunctivitis into two subgroups by the sign of inferior pleural follicles: with (n=59) andwithout (n=43). The infection proportion of HSV-1and ADV were determined by FQ-PCRin the two subgroups. Presents level of HSV-1and ADV in the subgroups were explored,and association between presents of inferior pleural follicles and different viral infectionwere analyzed. All the data were analyzed with SPSS l3.0.Results:①HSV-1positive percentage in chronic conjunctivitis patientsis23.53%(24/102), compared with HSV-1positive percentage of3.33%(1/30) in normalpopulation；HSV-1positive percentage is32.2%(19/59) in patients manifested inferiorpleural follicles, and11.63%(5/43)in patients without the manifestations；HSV-1infection positive percentage is significantly different (P<0.05) between the two subgroupscategorized by the sign of inferior pleural follicles.②ADV positive percentage in chronicconjunctivitis patients is27.45%（28/102）, compared with ADV positive percentage of6.67%(2/30)in normal population；ADV positive percentage is35.6%(21/59) in patientsmanifested inferior pleural follicles, and16.28%(7/43) in patients without themanifestations；ADV infection positive percentage is significantly different (P<0.05)between the two subgroups categorized by the sign of inferior pleural follicles.③Infectionproportion of HSV-1and ADV in chronic conjunctivitis patients is50.98%(52/102). Whilethe proportion is67.8%(40/59) in chronic conjunctivitis patients presented inferior pleuralfollicles.Conclusions：①There is a high percentage of viral infection involved by HSV-1andADV in chronic conjunctivitis.②Pleural follicle is associated with viral infection (HSV-1, ADV) inchronic conjunctivitis.更多还原