2型糖尿病患者干眼的临床观察

目的探讨2型糖尿病患者干眼的临床特点。方法对60例2型糖尿病患者分别测定泪液分泌试验（SIT）、泪膜破裂时间（BUT）及角膜荧光素染色（FL）,与非糖尿病患者进行对比。结果糖尿病组与对照组在泪液分泌试验、泪膜破裂时间、角膜荧光素染色均有显著性差异。结论干眼在2型糖尿病患者中常发生,在临床诊断与治疗中引起重视。     

术前配戴软性角膜接触镜对激光原位角膜磨削术后泪膜稳定性的影响

 目的 观察术前配戴软性角膜接触镜与未戴镜患者行激光原位角膜磨削术(LASIK)后泪膜相关指标的差异.方法 92例(183眼)近视眼患者在我院行LASIK手术,其中术前配戴角膜接触镜者37例(74眼)为A组,再根据戴镜时间分为3组,未戴镜者55例(109眼)为B组,分别观察术前,术后1个月、2个月、3个月、6个月、12个月的干眼症状、角膜荧光染色、泪膜破裂时间、泪膜分泌量,两组数据对比并进行统计学分析.结果 术前、术后1个月、2个月、3个月、6个月、12个月两组泪膜相关指标均存在差异;戴镜组术后1个月、2个月、3个月、6个月干眼症状、角膜荧光染色、泪膜破裂时间与术前相比均有显著差异,术后12个月恢复至术前水平,术后1个月、2个月、3个月泪液分泌量较术前减少,术后6个月恢复至术前水平;非戴镜组术后1个月、2个月干眼症状、角膜荧光染色、泪膜破裂时间及泪液分泌量与术前相比存在差异,术后3个月恢复至术前水平.戴镜组3组对比,术前术后各组泪膜破裂时间及泪液分泌量亦有差异,并且与戴镜时间呈负相关.结论 术前配戴软性角膜接触镜可加重LASIK术后泪膜不稳定,戴镜时间与泪膜相关指标呈负相关,术前术后应积极预防、治疗,以确保手术疗效.     

小牛血去蛋白提取物眼用凝胶与双氯芬酸钠滴眼液对干眼症的临床效果比较研究

目的比较玻璃酸钠滴眼液联合小牛血去蛋白提取物眼用凝胶与玻璃酸钠滴眼液联合双氯芬酸钠滴眼液治疗干眼症的临床疗效。方法将2013年2月—2014年2月在武警辽宁总队大连医院眼科门诊和大连医科大学附属第一医院眼科门诊就诊的132例(264只眼)干眼症患者,按随机数字表法分为A组和B组,每组66例(132只眼)。A组:采用玻璃酸钠滴眼液联合小牛血去蛋白提取物眼用凝胶进行治疗;B组:采用玻璃酸钠滴眼液联合双氯芬酸钠滴眼液进行治疗。每种药物4次/d,每次1滴点眼,两种药物使用间隔时间10 min。在用药前和用药后1个月进行干眼主观症状评分、泪膜破裂时间(BUT)、泪液分泌试验(SchirmerⅠ)、角膜荧光素染色检查,以比较及评价两组治疗效果。结果治疗后1个月,除泪液分泌试验比较无统计学意义外,主观症状评分、泪膜破裂时间、角膜荧光素染色检查均比治疗前有统计学意义(P<0.05)。结论治疗干眼症玻璃酸钠滴眼液联合双氯芬酸钠滴眼液疗效优于玻璃酸钠滴眼液联合小牛血去蛋白提取物眼用凝胶滴眼液的疗效。     

远航人员干眼症的干预效果观察

目的 通过对远航人员干眼症患者进行干预,观察对干眼症患者泪膜不稳定和眼表面损害的治疗效果,为我军今后进行远航训练和护航任务期间防治干眼症提供参考.方法 采用前瞻性研究,以参加“和谐使命-2010”任务的远航人员中确诊的干眼症患者84人作为研究对象,经知情同意分为干预组和非干预组,每组42人.依托866医院船诊治平台进行干预和观察,观察指标包括干预前,干预后7、14、28 d泪膜破裂时间(BUT)、角膜荧光素染色(FL)评分、基础泪液分泌试验(ST)结果,比较干预前后的差异以及干预组和非干预组间的差异.结果 干预7d后干眼症状明显改善,干预前后及干预组和非干预组间比较差异均有统计学意义(P＜0.05),干预组干预前的BUT、ST和FL评分分别为(5.62±1.61)s、(6.00±1.61 )mm、(3.43 ±0.86)分,干预后第7天分别为(6.12±1.53)s、(6.64±1.19)mm、(3.77±0.66)分.结论 对远航人员中的干眼症患者进行有效干预,对保证远航人员的眼部健康和提高工作效率具有重要的意义.     

准分子激光原位角膜磨镶术治疗高度近视术后干眼症临床研究

 目的了解高度近视患者行准分子激光原位角膜磨镶术(LASIK)术后干眼症状及相关指标的变化.方法84例(168只眼)高度近视患者行LASIK手术,分别观察术前、术后1周、1个月、2个月、3个月及6个月的干眼症状,包括干涩感、异物感等,并行角膜荧光素染色,记录泪液分泌量(Schirmer Ⅰ试验)和泪膜破裂时间(BUT),对数据进行统计学分析.结果术后1周至2个月干眼症状明显加重(P＜0.01),直至3个月角膜荧光素染色仍较术前明显增加(P＜0.05).术后1周至3个月泪液分泌量较术前明显减少(P＜0.01),术后1周至2个月BUT较术前明显缩短(P＜0.01).而术后1周有56眼(33.33%)达到干眼症诊断标准,术后1个月为61眼(40.39%),术后6个月恢复正常.结论高度近视LASIK术后发生干眼症为常见并发症,临床上应采取相应预防和治疗措施,以降低干眼症发生率,减少其危害.     

LASIK术后泪膜、眼表早期改变对屈光回退的影响

目的:研究LASIK术后早期泪膜及眼表变化对屈光回退的影响。方法:47例(92眼)近视患者行LASIK术,观察术前,术后1天,1周,2周,1月,3月,患者的干眼症状,测量泪液分泌量(Schirmer Ⅰ),泪膜破裂时间(BUT),眼表荧光素染色(Fl),眼表规则指数(SRI),不对称指数(SAI),残留屈光度。分组:是否出现屈光度回退分为屈光回退组和无屈光回退组,对上述数据进行统计分析。结果:LASIK术后1-3月18%的患者出现不同程度屈光回退,与术前泪液分泌量减少、术后3月F1增加、术后2周、1月、3月的SRI的增加及术后1周SAI的增加密切相关(P<0.05)。结论:LASIK术后泪膜及眼表的变化与术后屈光回退密切相关。     

加味沙参麦冬汤联合眼针治疗干眼症临床观察

目的 观察加味沙参麦冬汤联合眼针治疗干眼症临床疗效.方法 分析2015年2月-2016年2月治疗的78例干眼症患者临床资料,将其随机分为对照组和观察组,每组39例患者,对照组患者采用人工泪液治疗,观察组患者采用加味沙参麦冬汤联合眼针治疗,观察两组患者临床治疗效果.结果 观察组患者临床治疗疗效明显高于对照组,差异有统计学意义(P＜0.05);观察组患者临床症状评分明显低于对照组,差异有统计学意义(P＜0.05);观察组患者治疗后泪膜破裂时间(BUT)、泪液分泌试验(Schirmer试验)、荧光素染色评分明显优于对照组,差异有统计学意义(P＜0.05).结论 临床采用加味沙参麦冬汤联合眼针治疗干眼症效果确切,可有效改善患者临床症状,对临床治疗干眼症有重要的指导意义.     

不同海拔高度在准分子激光角膜原位磨镶术后干眼症发生的特点

目的：探讨不同海拔高度在准分子激光原位角膜磨镶术（LASIK）术后干眼症的发生差异。方法：随机抽取西宁地区（海拔2 260m）和环湖地区（海拔3 196m）各200眼分为A组和B组,术前排除干眼症,行LASIK手术。术后1天、10天、1个月随访,记录泪液分泌实验和泪膜破裂时间。结果：术后1天两组泪液分泌实验（SchrimerⅠ实验）和泪膜破裂时间（BUT）无明显差异（P〉0.05）,术后10天和术后1个月两组SchrimerⅠ实验和BUT均有明显差异（P〈0.05）B组术后10天和1个月分别有52眼（26%）和74眼（37%）有干眼症症状和表现。A组患者术后10天和1个月分别有14眼（7%）和28眼（14%）符合干眼症的诊断。结论：不同海拔高度泪膜稳定性不同,海拔越高泪膜稳定性越差,LASIK术后干眼症发生率越高。     

LASIK术后干眼症165例临床诊疗分析

目的 探讨165例LASIK术后干眼症患者的临床诊疗情况.方法 将收治的165例(330只眼)近视患者作为研究对象,将未行LASIK手术的80例患者作为对照组,将行LASIK手术的85例患者作为观察组,检查并分析两组患者的泪膜破裂时间(BUT)、泪液分泌试验(SIT)、角膜荧光素染色(FI)等干眼症的相关症状,比较上述症状指标.结果 与干眼症症状相符患者,对照组有24例(48只眼),所占比30.0％,观察组术后30 d,46例,所占比54.1％;术后60 d,37例,所占比43.5％;术后90d,19例,所占比22.4％;术后180 d,9例,所占比10.6％.结论 做好LASIK手术各个环节的工作,可预防和控制LASIK术后干眼症.     

甲状腺功能亢进准分子激光原位角膜磨镶术后干眼患者泪液炎症因子与眼表改变及泪膜功能相关性分析

目的 探讨甲状腺功能亢进准分子激光原位角膜磨镶术(LASIK)后干眼患者泪液炎症因子与眼表改变及泪膜功能的相关性。方法 选取江苏省人民医院自2019年1月至2021年12月收治的80例甲状腺功能亢进LASIK术后干眼患者作为B组,另选取同期于我院就诊的60例甲状腺功能亢进LASIK术后未患有干眼症的患者作为A组。比较两组患者泪液炎症因子[白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)]、眼表改变及泪膜功能。采用Pearson相关性分析法检验炎症因子水平与眼表改变及泪膜功能的相关性。结果 B组患者IL-1β、IL-6、IL-18、TNF-α水平明显高于A组(P<0.05)。B组患者眼表疾病指数问卷评分(OSDI)、角膜荧光素染色(FL)水平明显高于A组(P<0.05),泪液分泌试验(SIt)、泪膜破裂时间(BUT)水平明显低于A组(P<0.05)。Pearson相关性分析结果显示：甲状腺功能亢进LASIK术后干眼患者IL-1β水平与OSDI、FL水平呈正相关(P<0.05),与SIt、BU...     

Long-term impairment of the lacrimal glands after radioiodine therapy: a cross-sectional study

Impairment of the lacrimal glands after external radiation has been well documented, but there are only a few reports on the effects of radioiodine therapy on the lacrimal glands. Long-term effects of high-dose radioiodine therapy on tear secretion have not previously been studied. We investigated 175 eyes of 88 patients with a history of radioiodine therapy for thyroid carcinoma (68 females, 20 males; mean age 55+/-16 years, range 17-81 years) and compared them with a sex- and age-matched control group ( n=39). All patients had been given at least 2.96 GBq iodine-131 (maximal administered activity 22.3 GBq (131)I). An ophthalmological investigation was performed 64+/-71 months (range 3-317 months) after initial radioiodine therapy by a single ophthalmologist. Lacrimal gland function was evaluated with three different function tests. External eye morphology was considered, and detailed ophthalmological history-taking was performed. Patients with factors known to affect lacrimal gland function (contact lenses, autoimmune disorders, history of additional radiation exposure) were excluded from the study. A total of 81 patients (92%) had at least one abnormal function test indicating impaired lacrimal gland function. Schirmer's tear test was decreased (<10 mm/5 min) in 47 of the 88 patients and definitely abnormal (<5 mm/5 min) in 35 patients. A tear film break-up time of <10 s was found in 78 patients, and 62 patients had a definitely abnormal break-up time of <5 s. The lacrimal lipid layer was impaired in 43 patients. The function tests were all significantly altered in the study group as compared with the controls ( P<0.005, P<0.001, P<0.001, respectively). Both subjective symptoms of dry eye ( P<0.01) and changes in the external eye morphology ( P<0.001) were significantly more prevalent in the study group. Our findings suggest that in the majority of patients, lacrimal gland function may be permanently impaired after high-dose radioiodine therapy. All three layers of the tear film are involved and there is a pronounced long-term effect on the tear film stability.     

Clinical-dosimetric relationship between lacrimal gland dose and ocular toxicity after intensity-modulated radiotherapy for sinonasal tumours

Objective:

To characterise the relationship between lacrimal gland dose and ocular toxicity among patients treated by intensity-modulated radiotherapy (IMRT) for sinonasal tumours.

Methods:

40 patients with cancers involving the nasal cavity and paranasal sinuses were treated with IMRT to a median dose of 66.0 Gy. Toxicity was scored using the Radiation Therapy Oncology Group morbidity criteria based on conjunctivitis, corneal ulceration and keratitis. The paired lacrimal glands were contoured as organs at risk, and the mean dose, maximum dose, V₁₀, V₂₀ and V₃₀ were determined. Statistical analysis was performed using logistic regression and the Akaike information criterion (AIC).

Results:

The maximum and mean dose to the ipsilateral lacrimal gland were 19.2 Gy (range, 1.4–75.4 Gy) and 14.5 Gy (range, 11.1–67.8 Gy), respectively. The mean V₁₀, V₂₀ and V₃₀ values were 50%, 25% and 17%, respectively. The incidence of acute and late Grade 3+ toxicities was 23% and 19%, respectively. Based on logistic regression and AIC, the maximum dose to the ipsilateral lacrimal gland was identified as a more significant predictor of acute toxicity (AIC, 53.89) and late toxicity (AIC, 32.94) than the mean dose (AIC, 56.13 and 33.83, respectively). The V₂₀ was identified as the most significant predictor of late toxicity (AIC, 26.81).

Conclusion:

A dose–response relationship between maximum dose to the lacrimal gland and ocular toxicity was established. Our data suggesting a threshold relationship may be useful in establishing dosimetric guidelines for IMRT planning that may decrease the risk of acute and late lacrimal toxicities in the future.

Advances in knowledge:

A threshold relationship between radiation dose to the lacrimal gland and ocular toxicity was demonstrated, which may aid in treatment planning and reducing the morbidity of radiotherapy for sinonasal tumours.The majority of tear fluid is produced by the paired lacrimal glands, which are located in the superior temporal quadrants of the orbits. Each bilobed lacrimal gland is anatomically divided into the larger orbital and smaller palpebral parts, both of which contain excretory components consisting of ductal cells that mechanically assist in the secretion of tears on to the ocular surface by modifying the fluid secreted by acinar and myoepithelial cells [1]. The glands of Krause and Wolfring are smaller accessory lacrimal glands located in the superior fornix that secrete additional tear fluid. Functionally, the lacrimal gland is responsible for the secretion of fluid that continually moistens, lubricates and protects the surface of the eye.An increasingly recognised complication of radiotherapy to the periorbital region is dry eye syndrome, defined by the International Dry Eye WorkShop as a “multi-factorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface accompanied by increased osmolarity of the tear film and inflammation of the ocular surface” [2]. Although previous research has suggested a variable association between radiation dose to the lacrimal gland and incidence of dry eye syndrome [3–11], the exact nature of this dose–response relationship remains undetermined. This is particularly relevant given the ability of intensity-modulated radiotherapy (IMRT) to limit dose to normal structures designated as organs at risk (OARs). The aim of the present study was to characterise this relationship between various dosimetric parameters related to the lacrimal gland and ocular toxicity in patients treated with IMRT for sinonasal tumours.     

原发性翼状胬肉行联合手术干预的临床体会

目的：观察原发性翼状胬肉行联合手术干预效果并探讨其临床应用价值。方法选取2011年11月～2014年12月收治的86例原发性翼状胬肉患者为研究对象,均为单眼患者,随机抽签均分为对照组和观察组,其中对照组43例行翼状胬肉切除术治疗,观察组在对照组基础上行联合自体角膜缘干细胞移植术治疗,观察两组术后角膜透明率、角膜云翳发生率、角膜斑翳发生率情况,并观察两组术前、术后1个月内膜破裂时间（ BUT ）、泪液分泌试验（ SIt实验）、角膜荧光染色检查（ FL）,对两组进行比较。结果观察组术后角膜透明率93.02％较对照组高,角膜云翳发生率4.65％、角膜斑翳发生率2.33％均较对照组低,差异具有统计学意义（ P＜0.05）。术后两组BUT、SIt均较术前明显增大,FL均较术前明显减小,差异具有统计学意义（ P＜0.05）;术后观察组BUT（10.45±2.89）s、SIt（13.57±4.82）mm／5 min均较对照组增大显著,FL（0.41±0.01）分较对照组减小地显著,差异具有统计学意义（ P＜0.05）。结论原发性翼状胬肉行联合手术干预,能够提高术后角膜透明率、减小角膜云翳发生率及角膜斑翳发生率,在术后恢复角膜、泪膜、泪腺功能疗效显著,其在临床上的应用值得推广。     

The effect of high-dose radioiodine treatment on lacrimal gland function in patients with differentiated thyroid carcinoma

PURPOSE: There are a limited number of case reports confirming the radioiodine (I-131) presence in tears and only a few case reports of lacrimal gland dysfunction after I-131 therapy. This study was designed to clarify whether lacrimal gland function can be affected by I-131 therapy. MATERIALS AND METHODS: We studied 100 eyes of 50 patients who had received high doses of I-131 for treatment of differentiated thyroid carcinoma and 100 eyes of 50 age- and sex-matched control individuals without a history of interfering conditions. The exposed group was studied at least 3 months after their last I-131 therapy. Dry eye symptoms and Schirmer test values (wetting level in millimeters per 5 minutes) of an exposed group were compared with those of an unexposed group. RESULTS: Fifty-one percent of the exposed eyes and 50% of the unexposed ones revealed at least 1 of the dry eye symptoms. There was no significant difference in symptoms between 2 groups, except for burning sensation and eye redness, which were significantly higher in the exposed eyes. A lower Schirmer test value was noted in the exposed group, 14.5 +/- 10.8 mm, when compared with that in controls, 18.2 +/- 11.0 mm (P = 0.016), and the relative risk of an abnormal Schirmer test in exposed cases to control group was 1.78 +/- 0.62. Correlation coefficient analysis showed no significant relationship between Schirmer test values and cumulative doses of administered I-131. CONCLUSIONS: Reduction in the tear secretion from lacrimal glands is seen after high-dose I-131 therapy; however, their symptoms are no greater than an unexposed population.     

Lacrimal gland accumulation of 67Ga-citrate in patients with Sj?gren's syndrome

The extent of 67Ga accumulation in the two lacrimal glands in patients with keratoconjunctivitis sicca (KCS) of Sj?gren's syndrome was studied. Of the two main groups one consisted of 69 subjects without ophthalmic complaints (control group), the other consisted of 26 patients with KCS of Sj?gren's syndrome. Of the 26 patients with KCS, 7 had been diagnosed as probable KCS (probable sub-group) and the other 19 had been diagnosed definite KCS (definite sub-group). About 3 mCi (111 MBq) 67Ga-citrate was injected IV into each subject and this was followed by scintigraphy at 24, 48, and 72 h after the injection of 67Ga. A positive finding in the lacrimal gland was noted in 64 of 69 subjects (92.7%) in the control group and in 7 of 7 patients (100%) with probable KCS. Three of 19 patients with definite KCS (15.7%) showed positive findings under scintigraphy. When the scintigraphic finding in the lacrimal gland is not positive in patients with suspected KCS of Sj?gren's syndrome, they can then be diagnosed with little risk as definite KCS cases. Shirmer's test was performed on subjects in the probable and definite groups. There was statistical significance between the positive and equivocal or negative scintigraphic finding and Schirmer's values. These results suggest a correlation between gallium accumulation in the lacrimal gland and the tear production.     

小鼠下颌下腺细胞培养及其生物学特性研究

目的：建立和完善小鼠下颌下腺细胞培养方法,并进行生物学特性研究,为涎腺疾病治疗奠定理论基础,并为组织工程涎腺再生提供技术支持。方法无菌环境下切取小鼠下颌下腺,胶原酶消化,接种于含有胎牛血清、表皮生长因子、胰岛素、氢化可的松及转铁蛋白的低糖 DMEM 培养基中培养,倒置相差显微镜及 HE 染色进行形态学观察,透射电镜观察特异性酶原颗粒,生长曲线评估细胞生长特性,特异性α-淀粉酶免疫荧光鉴定细胞来源。结果下颌下腺原代细胞为圆形或多边形,呈铺路石样排列,其生长缓慢,12 d 左右汇合至80％。传代细胞与原代形态相同。HE 染色显示胞核胞浆对比明显。生长曲线大致呈“S”型,与其他细胞增殖特点相似。特异性α-淀粉酶免疫荧光染色阳性,表明细胞为具有功能的涎腺细胞。结论成功地建立了小鼠下颌下腺细胞原代及传代培养,将为涎腺疾病的治疗和涎腺再生提供实验基础。     

泪小管断裂经泪囊切开泪道重建术的应用

目的探讨经泪囊切开泪道置管重建术在复杂下泪小管断裂吻合术中的应用。方法 2013年1月—2016年12月重庆医科大学附二院眼科收治15例(15只眼)眼睑裂伤伴下泪小管断裂患者,修复术中不能找到鼻侧断端泪小管,采用经上泪小管定位泪囊,经创面分离切开泪囊后,将泪道引流管分别自上、下泪小点进入,下方引流管通过颞侧泪小管断端后直接进入泪囊,从鼻腔引出并打结。置管3个月后拔管,术后随访6个月,观察泪道重建术后有无溢泪症状及并发症等。结果 15例患者中8例泪道冲洗通畅,5例泪道冲洗部分冲洗液返流,无溢泪现象,另有2例患者下泪小管泪道冲洗不通,有轻微溢泪症状。结论对泪小管断裂修复术中不能找到鼻侧泪小管断端患者,采用经泪囊切开泪道置管重建术,是一种全新的手术方法,可以重建患者泪道,有效避免伤后出现溢泪症状。     

Lacrimal gland accumulation of 67Ga-citrate in patients with Sjögren's syndrome

The extent of ⁶⁷Ga accumulation in the two lacrimal glands in patients with keratoconjunctivitis sicca (KCS) of Sjögren's syndrome was studied. Of the two main groups one consisted of 69 subjects without ophthalmic complaints (control group), the other consisted of 26 patients with KCS of Sjögren's syndrome. Of the 26 patients with KCS, 7 had been diagnosed as probable KCS (probable sub-group) and the other 19 had been diagnosed definite KCS (definite sub-group). About 3 mCi (111 MBq) ⁶⁷Ga-citrate was injected IV into each subject and this was followed by scintigraphy at 24, 48, and 72 h after the injection of ⁶⁷Ga. A positive finding in the lacrimal gland was noted in 64 of 69 subjects (92.7%) in the control group and in 7 of 7 patients (92.7%) in the control group and in 7 of 7 patients (100%) with probable KCS. Three of 19 patients with definite KCS (15.7%) showed positive findings under scintigraphy. When the scintigraphic finding in the lacrimal gland is not positive in patients with suspected KCS of Sjögren's syndrome, they can then be diagnosed with little risk as definite KCS cases. Shirmer's test was performed on subjects in the probable and definite groups. There was statistical significance between the positive and equivocal or negative scintigraphic finding and Schirmer's values. These results suggest a correlation between gallium accumulation in the lacrimal gland and the tear production.     

Diffusion-weighted MR microimaging of the lacrimal glands in patients with Sjogren's syndrome

OBJECTIVE: The purpose of this study was to detect quantitative diffusion-weighted abnormalities in the lacrimal glands of patients with Sjogren's syndrome. MATERIALS AND METHODS: Diffusion-weighted MRI was performed on 31 healthy volunteers and 11 Sjogren's syndrome patients with impaired lacrimal function. The volunteers and patients underwent MRI with a single-shot spin-echo echo-planar technique using a 47-mm microscopy coil. The apparent diffusion coefficient (ADC) of the lacrimal and parotid glands was obtained with b factors of 500 and 1,000 sec/mm(2). T1-weighted and fat-suppressed T2-weighted MR microscopic images were also obtained to evaluate the gland morphology and signals. RESULTS: MR microscopy provided high-resolution images of the lacrimal glands that enabled ADC measurements. The ADCs of the normal lacrimal glands showed no significant sex- or age-related changes. The ADCs for the lacrimal glands were significantly higher than those of the parotid glands in the same subjects (mean +/- SD, 891 +/- 103 vs 703 +/- 84 x 10(-6) mm(2)/sec, respectively; p < 0.0001, Mann-Whitney U test). We found that ADCs of the lacrimal glands in Sjogren's syndrome patients were significantly lower than those from the normal glands of age-matched healthy volunteers (736 +/- 34 vs 923 +/- 84 x 10(-6) mm(2)/sec; p < 0.0001, Mann-Whitney U test). CONCLUSION: These findings suggest that the measurement of ADCs may be a useful tool to assess abnormalities of the lacrimal glands in patients with Sjogren's syndrome.     

多层螺旋CT在泪腺脱垂中的临床应用价值

目的 探讨泪腺脱垂的多层螺旋CT （MSCT）表现,以提高其CT诊断的准确性.方法 回顾性分析24例（45眼）泪腺脱垂患者的MSCT图像资料,并应用多平面重建技术（MPR）,分别从横断位、冠状位及矢状位分析泪腺脱垂的CT图像特点.结果 24例中有21例为双侧泪腺脱垂,其横断位表现为泪腺上部部分越过眶缘,其中13例（26眼）呈结节样,8例（16眼）呈分叶状;冠状位表现为泪腺大部分位于眶缘前方、眼球颞侧,呈类圆形团块影;矢状位亦可见相似表现.另有3例为单侧泪腺脱垂（均为部分脱垂）.结论 泪腺脱垂在CT图像上有特征性的表现,MSCT在其诊断中具有重要的价值.