一的制度,也缺乏相关法律法规的监督管理;近视眼防治对弱视防治的误解与干扰;未经科学验证的各种药物、仪器等疗法的使用等。希望将弱视防治的问题进行科学、规范管理。参考文献1李凤鸣.眼科全书[M].北京:人民卫生出版社,1996.2954.2FriendlyDS.Amblyopia:definition,classification,diagnosis,andman2agementconsiderationsforpediatricians,familyphysicians,andgen2eralpractitioners[J].PediatrClinNorthAm,1987,34:138921401.3李凤鸣.眼科全书[M].北京:人民卫生出版社,1996.2609.4施明光.临床视觉光学[M].杭州:浙江大学出版社,1993.171.5Schalij2DelfosNE,TermoteJU,CatsBP.Retinopathyinprematureinfants[J].NedTijdschrGeneeskd,2002,146:9772980.6Vital2DurandF,AyzacL.Tacklingamblyopiainhumaninfants[J].Eye,1996,10(Pt2):2392244.7SomerD,BudakK,DemirciS,etal.Against2the2rule(ATR)astig2matismasapredictingfactorfortheoutcomeofamblyopiatreatment[J].AmJOphthalmol,2002,133:7412745.8KasmannB,HohH,RuprechtKW.Resultsofocclusiontherapyinanisomyopicamblyopiawithmyelinatednervefibers[J].GerJOph2thalmol,1996,5:2412245.9YangCI,ChenSN,YangML.Excessivemyopiaandanisometropiaassociatedwithfamilialexudativevitreoretinopathy[J].ChangGungMedJ,2002,25:3882392.10ChoiMY,LeeKM,HwangJM,etal.Comparisonbetweenani2sometropicandstrabismicamblyopiausingfunctionalmagneticreso2nanceimaging[J].BrJOphthalmol,2001,85:105221056.11BirchEE,FawcettSL,StagerDRSr.Riskfactorsforthedevelop2mentofaccommodativeesotropiafollowingtreatmentforinfantileesotropia[J].JAAPOS,2002,6:1742181.12BarnesGR,HessRF,DumoulinSO,etal.Thecorticaldeficitinhu2manswithstrabismicamblyopia[J].JPhysiol,2001;533(Pt1):2812297.13OmuleckiW,Latecka2KrajewskaB,Palenga2PydynD,etal.Treat2mentofdislocatedlensesinpatientswithMarfan’ssyndromeusingvitrectomyandintraocularlenses[J].KlinOczna,2002,104:19222.(收稿日期:2004212203)(本文编辑:张莉)干眼症的发病机制刘祖国杨文照【摘要】眼表(角膜、结膜、副泪腺和睑板腺)、主泪腺和它们之间的神经连接组成的泪腺功能单位共同发挥对泪液分泌和泪膜形成的调控作用,维护眼表的健康,其中任一环节的损害均可导致泪膜完整性和正常功能的破坏。引起干眼症的起始病因很多,如果这些因素在未引起眼表改变时消失,则泪膜恢复正常;如这些因素不能消失,则引起眼表面的病理改变。虽然干眼症的临床表现类型不同,但其病理生理改变是相似的,炎症是干眼症发病机制中最关键的病理生理改变,而细胞凋亡、神经调节及性激素等也共同参与了干眼症的发病过程。【关键词】干眼症;发病机制;炎症;凋亡;性激素【中图分类号】R777.34【文献标识码】A【文章编号】100424469(2005)0520342204作者单位:广州510060,中山大学中山眼科中心责任作者:刘祖国(Email:zuguol@yahoo.com)Dryeyeanditspathogenesis/LIUZu2guo⋯//OphthalmolCHN.22005,14(5)2342～345(ZhongshanOphthalmicCenter,SunYat2senUniversity,Guangzhou510060,China)Correspondingauthor:LIUZu2guo,Email:zuguol@yahoo.com【Abstract】Tearsecretioniscontrolledbythelacrimalfunctionalunitconsistingoftheocularsurface(cornea,conjunctiva,acces2sorylacrimalglands,andmeibomianglands),themainlacrimalglandandtheinterconnectinginnervation.Abnormalitiesatanyportionofthisfunctionalunitcanresultinalossoftearfilmintegrityandnormalfunction.Manyfactorscontributetodryeye.Thetearfilmwillrecoverifthecausesareeliminatedbeforepathophysiologicalchangeshappenontheocularsurface.However,theocularsurfacewillbedamagedbyunstabletearfilm.Whatevertheinitialcausesofdryeye,thediseasesshowthesimilarpathophysiologicalprocessintheprogressingphase.Inflammationisthekeymechanismandtheotherfactorssuchasapoptosis,nervousandhormonalregulationarecloselyinv...
