ObJective To examine the expression of human leucocyte antigen-DR (HLA-DR),a marker of inflammation,in conjunctiva epithelial cells of the acute stage SJS/TEN patients.Methods Eight patients with SJS/TEN were included in the study,the severity of illness score (SIS) was identified using SCORTEN.The severity of eye score (SES) was evaluated according to conjunctival hyperemia,conjunctival exudate,conjunctival pseudomembrane,corneal erosion,eyelid involving and lid margin involving.The expression of HLA-DR in conjunctiva epithelial cells was detected by impression cytology and flow cytometry (FCM).The SIS,SES and conjunctival HLA-DR expression were investigated simultaneously.Informed consent was obtained from all patients.The correlation between SIS,SES and HLA-DR expression were performed by pearson correlation analysis.Results The mean SIS of 8 patients with SJS/TEN was 1.25±1.83 (n =8),the mean SES was 7.3843.48 (n =16),the mean conjunctival HLA-DR expression was 35.25±12.30％ (n =16).The SES was positively associated with conjunctival HLA-DR expression (n =16,r =0.739,P =0.001).There was no significant correlation between SES and SIS,SIS and conjunctival HLA-DR expression (n =8,r =0.626,P =0.097; n =8,r =0.600,P =0.116,respectively).Conclusions Conjunctival HLA-DR expression may play a pivotal role in the pathogenesis of the eye damage in SJS/TEN patients.Since ocular involvement in the acute stage may not relate to SJS/TEN,early ophthalmic assessment is helpful to put patients on proper treatment to reduce ocular complications.

<正>滴眼药是眼科最常用的检查诊断与治疗用药,然而用药时常会出现各种各样的副反应,如白内障术前使用的散瞳药物阿托品等可引起全身反应或中毒,表现为口干、唾液分泌减少、皮肤潮红、眩晕、心率加快等,对于患有高血压、冠心病病人有较大影响;青光眼病人使用的毛果云香碱可出现恶心、呕吐、眩晕、气喘、腹泻、腹痛,甚至可能引起哮喘发作等,而采用适当的滴眼方法能有效地预防或减轻毒副反应的发生,现介绍如下。

近年来随着抗生素、激素和免疫抑制剂的广泛使用,疱疹病毒(herpresvirus,HV)引起的眼部感染逐渐增多[1,2].与眼病有关的HV主要包括6种:单纯HV1型和2型(HSV-1,HSV-2)、巨细胞病毒(CMV)、EB病毒(EBV)、水痘-带状HV(VZV)和人疱疹病毒6型(HHV-6).HV引起的眼部感染多种多样,其临床表现常不典型,单凭临床所见往往无法明确诊断;而治疗HV眼部感染的关键在于早期诊断.采用PCR技术检测HV是一种快速而准确的方法.近年国内虽有应用PCR对HSV角膜炎进行检测的报道,但只能检测1～2种HV.本研究选择HV科病毒DNA多聚酶基因区中的一对引物,一次PCR同时扩增HSV-1、HSV-2、EBV和CMV4种HV相应的DNA片段[3],并对临床诊断或拟诊HV眼部感染的32例患者进行了PCR检测.