[综述]
感染性角膜炎常为单眼发病，除感染眼出现病理变化外，其健眼常会因预防性免疫防御反应而出现相应的改变，主要表现在角膜神经系统、泪液功能及角膜免疫系统等方面，如出现角膜神经密度的减少、角膜内皮细胞减少、角膜树突状细胞增多、泪液分泌减少以及泪液因子变化等。通过激光扫描共聚焦显微镜、泪液分泌功能测试、泪膜破裂时间等检测手段可对这些改变进行监测。动物模型研究与临床研究分析单眼感染性角膜炎健眼出现相应改变的原因可能与中枢神经系统介导的神经源性调节作用、角膜的神经生长因子表达水平变化、泪液反射通路、泪液渗透压改变以及神经体液免疫反应等相关。本文就单眼感染性角膜炎对侧健眼的病理生理变化进行综述，以进一步理解角膜内环境稳态和角膜疾病的病理生理学机制。
Infectious keratitis often occurs in single eye and causes changes in the nervous system, immune system and tear function, which may affect contralateral uninfected eye.Changes in the uninfected eye include a decrease in corneal nerve density and tear secretion, an increase in corneal dendritic cells and changes in tear cytokines.All the changes can be observed by in vivo confocal microscopy, Schirmer test I and tear film break-up time tests.Alternations in immune cells, cytokines and immunodulatory neuropeptide levels in contralateral eyes might mediate the incidence of bilateral infectious keratitis, and are also correlated with lacrimal reflex pathway.This article reviewed the pathophysiological changes in the contralateral uninfected eye of monocular infectious keratitis, which may help increase our understanding of the mechanisms involved in the corneal homeostasis and pathophysiology of corneal diseases.
刘馨甜,石妍,张弘. 单眼感染性角膜炎患者健眼的病理生理变化[J]. 中华实验眼科杂志,2020,38(03)：220-223.
DOI:10.3760/cma.j.issn.2095-0160.2020.03.011版权归中华医学会所有。
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