黏蛋白是泪膜的重要组成部分，按照功能可分为分泌型黏蛋白和跨膜型黏蛋白。分泌型黏蛋白主要由结膜杯状细胞分泌，功能包括维持泪膜稳定性、清除及抗菌作用、保护眼表；跨膜型黏蛋白主要由眼表上皮细胞表达，承担泪膜稳定性的维持、屏障及信号转导功能。黏蛋白质和量的异常都会引起泪膜稳定性下降，进而导致干眼的发生，而干眼可导致眼表上皮完整性破坏，进而加重黏蛋白的异常。黏蛋白的检测手法包括泪液蕨样变检查法、眼表染色法、印迹细胞学检测、激光扫描共焦显微镜检查、泪膜破裂模式检查及黏蛋白定量测定。临床上改善黏蛋白分泌的药物有P2Y2受体激动剂和黏蛋白分泌激动剂两类。眼科临床医生应了解眼表组织中黏蛋白的基本特征及功能，关注目前眼科黏蛋白的临床检测方法及其与干眼的关系，跟踪或参与黏蛋白相关研究和黏蛋白异常型干眼的精准诊疗研究，并更好地对混合型干眼、中重度干眼或免疫相关干眼进行综合治疗。
As an important part of the tear film, mucin can be divided into secretory mucin and membrane-associated mucin according to different functions.Secretory mucin, secreted by goblet cells, plays a key role in maintaining the stability of the tear film, antimicrobial properties and ocular surface protection.Membrane-associated mucin, expressed by corneal conjunctival epithelium, plays a key role in maintaining the stability of the tear film, barrier, and signal transduction.Quality or quantity abnormal of mucin may damage the stability of tear film, leading to dry eye.While dry eye may damage the integrity of the epithelium of ocular surface, resulting in exacerbation of mucin abnormalities.The detection methods of mucin include tear ferning test, ocular surface staining, impression cytology, confocal microscopy, tear break-up time, and quantitative detection of mucin.P2Y2 receptor agonists and mucin secretion agonists can improve mucin secretion.Ophthalmologists should understand the basic characteristics and functions of ocular surface mucin and pay close attention to current clinical examination and its association with dry eye in order to push forward the related study and develop the precise diagnosis and therapeutic methods for mucin deficiency dry eye as well as the comprehensive therapies of mixed type, midrate to severe dry eye and immune-associated dry eye.
洪晶. 密切关注眼表黏蛋白研究及其在干眼诊疗中的意义[J]. 中华实验眼科杂志,2020,38(11)：910-915.
DOI:10.3760/cma.j.cn115989-20200715-00499版权归中华医学会所有。
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