基于光纤光栅传感器的排泪动力检测及动力异常在泪道阻塞性疾病中的作用

Lacrimal duct obstruction diseases (LDOD) is the most common diseases of lacrimal apparatus system, it seriously affects life quality and visual health of patients. At present the researchers mainly concentrated on the inflammatory mechanism, but many clinical phenomenons cannot be explained by the inflammatory mechanism alone. Based on clinical observation and our preliminary research, we now propose a new concept of "tear drainage dynamics", and speculate that the abnormality of the tear drainage dynamics may be the initiating and important factor for the LDOD occurrence. This research will establish the mathematical model of elastic deformation of the flexible membrane related to the pressure change; develop the monitoring system of tear dynamics. The fiber grating sensor is small and sensitive, and it can real-time monitor the pressure changes at the different locations of the lacrimal duct simultaneously, which will help us understand the regular patterns of tear dynamics in lacrimal duct; then by using the animal model of nasolacrimal duct obstruction and botulin-induced tear dynamics-impaired animal model, the characteristics of the tear dynamics under different conditions will be investigated, as well as the expression of the inflammatory factors and pathologic changes in the local lacrimal duct, in order to reveal the relationship between the abnormal tear dynamics and LDOD. This project will provide scientific evidence and technological infrastructure for the prevention and treatment of LDOD related to the abnormal tear dynamics.

泪道阻塞性疾病（Lacrimal duct obstruction diseases, LDOD）是临床上最常见的泪器系统疾病，严重影响患者生活质量和视觉健康。目前其发病机制研究主要集中在炎症方面，但很多临床现象不能仅用现有机制解释。基于临床观察和前期基础研究，我们提出“排泪动力”的新概念，并推测排泪动力异常是LDOD发生的始动和重要因素。本研究拟通过建立柔性膜形变与压力变化的数学模型，研制排泪动力监测系统，利用光纤光栅感受器小而灵敏的优点，在体多点实时监测泪道压力变化，从而了解泪道排泪动力规律；进而通过鼻泪管阻塞动物模型及肉毒素致排泪动力受损动物模型，检测病理状态下泪道排泪动力的特征和局部炎症因子的表达及微结构的改变，揭示排泪动力异常与LOOD之间的相互关系，为寻找排泪动力不足的干预方法进而防治LDOD提供科学依据和技术基础。

泪道阻塞性疾病（Lacrimal duct obstruction diseases, LDOD）是临床上最常见的泪器系统疾病，严重影响患者生活质量和视觉健康。本研究提出排泪动力异常是LDOD发生的始动和重要因素。我们利用光纤光栅感受器小而灵敏的优点，在体多点实时监测泪道压力变化，从而了解到在正常人眼睑闭合过程中泪点、泪小管和泪囊都有压力差，这种压力差在泪道阻塞患者中变小，在功能性溢泪患者中消失；在临床DCR术后患者中观察到闭眼时泪囊上部扩张，下部缩小，睁眼时泪囊上部缩小，下部扩大,提示泪道是一个类似于胃肠道的“蠕动排泪”，并通过人泪道标本检测到数个神经标记物在泪道标本粘膜中有表达，提示神经调控在排泪动力中起作用。同时我们通过鼻泪管阻塞动物模型检测到鼻泪管粘膜从急性炎症逐渐过渡到慢性纤维化这一不可逆的过程，提示预防与早期治疗的重要性。综合以上，我们得出了排泪动力与LDOD的发病密切相关，泪道排泪过程中存在着节段性压力差，神经调控很可能在其中发挥重要作用，这些为进一步的动力机制研究及寻找早期防治LDOD的理念提供科学依据和技术基础。