目的：探讨泪液中前列腺素E2(prostaglandin E2，PGE2)水平与干眼严重程度的关系。方法：选取干眼患者60例，并接受眼表疾病指数(Ocular Surface Disease Index，OSDI)问卷调查及眼科检查，包括泪膜破裂时间(tear film breakup time，BUT)、角膜荧光素染色评分(corneal fuorescein staining score，CFLS)、泪液分泌试验(Schirmer I试验)。使用酶联免疫吸附测定(ELISA)测量泪液中PGE2的水平。分析泪液PGE2水平与干眼临床症状相关指标的关系。结果：干眼患者泪液中的PGE2水平为(446.39±139.34) pg/mL。干眼患者泪液中PGE2水平与OSDI评分呈正相关(r=0.458，P<0.001)。泪液PGE2水平与BUT(r=0.164，P=0.354)、CFLS评分(r=0.265，P=0.086)、Schirmer I试验(r=?0.076，P=0.460)均无明显相关性。应用线性回归分析表明，泪液PGE2水平与OSDI评分呈正相关(95%CI：7.04~20.18，t=4.01，P<0.001)。结论：泪液中PGE2的水平与OSDI评分呈正相关，与BUT、CFLS评分、Schirmer I试验均无明显相关性。

Objective: To investigate the relationship between the level of prostaglandin E2 (PGE2) in tears and the severity of dry eye. Methods: Sixty patients with dry eye were selected and investigated with the Ocular Surface Disease Index (OSDI) questionnaire and ophthalmic examination, including tear film break-up time (BUT), corneal fluorescein staining score (CFLS) and tear secretion test (Schirmer I test). The level of PGE2 in tears was measured by enzyme-linked immunosorbent assay (ELISA). The relationship between the level of PGE2 in tears and related indexes of dry eye clinical symptoms was analyzed. Results: The average level of PGE2 in tears of patients with dry  eye was (446.39±139.34) pg/mL. The level of PGE2 in tears of patients with dry eye was positively correlated with the OSDI score (r=0.458, P<0.001). PGE2 levels were not significantly correlated with BUT (r=0.164, P=0.354),Schirmer I score (r=?0.076, P=0.460), and CFLS score (r=0.265, P=0.086). Linear regression analysis showed that the level of PGE2 in tears was positively correlated with OSDI score (95% CI: 7.04–20.18, t=4.01, P<0.001).Conclusion: The level of PGE2 in tears is positively correlated with OSDI score, but has no significant correlation with BUT, the CFLS score and Schirmer I test.

    泪膜是覆盖于眼球表面的一层液体薄膜，从内而外分为黏液层、水液层和脂质层，每层成分的改变都会导致泪膜不稳定，进而导致干眼的发生。在研究泪膜破裂方式及相关泪液成分改变的基础上，学者Yokoi及其团队分别在2012年和2013年提出了有关干眼治疗和诊断的新概念，称为泪膜导向治疗(tear film-oriented therapy，TFOT)和泪膜导向诊断(tear film-oriented diagnosis，TFOD)，就是根据泪膜破裂模式(tear film break-up pattern，TFBUP)的不同，推断出相应的泪膜成分改变，补充不足的泪膜成分，这种诊疗方法目前正逐渐被接受。本文对不同泪膜破裂方式与泪膜成分改变的关系做了汇总分析，旨在为干眼的诊断和治疗提供更为科学实用的指导方案。

    Tear film is a layer of fluid film covering the surface of eye global, which is divided into mucus layer, aqueous layer and lipid layer from inside to outside. The change of each layer composition will lead to tear film instability, resulting in the occurrence of dry eye. On the basis of numerous studies on the correlation between tear composition and tear film break-up patterns, Yokoi and his team proposed new concepts on the diagnosis and treatment of dry eye called tear film-oriented therapy (TFOT) and tear film-oriented diagnosis (TFOD) in 2012 and 2013. That is according to different tear film break-up patterns (TFBUP), so changes in tear film composition can be deduced and supplemented, and this diagnosis and treatment method is gradually being accepted. In this paper, we summarized and analyzed the relationship between different tear film break-up patterns and changes in tear film composition to provide a more scientific and convenient guidance program for the diagnosis and treatment of dry eye.