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含脂质眼药水:向天然泪液迈进了一步。

Lipid-containing eye drops: a step closer to natural tears.

作者信息

Rieger G

机构信息

Ophthalmic Department of the Paracelsus Institute, Bad Hall, Austria.

出版信息

Ophthalmologica. 1990;201(4):206-12. doi: 10.1159/000310154.

Abstract

Disturbances of the lipid composition can, like mucin or fluid deficiency, cause 'dry eye'. The substitution of the lipids of the tear fluid has previously been unsatisfactory since eye ointments containing fats can lead to a considerable deterioration of the visual acuity due to the film of ointment resulting from an irregular spreading behavior. We proposed the introduction of physiological lipids that are normally present in tear fluid, such as phospholipids, saturated and unsaturated fatty acids and triglycerides, to provide lipid-containing eye drops. These best correspond to 'natural tears' and, due to the small size of the lipid particles, avoid a disturbance of the spreading behavior of the lipid layer. With lipid-containing eye drops of this kind, we carried out the following examinations: inquiry of patients' symptoms based on a standardized interview; Schirmer test under local anesthesia; break-up time (BUT); biomicroscopic evaluation of the lipid film, and stability tests as pH, gas chromatographic analysis of the fatty acid pattern and thin-layer chromatographic analysis of the lipid pattern. Schirmer test, BUT measurement and questioning about symptoms were undertaken after 1 week and then again after 3 weeks of treatment. All three parameters finally showed an improvement with a high statistical significance (p less than 0.001). The stability tests have shown that pH, lipid particle size, fatty acid and lipid composition of the examined lipid-containing eye drops were nearly unchanged till 4 months after preparation.

摘要

脂质成分紊乱,如同黏蛋白或液体缺乏一样,会导致“干眼症”。泪液脂质替代疗法此前并不令人满意,因为含脂肪的眼膏由于其不规则的铺展行为所形成的药膏膜,会导致视力显著下降。我们提议引入泪液中正常存在的生理性脂质,如磷脂、饱和与不饱和脂肪酸以及甘油三酯,来制备含脂质眼药水。这些脂质与“天然泪液”最为契合,并且由于脂质颗粒尺寸小,可避免脂质层铺展行为受到干扰。对于这类含脂质眼药水,我们进行了以下检查:基于标准化访谈询问患者症状;局部麻醉下的泪液分泌试验;泪膜破裂时间(BUT);脂质膜的生物显微镜评估,以及作为pH值的稳定性测试、脂肪酸模式的气相色谱分析和脂质模式的薄层色谱分析。泪液分泌试验、BUT测量以及症状询问在治疗1周后进行,然后在治疗3周后再次进行。所有这三个参数最终均显示出具有高度统计学意义的改善(p小于0.001)。稳定性测试表明,所检测的含脂质眼药水的pH值、脂质颗粒大小、脂肪酸和脂质组成在制备后4个月内几乎没有变化。

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