Palmer S L, Bowen P A, Green K
Department of Ophthalmology, Medical College of Georgia, Augusta 30912-3400, USA.
Ophthalmology. 1996 Apr;103(4):670-3. doi: 10.1016/s0161-6420(96)30636-2.
To determine Schirmer wetting (tear flow) in patients before and after kidney transplantation where systemic cyclosporine was used as an immunosuppressive.
Patients with end-stage renal disease who received living donor or cadaveric kidney transplants and simultaneous systemic cyclosporine were recruited. A 4-minute Schirmer test with topical anesthetic was performed in both eyes of each person before cyclosporine was initiated and three times after transplantation. The tear flow values from both eyes were averaged before analysis.
Tear flow increased significantly from precyclosporine levels of 19.4 +/- 1.5 mm/4 minutes (mean +/- standard error of the mean, n = 7; readings at 1 to 3 days before cyclosporine was begun) to 28.4 +/- 2.4 mm/4 minutes at 1 to 2 months after cyclosporine (P < 0.01), 26.4 +/- 2.0 mm/4 minutes at 3 to 5 months (P < 0.05), and 24.4 +/- 2.1 mm/4 minutes at 9 to 18 months (P < 0.05) after initiation of cyclosporine therapy. No relation existed between tear flow and systemic cyclosporine concentration.
Tear flow was significantly enhanced by systemic cyclosporine when given to renal allograft recipients as an immunosuppressive. The increased flow rate was sustained over the maximum follow-up of 18 months and indicates an unexpected, beneficial side effect of cyclosporine, even in the absence of a deficit in baseline tear production.
确定在使用全身性环孢素作为免疫抑制剂的肾移植患者术前和术后的Schirmer湿润试验（泪液流量）情况。
招募接受活体供体或尸体肾移植并同时使用全身性环孢素的终末期肾病患者。在开始使用环孢素之前以及移植后三次，对每个人的双眼进行4分钟的表面麻醉下的Schirmer试验。分析前将双眼的泪液流量值进行平均。
泪液流量从环孢素治疗前的19.4±1.5毫米/4分钟（平均值±平均值的标准误，n = 7；在开始使用环孢素前1至3天的读数）显著增加至环孢素治疗后1至2个月时的28.4±2.4毫米/4分钟（P < 0.01），3至5个月时为26.4±2.0毫米/4分钟（P < 0.05），9至18个月时为24.4±2.1毫米/4分钟（P < 0.05）。泪液流量与全身性环孢素浓度之间不存在关联。
对于肾移植受者，全身性环孢素作为免疫抑制剂使用时可显著提高泪液流量。在长达18个月的最长随访期内，泪液流量增加持续存在，这表明即使在基线泪液分泌无不足的情况下，环孢素也有意外的有益副作用。
