目的：探讨干眼患者结膜上皮细胞及泪液中干扰素调节因子4(IRF4)、可溶性致癌抑制因子2(sST2)表达情况及其临床意义。

方法：选取本院2019-01/2021-12期间收治的94例干眼患者作为干眼组，同期选取97例行眼科检查的体检者作为对照组，收集研究对象结膜上皮细胞及泪液，记录临床指标泪膜破裂时间(BUT)、角膜荧光素染色(CFS)评分、基础泪液分泌试验(SⅠt)。采用实时荧光定量PCR(qRT-PCR)法检测结膜上皮细胞IRF4、sST2水平，采用酶联免疫吸附(ELISA)法检测泪液IRF4、sST2水平，采用Pearson法分析干眼患者结膜上皮细胞及泪液中IRF4、sST2水平与临床指标的相关性。

结果：干眼组治疗前结膜上皮细胞及泪液中IRF4、sST2水平均显著高于对照组(P<0.001)。干眼患者治疗4wk后结膜上皮细胞及泪液中IRF4、sST2水平均显著低于治疗前(P<0.001)。干眼患者治疗4wk后BUT、SⅠt显著增加，CFS评分显著降低(P<0.001)。干眼患者治疗前结膜上皮细胞及泪液中IRF4、sST2水平与治疗前CFS评分均呈正相关，与治疗前BUT、SⅠt均呈负相关(P<0.001)。

结论：干眼患者结膜上皮细胞及泪液中IRF4、sST2水平均升高，且与干眼临床指标BUT、SⅠt、CFS评分均呈显著相关性，有潜力成为干眼新的治疗靶点。

METHODS: A total of 94 patients with dry eye who admitted to our hospital from January 2019 to December 2021 were selected as the dry eye group, and 97 physical examiners who underwent ophthalmic examination were selected as the control group at the same time. The conjunctival epithelial cells and tears of the subjects were collected, and the clinical indicators, including tear film break-up time(BUT), corneal fluorescein staining(CFS)score, and Schirmer Ⅰ test(SⅠt)were recorded. The levels of IRF4 and sST2 in conjunctival epithelial cells were detected by quantitative real-time polymerase chain reaction(qRT-PCR), and the levels of IRF4 and sST2 in tears were detected by enzyme-linked immunosorbent assay(ELISA). Pearson method was used to analyze the correlation between IRF4 and sST2 levels in conjunctival epithelial cells and tears and clinical indicators of dry eye patients.

RESULTS: The levels of IRF4 and sST2 in conjunctival epithelial cells and tears in dry eye group before treatment were significantly higher than those in control group(P<0.001). The levels of IRF4 and sST2 in conjunctival epithelial cells and tears of dry eye patients at 4wk after treatment were significantly lower than those before treatment(P<0.001). The BUT and SⅠt of dry eye patients increased significantly at 4wk after treatment, and the CFS score decreased significantly(P<0.001). The levels of IRF4 and sST2 in conjunctival epithelial cells and tears of dry eye patients before treatment were positively correlated with CFS score before treatment and negatively correlated with BUT and SⅠt before treatment(P<0.001).

CONCLUSION: The levels of IRF4 and sST2 in conjunctival epithelial cells and tears of patients with dry eye are increased, and are significantly correlated with BUT, SⅠt and CFS scores, which has potential to become a new therapeutic target for dry eye.