目的：研究缺氧诱导因子-1α(HIF-1α)、白细胞介素-17(IL-17)在干眼患者结膜上皮细胞及泪液中的表达水平及临床意义。

方法：回顾性研究。选取2021-02/2023-03在本院收治的干眼患者183例183眼，选择同期在本院体检健康的181例181眼作为对照组(均选取左眼入组)。检测两组参与者结膜上皮细胞和泪液中HIF-1α、IL-17表达水平，受试者工作特征(ROC)曲线分析结膜上皮细胞和泪液中HIF-1α、IL-17检测对干眼检测的诊断价值。

结果：与对照组相比，干眼组患者结膜上皮细胞中HIF-1α、IL-17表达水平升高(均P<0.01)； 泪液中HIF-1α、IL-17表达水平升高(均P<0.01)。Pearson相关性分析显示，干眼组患者结膜上皮细胞和泪液中HIF-1α、IL-17均与BUT及泪液分泌试验Ⅰ(SⅠt)负相关，与角膜荧光素染色评分正相关(均P<0.05)； 干眼组患者结膜上皮细胞和泪液中HIF-1α、IL-17表达水平呈现正相关(均P<0.001)。ROC曲线下面积显示，结膜上皮细胞中HIF-1α、IL-17联合检测诊断的AUC显著大于结膜上皮细胞中HIF-1α单独检测诊断的AUC(Z=5.574，P<0.001)，结膜上皮细胞中IL-17单独检测诊断的AUC(Z=4.351，P<0.001)，泪液中HIF-1α、IL-17联合检测诊断的AUC显著大于HIF-1α单独检测诊断的AUC(Z=3.583，P<0.001)，IL-17单独检测诊断的AUC(Z=4.303，P<0.001)。

结论：干眼患者结膜上皮细胞及泪液中HIF-1α、IL-17表达水平升高，联合检测HIF-1α、IL-17表达水平对干眼的诊断具有重要价值。

METHODS: Retrospective study. A total of 183 dry eye patients admitted to our hospital from February 2021 to March 2023 were selected, and 181 people who were physically healthy in our hospital during the same period were chosen as the control group. HIF-1α and IL-17 expression levels in conjunctival epithelial cells and tear fluid of the two groups of subjects were tested, and the diagnostic value of HIF-1α and IL-17 in conjunctival epithelial cells and tear fluid of the subjects in testing dry eyes was analyzed through receiver operating characteristics(ROC)curves.

RESULTS: Compared with the control group, patients in the dry eye group had elevated levels of HIF-1α and IL-17 expression in conjunctival epithelial cells(all P<0.01); and HIF-1α and IL-17 expression increased in tear fluid(all P<0.01). Pearson correlation analysis showed that HIF-1α and IL-17 in the conjunctival epithelium and tear fluid of dry eye patients were negatively correlated with BUT and Schirmer I test(SⅠt), and positively correlated with corneal fluorescein staining scores(all P<0.05); expression levels of HIF-1α and IL-17 in conjunctival epithelial cells and tear fluid of dry eye patients showed positive correlation(all P<0.001). The area under the ROC curve showed that the AUC for the combined diagnosis of HIF-1α and IL-17 in conjunctival epithelium was significantly greater than the AUC for HIF-1α alone in conjunctival epithelium(Z=5.574, P<0.001). The AUC of IL-17 alone in conjunctival epithelial cells(Z=4.351, P<0.001)and the AUC of the combined HIF-1α, IL-17 in tear fluid were significantly greater than the AUC of HIF-1α alone(Z=3.583, P<0.001)and the AUC of IL-17 alone(Z=4.303, P<0.001).

CONCLUSION: Conjunctival epithelial cells and tear fluid of dry eye patients have elevated expression levels of HIF-1α and IL-17, and joint detection of HIF-1α and IL-17 expression levels is of great value in the diagnosis of dry eye.