인공눈물 점안 횟수에 따른 눈물 내 총 단백질과 리포칼린 농도의 변화
Changes in Total Tear Protein and Lipocalin Concentration According to Frequency of Artificial Tear Usage
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목적: 건성안증후군에서 인공눈물 점안 횟수에 따른 눈물 내 총 단백질의 농도, 리포칼린(Lipocalin)의 농도를 분석함으로써, 인공눈물의 빈번한 사용이 건성안증후군에 미치는 영향을 알아보고자 한다. 대상과 방법: 24안의 건성안환자군과 24안의 정상군을 대상으로 인공눈물을 15분 간격으로 8회 점안하였다. 인공눈물 점안 전과 1회, 2회, 4회, 8회 점안 후 각 시기의 눈물 내 총 단백질과 리포칼린 농도와 눈물 내 총 단백질 농도에 대한 리포칼린 농도의 비를 분석하였다. 결과: 인공눈물 점안 전후의 눈물 내 총 단백질 농도는 정상군은 3.35에서 3.16 mg/mL, 환자군은 1.53에서 0.87 mg/mL로 두 군 모두에서 유의한 감소를 보였다(p=0.04, p<0.01). 리포칼린 농도 또한 정상군은 1.15에서 0.85 mg/mL, 환자군은 0.49에서 0.22 mg/mL로 유의한 감소를 보였다(모두, p<0.01). 총 단백질 농도에 대한 리포칼린 농도의 비는 정상군에서 유의한 감소를 보였으나(p=0.03) 환자군에서는 유의한 변화를 보이지 않았다(p=0.21). 결론: 건성안환자에서 인공눈물 점안 후 눈물 내 총 단백질 농도와 리포칼린 농도는 의미 있는 감소를 보였다. 특히 인공눈물 4회 점안 후 총 단백질 농도에 대한 리포칼린 농도의 비가 급격히 감소하는 결과가 짧은 시간에 다빈도의 인공눈물 사용이 건성안증후군의 악화를 야기할 가능성이 있다는 점을 시사한다.
Abstract
Purpose: To investigate the effect of frequent use of artificial tears on dry eye syndrome (DES) by analyzing the changes in total protein concentration, lipocalin concentration, and the ratio of lipocalin-to-total protein concentration in tears. Methods: A prospective study was performed on 24 eyes of patients with DES and 24 eyes of control subjects. Artificial eye drops were applied a total of eight times (15-minutes intervals) to all participants. The concentrations of total protein and lipocalin in tears were analyzed before, and after one, two, four, and eight applications. The ratio of lipocalin-to-total protein concentration was also analyzed. Results: Total tear potein concentration of 3.35 mg/mL had decreased to 3.16 mg/mL after use of artificial tears for control while it had decreased from 1.53 to 0.87 mg/mL for patients. Both groups showed significant decrease (p = 0.04, p < 0.01, respectively). Lipocalin concentration also showed significant decreases in both control and DES patients for all applications (from 1.15 to 0.85 mg/mL for control, and from 0.49 to 0.22 mg/mL for DES patients, both, p < 0.01). The change in the ratio of lipocalin- to-total protein concentration was significant in the control group (p = 0.03) but not in the patient group (p = 0.21). Conclusions: A significant decrease was observed in the concentrations of total protein and lipocalin in the DES patient group. The ratio of lipocalin-to-total protein concentration was also significantly decreased when eye drops were applied four times. These results suggested that the frequent use of artificial eye drops exacerbated DES.
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