目的：检测围绝经期干眼患者结膜上皮细胞微小RNA-744-5p(miR-744-5p)、泛素蛋白连接酶3(PELI3)表达水平，分析二者与性激素水平、炎症因子水平及泪液分泌功能的相关性。

方法：选取我院2020-02/2022-02期间收治的围绝经期干眼患者60例作为观察组，另纳入60例围绝经期体检眼科检查无异常参与者作为对照组。收集干眼患者泪膜破裂时间(BUT)、基础泪液分泌试验(SⅠt)结果及角膜荧光素染色(FL)评分等泪液分泌功能相关指标； 采用印记细胞学方法获取两组结膜上皮细胞，经实时荧光定量聚合酶链式反应(qRT-PCR)法检测miR-744-5p表达水平，采用酶联免疫吸附法检测结膜上皮细胞中PELI3水平以及血清卵泡刺激素(FSH)、雌二醇(E2)、黄体生成素(LH)、白细胞介素-1(IL-1)、IL-6、肿瘤坏死因子-α(TNF-α)水平； 采用Pearson法和Spearman法进行相关性分析。

结果：观察组患者结膜上皮细胞miR-744-5p表达水平较对照组升高，PELI3表达水平较对照组降低(均P<0.05)。与对照组比较，观察组患者血清FSH、IL-1、IL-6、TNF-α表达水平升高，血清E2、LH表达水平降低(均P<0.05)。相关性分析显示，围绝经期干眼患者结膜上皮细胞miR-744-5p与PELI3呈负相关(r=-0.476，P<0.01)； miR-744-5p与LH、E2、BUT、SⅠt呈负相关(均P<0.05)，与FSH、IL-1、IL-6、TNF-α、FL评分呈正相关(均P<0.05)； PELI3与FSH、IL-1、IL-6、TNF-α、FL评分呈负相关，与E2、BUT、SⅠt呈正相关(均P<0.05)。

结论：围绝经期干眼患者结膜上皮细胞中miR-744-5p水平升高，PELI3水平降低，PELI3、miR-744-5p与围绝经期干眼患者性激素水平、炎症因子水平及泪液分泌功能密切相关。

METHODS: A total of 60 perimenopausal patients with dry eye admitted to our hospital from February 2020 to February 2022 were selected as the observation group, in addition, 60 perimenopausal subjects with no abnormal eye examination were included as a control group. The tear film break-up time(BUT), Schirmer I test(SⅠt)and corneal fluorescein staining(FL)scores of perimenopausal patients with dry eye were collected. The conjunctival epithelial cells of the two groups were obtained by impression cytology, the expression level of miR-744-5p was detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR), the PELI3 levels of conjunctival epithelial cells and serum levels of follicle stimulating hormone(FSH), estradiol(E2), luteinizing hormone(LH), interleukin-1(IL-1), interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected by enzyme-linked immunosorbent assay; correlation analysis was conducted by Pearson and Spearman methods.

RESULTS: The expression level of miR-744-5p in conjunctival epithelial cells of patients in the observation group was higher than that in the control group, and the expression level of PELI3 was lower than that in the control group(all P<0.05). Compared with the control group, the expression levels of FSH, IL-1, IL-6 and TNF-α in serum of patients increased in the observation group, and the expression levels of E2 and LH in serum decreased(all P<0.05). Correlation analysis showed that miR-744-5p was negatively correlated with PELI3 in conjunctival epithelial cells of perimenopausal dry eye patients(r=-0.476, P<0.01); miR-744-5p was negatively correlated with LH, E2, BUT and SⅠt(all P<0.05), while it was positively correlated with FSH, IL-1, IL-6, TNF-α and FL scores(all P<0.05); PELI3 was negatively correlated with FSH, IL-1, IL-6, TNF-α and FL scores, while it was positively correlated with E2, BUT and SⅠt(all P<0.05).

CONCLUSION: The level of miR-744-5p increased and PELI3 decreased in conjunctival epithelial cells of perimenopausal patients with dry eye. PELI3 and miR-744-5p were closely related to the sex hormones level, inflammatory factor level and the function of tear secretion in perimenopausal patients with dry eye.