干眼病患者结膜损害的观察研究  

The study of punctation in ocular conjunctiva of patients with dry eye

作　　者：钱勇[1] 刘菊[1] 段文静[1] 祃红燕[1] 卢颖[1] 张励[2] 

机构地区：[1]首都医科大学教学医院电力总医院眼科,北京100073 [2]中国中医研究院眼科医院

出　　处：《临床眼科杂志》2008年第5期408-410,共3页Journal of Clinical Ophthalmology

摘　　要：目的探讨干眼病患者结膜损害的观察方法。方法选择2006年6月至2007年10月在我院门诊确诊的47例(94只眼)干眼病患者,对其94只眼用荧光素染色后分别用钴蓝光和蓝光滤过片观察眼表结构的改变情况。结果在眼表上皮细胞方面,钴蓝光观察94只眼中有85只眼染色有异常,其中染色累及睑裂部角结膜有75只眼,染色累及下方结膜有10只眼;而用蓝光滤过片观察后,发现染色有异常的有90只眼,其中染色累及睑裂部角结膜有25只眼,染色累及下方结膜46只眼,染色累及上方结膜19只眼,Kappa一致性检验,二者有差异;染色累及上方结膜19只眼的干眼病患者泪膜破裂时间为均值4.07s,标准差0.14s;与正常眼泪膜破裂时间至少5s相比有统计学差异。结论眼表结构荧光染色后的的蓝光滤过片观察方法简便、特异性、敏感性高,尤其是在结膜上皮的损害观察方面优势明显。所有上方结膜损害的干眼病患者的泪膜稳定性差,主观症状中异物感症状重。Objective To investigate the benefit of the blue-free barrier filter in injuries of ocular conjunctiva of dry eye. Methods The study involved 94 eyes of 47 dry eye patients who had diagnosed in Beijing Electric Power hospital between June 2006 and October 2007, afer fluorescein staining , all eyes had examined by coboh-blue light and blue-free barrier fiher,eomparised the differentence by Kappa test. Results Ocular surface epithelium change： by coboh-blue light examination 85 eyes had punctate ,75 eyes had punctate in corneal and conjunetiva of palpebral fissure, 10 eyes had punctate in the lower eonjunctiva ;by blue-free barrier filter examination 90 eyes had punctate ,25 eyes had punctate in corneal and eonjunctiva of palpebral fissure, 46 eyes had punctate in the lower conjunctiva, 19 eyes had punetate in the upper conjunctiva, The Kappa test was used to compare two test results, and the Kappa value was 0. 101 （ P 〈 0.001 ）, 19 eyes had punctation in the upper conjunctiva,The mean of tear film break up time is （4.07 ± 0.14）s, Significant differences existed between 19 eyes and the normal people. Conclusion The method of blue-free barrier filter provided fast, sensitive diagnostic methods in ocular surface epithelium of dry eye,espicial in ocular conjtmctiva. The stability of tear film with punctation in the upper conjunctiva was bad, the patients individual symptom was serious.

关 键 词：干眼病 蓝光滤过片 钴蓝光 结膜 

分 类 号：R777[医药卫生—眼科]