糖尿病2型患者眼表状态的改变  

Ocular surface change of type 2 diabetic patients

作　　者：胡岚君 赵金荣[1] 张金英[1] 

机构地区：[1]中国天津市人民医院眼科,300121

出　　处：《国际眼科杂志》2008年第11期2263-2265,共3页International Eye Science

摘　　要：目的:探讨2型糖尿病患者眼表状态的改变。方法:107例(107眼)2型糖尿病患者(DM组)及100例100只正常眼(对照组),观察分析两组患者主观感觉,基础泪液分泌试验(schirmerI test,SIt),泪膜破裂时间(tear breaking up time,BUT)测定角膜荧光素染色及结膜印迹细胞学状态改变。结果:DM组患者发生干眼的几率(54.2%)较对照组(17.0%)明显增高,差异具有统计学意义。DM组基础泪液分泌试验(8.48±4.34mm)较对照组(13.73±4.79mm)降低,BUT(6.78±4.08s)较对照组(14.31±4.78s)明显缩短,角膜荧光素着色点(19.6%)较对照组(6.0%)明显增多,差异具有显著意义(P<0.05);结膜印迹细胞学检查DM组结膜杯状细胞密度平均值(80.03±40.38/mm2)较对照组(132.14±33.01/mm2)明显降低,结膜鳞状化生级别较对照组增高,两组差异有统计学意义(P<0.01)。结论:糖尿病可引起角膜、结膜状态的改变。对于糖尿病患者尤其是在各种手术时要充分考虑眼表的改变,给予恰当的治疗。AIM： To investigate the changes of tear film function and ocular surface of type 2 diabetes mellitus. METHODS： Totally 107 patients with type 2 diabetic （107 eyes） in diabetic group and 100 non-diabetic individuals with matching age and gender as controls （100 eyes） were enrolled in the study. All patients were inquired about dry eye syndrome and received the examinations as follows： tear film function, Schirmer I test （Sit）, tear breaking up time （ BUT）, corneal fluorescein staining （FL） and impression cytology. RESULTS. The diabetic group showed higher prevalence rate of dry eye syndrome （54.2%） than that of the control group （17. 0%）, showing a significant difference （P 〈 0.01 ）. Type 2 diabetes mellitus showed lesser Sit （8.48±4.34mm） than controls（13. 73 ± 4. 79mm ） （P〈0.05）, faster BUT（6. 78±4. 08 seconds） in diabetics patients and （14.31±4.78 seconds） in controls （P〈 0.01）, higher rate of FL （19.6%） in diabetics patients and （6.0%） in controls （P〈0.01）. Goblet cells density decreased （80.03± 40.38/mm^2） compared with the controls （132. 14 ±33.01/mm^2 ） and its Squamous metaplasia-level increased （P〈0.01）. CONCLUSION ： The patients with type 2 diabetics show a tendency to develop tear film dysfunction and conjunctiva impairment. They are susceptible population of dry eye. We should think of this thoroughly and give proper treatment especially to people before operation.

关 键 词：2型糖尿病 干眼症 泪膜 印迹细胞学 

分 类 号：R587.1[医药卫生—内分泌] R777[医药卫生—内科学]