糖尿病患者泪膜损伤的临床特征分析  

The clinical characters of tear film instability in diabetes patients

作　　者：赵萌[1] 邹留河[1] 焦璇[1] 彭晓燕[1] 

机构地区：[1]首都医科大学附属北京同仁医院眼科中心北京市眼科研究所北京市眼科学与视觉科学重点实验室,北京100730

出　　处：《中华实验眼科杂志》2011年第11期1019-1022,共4页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金资助项目（30872820）

摘　　要：背景近年来研究证实糖尿病患者的干眼症发病率较非糖尿病患者高，而超声乳化白内障手术、视网膜光凝等方面的临床研究也进一步证实糖尿病患者眼表存在泪膜障碍。目的探讨糖尿病患者泪膜异常的临床特征。方法对2010年1～9月就诊于北京同仁医院眼科中心眼底病门诊的患者进行糖尿病病史调查及泪膜破裂时间（BUT）、泪液分泌试验（Schirmer试验）检查，泪膜损伤的诊断标准为存在Schirmer试验异常和／或BUT异常。存在泪膜损伤的162例患者按照是否患有糖尿病分为糖尿病组和非糖尿病组。对患者进行干眼症问卷调查（DEQ）评分，对2组患者右眼Schirmer试验结果、BUT的差异进行比较，并对2组睑板腺形态评分〉1级的人数和构成比、出现干眼症状的人数和构成比的差异进行比较。结果糖尿病组80例，泪膜损伤的Schirmer试验结果中位数为8[5，9]mm，非糖尿病组患者82例，中位数为6[5，7]mm，差异有统计学意义（u=2452，P=0．00）。糖尿病组泪膜损伤BUT的中位数为3[2，4]s，非糖尿病组中位数为4[3，5]S，差异有统计学意义（U：2104，P〈0．叭）。糖尿病组泪膜损伤患者DEQ评分中位数为15[10，19]，非糖尿病组患者DEQ评分中位数为21[19，23]，差异有统计学意义（u=132，P〈0．01）。糖尿病组和非糖尿病组睑板腺形态学异常者分别为51．2％（41／80）和32．9％（27／82），差异有统计学意义（y。=16．07，P=0．00），糖尿病组和非糖尿病组出现干眼症状者分别为51．2％（41／80）和93．9％（77／82），差异有统计学意义（χ2=37．24，P〈0．01）。糖尿病组患者DEQ评分、睑板腺形态学评分与糖尿病病程均无明显相关性（r=0．16，P=0．16；r=0．10，P=0．36）。糖尿病组有39例（48．8％）患者无干眼症的典型症状但合并有严重的泪膜损伤。结论与非糖尿病患者相比，糖尿病患者具�Background The current epidemiology study had shown the prevalence of age and sex adjusted dry eye was higher in patients with diabetes than population without diabetes. Further researches demonstrated that the tear film disturbance is common after the phacoemulsification or photocoagulation in the eyes of diabetic patients. Objective The aim of this study was to characterize the clinical features of tear film instability in diabetes patients. Methods One hundred and sixty-two patients with tear-film abnormality referred to Tongren Eye Center from January 1,2010 to September 1,2010 underwent questionnaire about diabetes and other diseases, BUT, Sehirmer test. Tear film instability was diagnosed as abnormality of either Sehirmer test or BUT and showed as M （ Q25, Q75 ）. The right eyes of 162 dry eye patients meeting with the ineluding criteria were enrolled. The patients were assigned to two groups according to with （80 patients） or without （82 patients） diabetes mellitum. DEQ questionnaire were scored. The pereentage of eases with meibomain gland abnormal score 〉 1 was calculated. Mann-Whitney U analysis and Chi- square analysis were used to compare the difference between the two groups. Results The Schirmer test in diabetic group was 8 （ qualities ： 5,9 ） mm and was longer than 6 （ qualities： 5,7 ）mm in non-diabetic patients （ U = 2452, P=0.00）. The result of BUT test was 3 （ qualities： 2,4） seconds in diabetic patients and was shorter than 4 （qualities：3,5） seconds in non-diabetic patients（ U= 2104,P〈0.01 ）. The DEQ score of diabetic patients was 15 （ qualities ： 10,19, which was less than21 （ qualities ： 19,23.25 ） in non-diabetic patients. 51.2% （ 41/80 ） diabetic participants and 32.9% （27/82） nondiabetic participants appeared meibography（ grade larger than 1 ） （X2 = 16.07, P=0.00）. The percentages of dry eyes were 51.2% （41/80） and 93.9% （77/82） respectively in diabetes and non- diabetes groups（x2 = 37.24, P〈0.01 ）. No s

关 键 词：糖尿病 泪膜 睑板腺 干眼 

分 类 号：R77[医药卫生—眼科] R587[医药卫生—临床医学]