247例干眼症患者临床特征分析  

Clinical characteristics of 247 patients with dry eye

作　　者：崔先进[1] 孙倩娜[1] 

机构地区：[1]山东省临沂市人民医院眼科,276003

出　　处：《眼科》2012年第3期177-180,共4页Ophthalmology in China

摘　　要：目的通过分析干眼症患者的临床资料,了解其临床特征,为诊断提供经验支持。设计回顾性病例系列。研究对象收集2010年10月至2011年12月就诊于临沂市人民医院眼科的干眼症患者247例(494眼)。方法对上述患者的临床资料进行总结分析,并进行相关检查,包括裂隙灯、角膜荧光素染色、泪膜破裂时间(BUT)和基础泪液分泌试验(SΙt)。干眼症诊断标准:在确定排除眼部其他疾病后,(1)BUT≤5 s,主观症状1项阳性;(2)5 s<BUT≤10 s,主观症状1项阳性,SΙt湿长≤5 mm;(3)BUT≤10 s,主观症状1项阳性,角膜荧光素染色阳性。将干眼症患者分为水样液缺乏型、睑板腺功能障碍型和混合型三型。主要指标症状,角膜荧光素染色、BUT和SΙt。结果 247例干眼症患者中,年龄13～78岁,平均(29.32±14.28)岁,男女比例1:1.25。眼部不适症状最多见为视疲劳(182例,73.68%)和眼部干涩(174例,70.45%),其次是眼痒(171例,69.23%)、异物感(159例,64.37%)、眼红(150例,60.73%)和视物模糊/视力下降(144例,58.30%)。本组患者主要集中在30～44岁年龄段(114例,46.15%),其次为18～29岁年龄段(73例,29.55%)。水样液缺乏型患者170例(68.83%),平均年龄(26.14±10.19)岁;睑板腺功能障碍者56例(22.67%),平均年龄(33.30±8.26)岁;混合型者21例(8.50%),平均年龄(50.23±9.28)岁(F=2.84,P<0.001)。结论干眼症患者的临床症状多样,各年龄段均有发病,但呈现低龄化趋势,临床分类仍以水液缺乏型干眼最常见,年轻人占多数。Objective To review and analyse the clinical characteristics of dry eyes. Design Retrospective case series. Participants A total of 247 new outpatients （494 eyes） with dry eyes who visited in Linyi People Hospital from Oct. 2010 to Dec. 2011 were included. Methods The clinical records of the participants were reviewed and some dry eye tests were performed, including slit-lamp examination, corneal fluoreseein staining test, tear break-up time （BUT） and basal Schirmer I test （Sit）. Make sure of excluding other ocular diseases, the definition of the dry eyes were： （1） BUT≤5 s, and had one of the positive subjective symptoms; （2） 5 s〈BUT≤ 10 s, and had one of the positive subjective symptoms, and Sit ≤5 ram; （3） BUT≤ 10 s, and had one of the positive subjective symptoms, and positive fluorescein staining of cornea. Clinical types of dry eyes were including aqueous tear deficiency, meibomian gland dysfunction （MGD）, and mixed type. Main Outcome Measures The positive subjective symptoms, corneal fluorescein staining test, BUT and Sit. Results On analyzing the main complaints of 247 patients （mean age 29.32±14.28 years; range 13±78 years, the ratio of male and female was 1：1.25.） , the most common complaints were asthenopia （182 cases, 73.68%） and ocular dryness （174 cases, 70.45%）, then followed by ocular itching （171 cases, 69.23%）, foreign body sensation （159 cases, 64.37%）, red eye （150 cases, 60.73%）, impairment of vision （144 cases, 58.30%） , photophobia/lacrimation （116 cases, 46.96%） and ophthalmalgia （97 cases, 39.27%）. Among the 247 cases, 114 cases （46.15%） were aged 30±44 years and 73 cases （29.55%） aged 18±29 years. 170 cases （68.83%） were aqueous tear deficiency, whose mean age was 26.14±10.19 years; 56 cases （22.67%） were MGD, whose mean age was 36.30±8.26 years; 21 cases were mixed type, whose mean age was 50.23＋9.28 years （F=2.84, P〈0.001）. Conclusion The clinical manifestations of dry eyes are di

关 键 词：干眼症/诊断 临床表现 

分 类 号：R777[医药卫生—眼科]