无眼征Graves病患者的眼表损害  

Ocular surface damage of Graves disease patients without eye symptoms

作　　者：张磊[1,2] 何彦津[1] 

机构地区：[1]天津医科大学眼科中心,天津市300384 [2]滨州医学院附属医院眼科

出　　处：《眼科新进展》2012年第12期1161-1164,共4页Recent Advances in Ophthalmology

摘　　要：目的评价无眼征的Graves病(Graves disease,GD)患者的眼表损害以及泪膜功能变化,了解眼表炎症在干眼发生机理中的作用。方法本研究选取38例(76眼)无眼征的GD患者与30名(60眼)正常人。记录睑裂高度、眼球突出度、眼表疾病指数(ocular surface disease index,OSDI)、泪液分泌试验、泪膜破裂时间、角膜荧光素染色及结膜印迹细胞检查结果,并将两组数据进行比较。结果 OSDI得分:GD组为(43.34±10.32)分,对照组为(22.56±11.21)分,差异有统计学意义(P<0.01)。泪液分泌量:GD组为(13.2±7.1)mm,对照组为(22.4±4.5)mm,差异有统计学意义(P<0.01)。泪膜破裂时间GD组为(7.2±2.1)s,对照组为(10.4±2.9)s,差异有统计学意义(P<0.01)。角膜荧光素染色:GD组阳性20眼,对照组6眼,差异有统计学意义(P=0.016)。结膜印记细胞学检查:GD组中0级26眼,1级23眼,2级17眼,3级6眼;正常对照组中,0级39眼,1级13眼,2级6眼,3级2眼,两组分布差异有统计学意义(P=0.008)。两组睑裂高度及眼球突出度差异无统计学意义(t值分别为0.482、-0.357,P值分别为0.632、0.723)。结论无眼征GD患者眼表有损害并存在干眼的表现,可能与眼表炎症有所关联。Objective To evaluate the ocular surface damage and the changes of tear film function in Graves disease （GD） patients without eye symptoms, and investi- gate the function of ocular inflammation in the pathogenesis of dry eye. Methods A total of 38 patients（76 eyes） with GD without eye symptoms and 30 healthy controls（60 eyes） were included in this study. The palpebral fissure height, degree of proptosis, ocu- lar surface disease index（ OSDI）, Schirmer I tear test,break-up time（ BUT）, corneal flu- orescence staining（ FL）, and conjunctival impression cytology（IC） were assessed. The results were compared between the patient and the control groups. Results The OS- DI score was 43.34 ± 10.32 in the GD group and 22.56 ± 11.21 in the control group, there was significant difference （P 〈 0.01 ）. The value of Schirmer I test was（ 13.2 ± 7. 1 ） mm in the GD group and （ 22.4 ± 4.5 ）mm in the control group, there was significant difference（P 〈 0.01 ）. BUT was（7.2 ± 2. 1 ） s in the GD group and （ 10.4 ± 2.9 ） s in the control group,there was significant difference （P 〈 0.01 ）. In the corneal fluorescence staining test,20 eyes were positive in the GD group and 5 eyes in the control group, there was statistical difference（P = 0.016）. Conjunctival impress cytology showed grade 0 was in 26 eyes（36. l1% ）,grade 1 in 23 eyes（31.94% ）,grade 2 in 17 eyes（23.61% ）, grade 3 in 6 eyes（8.33% ） in GD group,whereas grade 0 in 39 eyes（65.00% ） ,grade 1 in 13 eves（21.67% ）. grade 2 in 6 eyes （10.00%）. grade 3 in 2 eyes （3.33%）in control group ,there was significant difference（P = 0.008 ）. There was no statistical difference in interpalpebral distance and protosis between two groups （ t = 0.482, - 0.357 ;P = 0. 532,0. 723 ）. Conclusion Dry eye and ocular surface damage appear in GD without eye symptoms, which may be associated with the ocular surface inflammation.

关 键 词：GRAVES病 干眼 眼表 泪膜 结膜 印迹细胞学 

分 类 号：R581.1[医药卫生—内分泌]