季节性过敏性结膜炎急性发作期与非发病期泪膜功能的改变  

Change of tear ftim function in seasonal allergic conjunctivitis between acute exacerbation andnon-onset phase

作　　者：李轩[1] 姜志昕[1] 郝朋[1] 

机构地区：[1]300020,天津市眼科学与视觉科学重点实验室 天津市眼科研究所 天津医科大学眼科临床学院 南开大学眼科医院 天津市眼科医院眼科

出　　处：《中国医师进修杂志》2013年第24期15-17,共3页Chinese Journal of Postgraduates of Medicine

基　　金：天津市应用基础与前沿技术研究计划

摘　　要：目的探讨季节性过敏性结膜炎（SAC）患者急性发作期与非发病期泪膜功能的改变。方法前瞻性对照研究，15例（30眼）SAC患者（SAC组）于急性发作期与非发病期分别行泪膜功能评估，包括泪膜破裂时间（BUT）、SchirmerI检测（SIt）及泪膜干涉成像仪检查。选择同期15例健康志愿者作为对照组，检测其泪膜功能。结果SAC组急性发作期BUT显著低于非发病期和对照组[（6.974-1.56）8比（11.274±1.39）、（12.00±1.11）s]，差异有统计学意义（U=20.50，P=0.000；U=1.00，P=0.000）；SAC组非发病期BUT与对照组比较差异无统计学意义（U=322.00，P〉0.05）。SAC组急性发作期、非发病期及对照组sIt比较差异均无统计学意义（P〉0.05）。泪膜干涉成像仪检查，对照组80.0％（24／30）为Ⅰ～Ⅱ级，20.0％（6／30）为Ⅲ级；SAC组急性发作期20.0％（6／30）为Ⅰ～Ⅱ级，80.0％（24／30）为Ⅲ～V级；SAC组非发病期60.0％（18/30）为Ⅰ～Ⅱ级，40.0％（12／30）为Ⅲ～V级，SAC组急性发作期泪膜干涉成像仪分级与非发病期及对照组比较差异均有统计学意义（χ^2=19.27，P=0.000；χ^2=8.40，P=0.004）；SAC组非发病期与对照组比较差异无统计学意义（P=1.98，P〉0.05）。结论SAC可引起泪膜功能的改变，导致泪膜不稳定；季节过敏性炎性反应所致的泪膜不稳定，不表现为永久性，SAC非发病期泪膜功能可恢复至正常。Objective To investigate the change of tear film function in patients with seasonal allergic conjunctivitis （SAC） between acute exacerbation and non-onset phase. Methods This was a prospective controlled study. Functional assessment of teat film was performed in 30 eyes of 15 patients with SAC （SAC group） between acute exacerbation and non-onset phase and 15 healthy controls （control group）. The tear film function included tear film break-up-time （BUT）, Schirmer I test （Sit） and tear film interferometer imager measurement. Results BUT was significantly decreased in SAC group on acuteexacerbation compared with that on non-onset phase and control group [（6.97±1.56） s vs. （ 11.27±1.39）, （12.00±1.11） s], and there was significant difference （U =20.50,P =0.000;U = 1.00,P =0.000）. Moreover, BUT in SAC group on non-onset phase was similar as control group （U = 322.00, P 〉 0.05）. There was no significant difference in Sit among SAC group on acute exacerbation and non-onset phase and control group（P〉 0.05 ）. In tear film interferometer imager measurement, 80.0%（24/30） was Ⅰ - Ⅱ grade, 20.0% （6/30） was HI grade in control group, 20.0%（6/30） was Ⅰ - Ⅱ grade, 80.0%（24/30） was Ⅲ- V grade in SAC group on acute exacerbation, 60.0%（18/30）was Ⅰ - Ⅱ grade, 40.0%（12/30）was Ⅲ- V grade in SAC group on non-onset phase, and there was significant difference between SAC group on acute exacerbation and SAC group on non-onset phase, control group （χ^2= 19.27,P = 0.000; χ^2= 8.40,P = 0.004） ,and there was no significant difference between SAC group on non-onset phase and control group （ χ^2 = 1.98, P 〉 0.05）. Conclusion SAC can cause the instability of tear film during the acute exacerbation, whereas this instability can be recovered within the non-onset phase of SAC, which is close to the normal control.

关 键 词：结膜炎 变应性 泪膜 眼表 

分 类 号：R777.31[医药卫生—眼科]