甲状腺相关眼病28例合并干眼临床分析  

Clinical analysis of 28 cases with dry eye in thyroid associated ophthalmopathy

作　　者：陆士恒[1] 张忆[1] 吕骄[1] 

机构地区：[1]上海市浦东新区公利医院,200135

出　　处：《中国实用眼科杂志》2013年第9期1150-1152,共3页Chinese Journal of Practical Ophthalmology

基　　金：上海市浦东新区科委、卫生局资助（PKJ2010-Y12）

摘　　要：目的分析甲状腺相关眼病（TAO）合并十眼症患者的临床特点.方法将在上海市浦东新区公利医院眼科收治诊断为TAO并合并有干眼患者28例（55只眼）作为病例组，26名年龄、性别匹配的正常人作为对照组，对其临床资料进行详细记录包括甲状腺相哭免疫指标，s—TSH，FT3，FT4，TAO活动性评分（CAS），泪液基础分泌试验（SIt）、泪膜破裂时间（BUT）、角膜荧光素染色评分等项目（FI），利用SPSS13．0统计软件进行统计分析，免疫指标采用Mann—Whitney Test检验，其他指标用单因素方差分析？结果28例患者中，TAO活动期患者12例（42．85％），非活动期患者16例（57．14％）。活动期和非活动期甲亢眼病患者在甲状腺免疫指标的比较，差异有统计学意义s—TSH，P〈0．01；FT3，P=0．013；FT4，P〈0．01。TAO患者的BUT比对照组显著的减少（P〈0．01），而Schirmer实验显示TAO患者和对照组相比差异无统计学意义。角膜荧光素染色评分在TAO活动期的患者和对照组比较，差异有统计学意义。结论（1）TAO的泪液分泌正常。（2）TAO合并十眼是眼表的炎症导致泪膜不稳定引起的蒸发过强干眼。（3）活动期TAO患者的角膜受损。Objective To study the clinical involvement of the dry eye in patients affected by active and inactive thyroid associated ophthalmopathy （TAO）. Methods The study included 28 TAO patients （55eyes） and 25 age and sex-matched healthy control subjects. Each participant underwent a full eye examination, including an evaluation of symptoms （clinical active score, CAS）, tear secre-tion test （Schirmer I test, Sit）, tear break-up time （BUT） and fluorescent integral （FI）. Their clinical manifestation were summarized and analyzed. The main indices of immunity were compared with Mann-Whitney Test. One way ANOVA with the least-significant difference （LSD） post hoc test re-vealed statistically significant differences between patients and controls in other evaluated parameters. Results Twelve （42.85%） of the 28 patients had active TAO. The main immune indices of TAO significant differences in active compared with inactive disease. Patients with TAO patients showed statistically significant decrease in BUT. There was no significant difference between TAO group and control in Sit. The injury of cornea was observed only in active patient of TAO. Conclusions TAO is complicated with evaporative dry eye secondly. Tear secretion is normal in TAO patients. The dry eye associated with TAO therefore seems to be mainly evaporative, due to the ocular sur- face active inflammation.

关 键 词：甲状腺相关眼病 干眼 眼表 

分 类 号：R771.3[医药卫生—眼科]