狼疮性肾炎伴干眼患者的泪河分析以及人工泪液的干预治疗  

Analysis of tear meniscus and intervention with artificial tears in lupus nephritis patients with xerophthalmia

作　　者：石尧[1] 王春红[1] 薛春燕[1] 黄振平[1] 

机构地区：[1]南京大学医学院临床学院(南京军区南京总医院)眼科,南京医学硕士210002

出　　处：《医学研究生学报》2014年第6期605-607,共3页Journal of Medical Postgraduates

基　　金：中国博士后科学基金(2013M532232)

摘　　要：目的干眼是一种临床常见的眼表疾病,狼疮性肾炎(Lupus nephritis,LN)引起的干眼越来越受到重视。文中通过眼前节光学相干断层扫描仪(anterior segment optical coherence tomography,AS-OCT)观察LN干眼患者泪河形态的变化,比较人工泪液治疗后泪河形态的改变,以期指导临床合理用药。方法选取南京军区南京总医院门诊就诊的LN干眼患者60例(120只眼)作为LN干眼组、60例无眼部疾病的患者(120只眼)作为对照组,采用前节OCT比较2组下方泪河高度(tear meniscus height,TMH)、泪河深度(tear meniscus depth,TMD)、泪河横截面面积(tear meniscus area,TMA);对LN干眼组采用人工泪液进行干预治疗,记录治疗前、治疗后1个月TMH、TMD以及TMA的变化。结果 LN干眼组TMH、TMD、TMA分别为(0.159±0.016)mm、(0.154±0.009)mm、(0.021±0.002)mm2,与对照组相比差异均有统计学意义(P<0.01)。LN干眼组使用人工泪液后滴眼1个月后TMD、TMH、TMA均较使用前显著增加,差异有统计学意义(P<0.01)。结论 AS-OCT测量LN干眼患者的泪河形态图像清楚、客观稳定,可以作为LN干眼诊断和病情评价的指标之一;人工泪液可有效地改善LN干眼患者的泪河高度、泪河深度以及泪河横截面积。Objective Xerophthalmia is a common disease of the ocular surface.Lupus nephritis（ LN） may induce changes in the ocular surface,which has aroused increasing attention in ophthalmology.This study was to observe the morphological changes of the tear meniscus in LN patients with xerophthalmia after treated with artificial tears.Methods This clinical trial included 60 LN patients with xerophthalmia（ 120 eyes） and another 60 without.The xerophthalmia group received artificial tear eye-drops for 1 month.The tear meniscus height（ TMH）,tear meniscus depth（ TMD）,and tear meniscus area（ TMA） were measured by anterior segment optical coherence tomography（ AS-OCT） before and after intervention.Results There were significant differences between the xerophthalmia and control groups in the baseline TMH（ [0.159 ± 0.051] vs [0.269 ± 0.053] mm,P ＆lt; 0.01）,TMD（ [0.154 ±0.012]vs [0.198 ± 0.007]mm,P ＆lt; 0.01）,and TMA（ [0.021 ± 0.069]vs [0.052 ± 0.021]mm2,P ＆lt;0.01）.After 1 month of intervention with artificial tears,the xerophthalmia patients showed dramatically increased TMH（ [0.179 ± 0.014] vs [0.159 ±0.051]mm,P ＆lt; 0.01）,TMD（ [0.163 ± 0.015]vs [0.154 ± 0.012]mm,P ＆lt; 0.01）,and TMA（ [0.040 ± 0.017]vs [0.021 ±0.069]mm2,P ＆lt;0.01）.Conclusion AS-OCT,with its advantages of clearly and objectively imaging and measuring the cross section of the tear meniscus,can be applied to the diagnosis and assessment of xerophthalmia in LN patients,and artificial tear eyedrops can effectively relieve their xerophthalmia symptoms.

关 键 词：狼疮性肾炎 干眼 泪河 眼前节光学相干断层扫描仪 人工泪液 

分 类 号：R593.242[医药卫生—内科学]