青少年屈光不正在合并眼睑刷上皮病变状态下泪膜研究  

Research the changes of tear film in teenager refractive error patients with lid-wiper epitheliopathy

作　　者：王东华[1] 唐国芬[1] 乔志燕[1] 王绍美[1] 张铁民[1] 

机构地区：[1]承德医学院附属医院眼科,承德067000

出　　处：《中国实用眼科杂志》2014年第11期1309-1312,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 研究青少年屈光不正患者在合并眼睑刷上皮病变状态下的泪膜变化情况.方法 临床病例对照研究.对2013年1～8月在承德医学院附属医院眼科就诊的青少年屈光不正伴干眼患者78例中,进一步筛选出眼睑刷上皮病变阳性者56例,分为治疗组34例,对照组22例.使用干眼评估问卷来评价干眼症状;使用眼表染色的方法来进行眼睑刷上皮病变程度分级,分别观察治疗2周前后的泪膜破裂时间（BUT）、Schirmer Ⅰ试验和角膜荧光染色情况来评估泪膜变化情况.结果 治疗组在治疗前后比较干眼症状评分（t =27.45,P=0.00,P＜0.05）、眼睑刷染色评分（t=19.41,P=0.00,P＜0.05）、Schirmer Ⅰ试验（t=16.45,P=0.00,P＜0.05）及角膜荧光染色评分（t=10.35,P=0.00,P ＜0.05）等均呈下降趋势,差异有统计学意义,BUT（t=-24.57,P=0.00,P＜0.05）呈上升趋势,差异有统计学意义;对照组在治疗前后比较干眼症状评分（t =4.86,P=0.18,P＞0.05）、眼睑刷染色评分（t =3.18,P=0.07,P＞0.05）、Schirmer Ⅰ试验（t=2.07,P=0.09,P＞0.05）及角膜荧光染色评分（t =4.05,P=0.21,P＞0.05）,其差异均无统计学意义,BUT（t=-3.59,P=0.12,P ＞0.05）,各观察指标前后比较无明显变化趋势;治疗组与对照组在治疗后比较,干眼症状评分（t =-0.89,P=0.00,P＜0.05）、眼睑刷染色评分（t=-6.68,P=0.00,P＜0.05）、角膜荧光染色评分（t =-5.14,P=0.00,P＜0.05）及Schirmer Ⅰ试验（t=-3.94,P=0.00,P＜0.05）呈现下降趋势,其差异均有统计学意义,BUT（t=8.39,P=0.00,P＜0.05）呈上升趋势,差异有统计学意义.结论 眼睑刷上皮病变是导致青少年屈光不正患者泪膜稳定性下降的一个重要因素.Objective To research the changes of tear film in teenagers refractive error patients with lid-wiper epitheliopathy.Methods In the preliminary screening of teenagers refractive error with dry eye patients in 78 cases,further screening of 56 cases of LWE （＋）,34 cases were divided into treatment group,22 cases in the control group.The use of dry eye questionnaire to evaluate the symptoms of dry eye; ocular surface staining method used to grade the severity of LWE were observed before and after 2 weeks treatment,the tear break-up time （BUT）,Schirmer Ⅰ test and corneal fluorescence staining to evaluate the tear film changes.Results In the treatment group before and after the treatment of dry eye symptoms score （t =27.45,P =0.00,P ＜0.05）,lid-wiper staining score （t =19.41,P =0.00,P ＜0.05）,Schirmer Ⅰ test （t =16.45,P =0.00,P ＜0.05） and corneal fluorescein staining scores （t =10.35,P =0.00,P ＜0.05） were decreased,BUT （t =-24.57,P =0.00,P＜ 0.05）; the control group before and after the treatment of dry eye symptoms score （t =4.86,P =0.18,P ＞0.05）,lid-wiper staining score （t =3.18,P =0.07,P ＞0.05）,Schirmer Ⅰ test （t =2.07,P =0.09,P ＞0.05） and corneal fluorescein staining scores （t =4.05,P =0.21,P ＞0.05）,BUT （t =-3.59,P =0.12,P ＞0.05）; the treatment group and the control group after treatment,dry eye symptoms score （t =-0.89,P =0.00,P ＜0.05）,lid-wiper staining score （t =-6.68,P =0.00,P ＜0.05）,Schirmer Ⅰ test （t =-3.94,P =0.00,P ＜0.05） and corneal fluorescein staining scores （t =-5.14,P =0.00,P ＜0.05） were decreased,BUT （t =8.39,P =0.00,P ＜0.05）.Conclusions Lid-wiper epitheliopathy is an important cause of the decline in teenagers refractive error patients tear film stability.

关 键 词：青少年 屈光不正 眼睑刷上皮病变 泪膜 

分 类 号：R988.1[医药卫生—药品]