主客观评价方法在社区中老年青光眼伴干眼患者眼表疾病评价中的应用  

Application of Subjective and Objective Assessment Method in the Evaluation of Ocular Surface Diseases in Middle Aged and Elderly Patients With Glaucoma and Xerophthalmia

作　　者：吴丽萍[1] 胡春玲[1] 张悦[1] 常青[1] 黄侃依 方宗君 

机构地区：[1]复旦大学附属华山医院宝山分院眼科,上海市200431 [2]宝山区长江路社区卫生服务中心

出　　处：《中国全科医学》2015年第29期3548-3550,3554,共4页Chinese General Practice

基　　金：上海市宝山区科技发展基金项目(12-E-29)

摘　　要：目的探讨眼表疾病指数(OSDI)问卷、泪膜破裂试验(TBUT)、角结膜荧光染色和Schirmer试验在社区中老年青光眼伴干眼患者眼表疾病评价中的价值。方法选取2013年5—10月于上海市某大型社区筛查的136例患者为研究对象,其中青光眼伴干眼患者64例(青光眼伴干眼组),单纯干眼患者72例(单纯干眼组)。干眼筛查采用OSDI问卷、TBUT、角结膜荧光染色和Schirmer试验。通过视野、眼压及眼底检查筛查青光眼患者。结果两组眼部不适相关评分比较,差异无统计学意义(P>0.05)。青光眼伴干眼组视力相关评分和OSDI总分高于单纯干眼组(P<0.05)。两组OSDI评分严重程度比较,差异有统计学意义(P<0.05)。两组TBUT、Schirmmer试验结果比较,差异无统计学意义(P>0.05);青光眼伴干眼组角结膜荧光染色评分高于单纯干眼组,差异有统计学意义(P<0.05)。两组TBUT严重程度比较,差异有统计学意义(P<0.05)。两组Schirmmer试验严重程度比较,差异无计学意义(P>0.05)。结论相比于其他方法,OSDI不能准确评价青光眼患者眼表疾病,而角结膜荧光染色可能是诊断青光眼患者眼表疾病的较好方法。Objective To explore the value of OSDI,TBUT,corneal fluorescent staining and Schirmer test in the evaluation of ocular surface diseases in middle aged and aged patients with glaucoma and xerophthalmia. Methods We enrolled136 patients who received screening in a large-scale community in Shanghai from May to October,2013. We assigned 64 patients with glaucoma and xerophthalmia into combined group and 72 patients with only xerophthalmia into xerophthalmia group. We screened patients with xerophthalmia by OSDI,TBUT,corneal fluorescent staining and Schirmer test,and patients with glaucoma by examination of Field of View, intraocular pressure and fundus oculi. Results The two groups were not significantly different in the relevant scores of ocular discomfort（ P〉0. 05）. Combined group was higher（ P〈0. 05） than xerophthalmia group in the relevant scores of eyesight and the total score of OSDI. The two groups were significantly different in the severity of OSDI score（ P〈0. 05）. The two groups were not significantly different in TBUT and Schirmmer results（ P〈0. 05）;combined group was higher（ P〈0. 05） than xerophthalmia group in the score of corneal fluorescent staining. The two groups were significantly different in the severity degree of TBUT（ P〈0. 05）. The two groups were not significantly different in the severity degree of Schirmmer test（ P〉0. 05）. Conclusion Compared to other methods,OSDI can not accurately evaluate the ocular surface diseases in patients with glaucoma,and corneal points staining may be a better way for the diagnosis of the disease.

关 键 词：青光眼 干眼病 中年人 老年人 眼表疾病指数 角结膜荧光染色 

分 类 号：R775[医药卫生—眼科]