局部药物治疗对前葡萄膜炎患者干眼及泪膜质量的影响  

The effects of the topical drops on dry eye and tear films quality in patients with anterior uveitis

作　　者：王丽娜[1,2] 郑曰忠[1] Wang Lina Zheng Yuezhong(Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin 30002 Xiaozhan Hospital, Jinnan District, Tianjin 300353, Chin)

机构地区：[1]天津医科大学眼科临床学院 天津市眼科医院 天津市眼科学与视觉科学重点实验室 天津市眼科研究所,300020 [2]天津市津南区小站医院

出　　处：《临床眼科杂志》2017年第1期46-48,共3页Journal of Clinical Ophthalmology

摘　　要：目的观察急性前葡萄膜炎患者在局部药物治疗后的干眼状况和泪膜质量变化。方法自2015年10月至2016年5月间,从天津市眼科医院门诊连续收集急性前葡萄膜炎患者53例,经局部药物积极治疗4~6周后所有患者病情稳定。选择恢复期患者进行泪液分泌试验(SIT)、泪膜破裂时间(BUT)、泪膜脂质层分析、角膜上皮染色和干眼问卷调查。同期选取初次就诊的非干眼患者32例作为对照,对两组患者数据进行统计分析。结果53例葡萄膜炎患者双眼SIT平均值分别为(10.45±9.32)mm和(10.79±8.40)mm,32例对照者双眼SIT平均值分别为(9.56±7.47)mm和(11.73±7.84)mm,两组比较差异无统计学意义(F=0.21/0.26,P=0.648/0.609)。53例患者双眼BUT平均值分别为(5.32±3.33)s和(5.53±4.01)s,对照组患者双眼BUT平均值分别为(5.03±3.40)s和(5.53±3.62)s,两组比较差异无统计学意义(F=0.15/0.05,P=0.701/0.832)。干眼问卷调查评分与SIT(r=-0.23,P=0.009)、脂质层分析结果(r=-0.19,P=0.003)和患者年龄存在相关性(r=0.22,P=0.006),与BUT不相关(r=-0.10,P=0.256);患眼应用重组人表皮生长因子滴眼液与角膜上皮染色情况存在相关性(r=-0.47,P=0.002)。患者组患眼干眼问卷调查和角膜染色与健眼比较差异均有统计学意义(t=2.37/2.03,P=0.023/0.050)。结论长时间局部药物治疗前葡萄膜炎可出现轻度干眼症状、导致轻度角膜上皮损害或泪膜质量改变,合理使用药物和采取有效措施可有效治疗前葡萄膜炎和预防眼表组织损害。Objective To observe the dry eye and tear films quality changes in acute anterior uveitis patients after topical drops treatment. Methods 53 cases of anterior uveitis patients were continuous enrolled from Tianjin Eye Hospital. Topical drops were used for 4～6 weeks and inflammation diminished in all patients before any tests. Schirmer I test（ SIT）,tear break-up time（ BUT）,lipid layer analysis,corneal surface dying and dry eye questionnaire were performed after recovery. 32 normal subjects without dry eye complaints were enrolled during the same period as controls. Results There was no difference in SIT or in BUT between two eyes in uveitis patients or in control subjects. Dry eye questionnaire results were correlated with SIT（ r=-0.23,P=0.009）,lipid layer analysis（ r=-0.19,P=0.003） and age（ r=0.22,P=0.006）,but not with BUT（ r=0.10,P=0.256）. Application of topical recombinant human epidermal growth factor was associated with corneal epithelium dying results（ r=-0.47,P=0.002）. There was significant difference in dry eye questionnaire and corneal staining（ t=2.37/2.03,P=0.023/0.050） between the uveitic eye and the healthy eye. Conclusions Slight dry eye symptoms,corneal epithelial damage or tear film quality changes could occur in anterior uveitis patients after prolonged topical drops treatment. The correct usage of topical drugs and close observation could prevent ocular surface damage.

关 键 词：前葡萄膜炎 局部药物治疗 眼表 干眼 

分 类 号：R773[医药卫生—眼科]