脂溢性皮炎对干眼患者眼表损伤的影响  

Ocular surface damage in dry eye patients with seborrheic dermatitis

作　　者：毛春洁[1] 赫天耕[1] 孙智勇[1] 孟祥达[1] 颜华[1] Mao Chunjie;He Tiangeng;Sun Zhiyong;Meng Xiangda;Yan Hua(Department of Ophthalmology,General Hospital of Tianjin Medical University,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院眼科,300052

出　　处：《中华实验眼科杂志》2019年第10期820-823,共4页Chinese Journal Of Experimental Ophthalmology

基　　金：天津市自然科学基金项目(16JCQNJC13000).

摘　　要：目的观察伴脂溢性皮炎的干眼患者眼表功能变化,探讨脂溢性皮炎在眼表损伤中的意义.方法采用队列研究设计,纳入2015年10月至2016年3月于天津医科大学总医院眼科初诊为干眼的患者49例49眼,其中脂溢性皮炎组患者21例,非脂溢性皮炎组患者28例.对2个组患者的性别、年龄、睑板腺功能障碍、睑缘评分、睑缘分泌物评分、睑板腺成像评分、结膜充血评分、眼表疾病指数(OSDI)、基础泪液分泌试验(SⅠt)、泪膜破裂时间(BUT)、角膜荧光素染色评分等进行比较.结果2个组性别、年龄比较,差异均无统计学意义(χ2=1.536,P=0.215;t=0.642,P=0.524).脂溢性皮炎组睑板腺功能障碍发生率为57.15%(12/21),明显高于非脂溢性皮炎组的25.00%(7/28),差异有统计学意义(χ2=5.222,P=0.022).脂溢性皮炎组患者睑缘评分、睑板腺分泌物评分、睑板腺成像评分和角膜荧光素染色评分明显高于非脂溢性皮炎组,差异均有统计学意义(Z=2.105、3.303、3.368、3.036,均P<0.05).脂溢性皮炎组患者OSDI为26.43±8.05,明显大于非脂溢性皮炎组的16.75±5.74,脂溢性皮炎组BUT为(6.14±1.98)s,明显短于非脂溢性皮炎组的(8.75±1.38)s,差异均有统计学意义(t=4.918、5.434,均P<0.05).结论脂溢性皮炎可能会加重干眼患者的眼表损伤.Objective To observe the ocular surface function changes of dry eye patients with seborrheic dermatitis and discuss the significance of seborrheic dermatitis in ocular surface damage. Methods A cohort study was performed.Forty-nine patients (49 eyes) who were initial diagnosed with dry eye enrolled in General Hospital of Tianjin Medical University from October 2015 to March 2016 were divided into 2 groups, including 21 patients with seborrheic dermatitis and 28 patients without seborrheic dermatitis.Gender, age, meibomian gland dysfunction (MGD), eyelid margin scores, eyelid secretions scores, meibomian gland imaging scores, conjunctival congestion scores, ocular surface disease index (OSDI), Schirmer Ⅰtest (SⅠt), break-up time of tear film (BUT), fluorescent integral score were examined and compared.The study was followed the Declaration of Helsinki and was approved by General Hospital of Tianjin Medical University (No.IRB2015-YX-069). Written informed consent was obtained from all subjects before entering the study. Results There were not significant differences in gender and ages (χ2=1.536, P=0.215;t=0.642, P=0.524). The rate of MGD in seborrheic dermatitis group was 57.15%, which was significantly higher than that in the non-seborheic dermatitis group (25.00%), with significan difference between the two groups (χ2=5.222, P=0.022). There were significant differences in eyelid margin scores, eyelid secretions scores, meibomian gland imaging scores, fluorescent integral scores between the two groups (Z=2.105, 3.303, 3.368, 3.036, all at P<0.05). The OSDI in the seborheic dermatitis group was 26.43±8.05, which was significantly larger than that in the non-seborheic dermatitis group (16.75±5.74);the BUT in the seborheic dermatitis group was (6.14±1.98)s, which was significantly shorter than that in the non-seborheic (8.75±1.38)s (t=4.918, 5.434;both at P<0.05). Conclusions Seborrheic dermatitis may aggravate ocular surface dysfunction in dry eye patients.

关 键 词：眼表损伤 脂溢性皮炎 干眼 睑板腺功能障碍 

分 类 号：R777.34[医药卫生—眼科] R758.732[医药卫生—临床医学]