儿童与成人干眼临床表现的差异性研究  

Study on the difference of clinical manifestations of dry eye between children and adults

作　　者：黎彦宏[1] 宋金鑫[1] 杨建刚[1] 程钰[1] Yan-Hong Li;Jin-Xin Song;Jian-Gang Yang;Yu Cheng(Department of Ophthalmology,Xi'an No.1 Hospital,Shaanxi Institute of Ophthalmology,Shaanxi Key Laboratory of Ophthalmology,Clinical Research Center for Ophthalmology Diseases of Shaanxi Province,Department of Ophthalmology,First Affiliated Hospital of Northwestern University,Xi'an 710002,Shaanxi Province,China)

机构地区：[1]中国陕西省西安市第一医院眼科陕西省眼科研究所陕西省眼科学重点实验室陕西省眼科疾病临床医学研究中心西北大学附属第一医院眼科

出　　处：《国际眼科杂志》2019年第9期1619-1622,共4页International Eye Science

基　　金：陕西省重点研发计划项目(No.2017SF-279);西安市科技计划项目[No.2017116SF/YX010(8)]~~

摘　　要：目的:探讨儿童与成人干眼临床表现的差异。方法:选取2018-06/2019-02在我院眼科门诊就诊的具有干眼主观症状的儿童患者52例52眼(儿童组)和成人患者55例55眼(成人组),进行主观症状问诊,并采用Keratograph 5M非侵入性眼表综合分析仪进行下睑泪河高度(TMH)、首次泪膜破裂时间(BUTf)、平均泪膜破裂时间(BUTave)、泪膜脂质层厚度(LLT)、睑板腺缺失率测量。结果:儿童组患者TMH(0.15±0.04mm)、BUTf(3.22±1.24s)、BUTave(4.27±1.67s)、睑板腺缺失率[0.00%(0.00%,5.03%)]均明显低于成人组[0.20±0.05mm、4.36±1.93s、5.15±1.49s、9.90%(5.30%,18.40%),均P<0.01],但两组患者LLT无差异(72.31±22.20nm vs 68.58±21.05nm,P>0.05)。两组患者BUTf与BUTave均呈正相关,儿童组患者LLT和睑板腺缺失率无相关性(r_s=-0.23,P=0.10),而成人组患者LLT和睑板腺缺失率呈负相关(r_s=-0.28,P<0.05)。结论:儿童与成人干眼在症状、临床表现、检查方面均不同,症状主要为瞬目次数增加,检查主要表现为短BUT,伴随TMH降低,而睑板腺缺失率相对不明显。?AIM: To explore the difference of dry eyes between children and adults in terms of symptoms and laboratory examinations.?METHODS: Patients in 2018-06/2019-02 with the subjective symptoms of dry eye, and served in Xi’an First Hospital, including 52 children clinic cases(52 eyes) and 55 adult patients cases(55 eyes), all the cases were consulted and examined by slit lamp microscope in anterior segment. Both eyes of tear meniscus height(TMH), the first tear film break-up time(BUTf), the average tear film break-up time(BUTave), lipid layer thickness(LLT) and mesangial gland loss rate were measured by a Keratograph 5 M non-invasive ocular surface analyzer.?RESULTS: In children, patients’ TMH(0.15±0.04 mm), BUTf(3.22±1.24 s), BUTave(4.27±1.67 s), and the rate of meibomian gland loss [0.00%(0.00%, 5.03%)] were significantly lower than those in the adult group [0.20±0.05 mm, 4.36±1.93 s, 5.15±1.49 s, 9.90%(5.30%, 18.40%), all P<0.01]. The LLT in the children was higher than that of the adult group, and the difference was not statistically significant(72.31±22.20 nm vs 68.58±21.05 nm, P>0.05). Both groups of patients had positive correlation sympathise with BUTf and BUTave, with no correlation between LLT and meibomian gland loss rate in children(r_s=-0.23,P=0.10), and adult group patients with negative correlation of LLT and meibomian gland loss rate(r_s=-0.28,P<0.05).?CONCLUSION: Children’s dry eyes and adult dry eyes in the symptoms, clinical manifestations and examination are different. The main symptom is the increase in the number of blinks. The inspection is mainly characterized by a short BUT. With the decrease of TMH, the rate of meibomian gland loss is relatively insignificant.

关 键 词：儿童 干眼 Keratograph 5M 差异 泪膜破裂时间 睑板腺 

分 类 号：R47[医药卫生—护理学]