基于TFOS DEWSⅡ标准的单纯红斑狼疮患者合并干眼的相关研究  

Correlation between systemic lupus erythematosus and dry eye based on the TFOS DEWSⅡ standard

作　　者：顾正宇[1] 许亚静[1] 李阳[1] 廖荣丰[1] Gu Zhengyu;Xu Yajing;Li Yang;Liao Rongfeng(Department of Ophthalmology,First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院眼科

出　　处：《临床眼科杂志》2020年第1期10-13,共4页Journal of Clinical Ophthalmology

基　　金：安徽医科大学第一附属医院国家自然培育基金(基金号:YNKY2017016)

摘　　要：目的参照最新国际泪膜和眼表协会干眼疾病工作组第二次会议(TFOS DEWSⅡ)干眼诊断标准评估系统性红斑狼疮(SLE)患者的眼部主观症状和客观体征改变,研究SLE与干眼的相关性。方法采用横断面研究方法,选择70例SLE患者作为观察组。选择70例年龄、性别匹配的健康人作为对照组。参照TFOS DEWSⅡ标准对患者进行干眼检查,在眼表疾病指数(OSDI)问卷评分的基础上;用Keratograph5M眼表综合分析仪对干眼患者进行非侵入性泪膜破裂时间、泪河高度、脂质层分级、睑板腺面积缺失等评估。分析SLE组与对照组之间的眼表检测参数及干眼发病率的差异,并对SLE干眼进行分型。结果与对照组相比,SLE组更易发生干眼(41%vs.23%,P<0.05)。SLE组的OSDI评分、非侵入性泪膜破裂时间、泪河高度、脂质层分级、睑板腺面积缺失较对照组差,差异有统计学意义(P<0.05)。两组的睑板腺开口分级、角膜荧光染色比较,差异无统计学意义(P>0.05)。SLE干眼可分为3型:水液缺乏型、蒸发过强型、混合型。结论TFOS DEWSⅡ干眼诊断标准弥补了传统诊断标准的不足,能够更加全面、客观的对干眼进行诊断。本研究结果显示,与正常人相比较,有更大比例的SLE参与者符合TFOS DEWSⅡ干眼诊断标准,干眼风险增加。Objective To evaluate the changes in dry eye symptoms and signs of patients with systemic lupus erythematosus(SLE)based on the latest TFOS DEWSⅡdiagnostic criteria,and to investigate the association between SLE and dry eye.Methods A cross-sectional study was conducted with 70 SLE patients were recruited as the observation group.Another 70 age and gender-matched healthy subjects were recruited as the control group.Patients were examined for dry eye with reference to the TFOS DEWSⅡstandard.The ocular examinations included Ocular Surface Disease Index score(OSDI),non-invasive tear meniscus height(NITMH),non-invasive keratograh breakup time(NIKBUT),meibomian gland loss,lashes and lid margin,lipid layer,and ocular surface fluorescent staining.The differences in ocular surface parameters and incidence of dry eye between the SLE group and control group were analyzed,and the types of SLE-associated dry eyes were classified.Results Compared with the control group,patients with SLE were more prone to dry eyes(41%vs.23%,P<0.05).The OSDI score,NITMH,NIKBUT,lipid layer grading,and meibomian gland loss in SLE group were worse than the control group,with statistically significant differences(P<0.05).Classification of meibomian gland openings and corneal fluorescence staining of the two groups showed no significant differences(P>0.05).SLE-associated dry eye can be divided into three types:water-fluid deficiency type,over-evaporation type and mixed type.Conclusions The diagnostic criteria of TFOS DEWSⅡdry eye adds to the traditional diagnostic criteria,and can diagnose dry eye more comprehensively and objectively.Results of this study showed that compared with healthy subjects,a larger proportion of SLE participants met the diagnostic criteria for TFOS DEWSⅡdry eye,and the risk of dry eye was also higher.

关 键 词：泪膜和眼表协会 干眼疾病工作组 第二次会议 系统性红斑狼疮 干眼 

分 类 号：R593.241[医药卫生—内科学] R777[医药卫生—临床医学]