眼部蠕形螨感染与睑板腺功能障碍的相关性分析  

Correlation Analysis between Ocular Demodex Infestation and Meibomian Gland Dysfunction

作　　者：程胜男 黄渝侃[1] Cheng Shengnan;Huang Yukan(Department of Ophthalmology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院眼科,武汉430022

出　　处：《华中科技大学学报（医学版）》2020年第1期67-71,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：国家自然科学基金资助项目(No.81670824);湖北省自然科学基金面上项目(No.2016CFB421)。

摘　　要：目的通过观察睑板腺功能障碍(meibomian gland dysfunction,MGD)患者的睑板腺形态和功能、眼表情况以及眼部蠕形螨感染情况,分析眼部蠕形螨感染与MGD的相关性。方法选取2017年9月至11月就诊于华中科技大学同济医学院附属协和医院眼科门诊的患者83例,分为MGD组和非MGD组。依次行眼表疾病指数(ocular surface diseases index,OSDI)量表填写、泪膜脂质层厚度(tear film lipid layer thickness,LLT)测量、睑板腺缺失率检测、泪膜破裂时间(break-up time,BUT)检查、角膜荧光素染色(fluorescein staining,FL)、泪液分泌试验(SchirmerⅠtest,SⅠT)、睑缘及睑板腺开口状态的观察、活体共聚焦显微镜(in vivo confocal microscopy,IVCM)观察眼部蠕形螨感染情况。结果 MGD组BUT低于非MGD组,FL评分、睑缘及睑板腺评分、睑板腺缺失率均高于非MGD组,差异均有统计学意义(均P<0.05)。MGD组蠕形螨检出阳性率为89.32%,高于非MGD组的62.90%,差异有统计学意义(χ2=16.510,P<0.01)。MGD组蠕形螨感染阳性患者中有28.26%(26眼)为轻度感染,明显低于非MGD组的43.59%(17眼);MGD组有44.56%(41眼)为中度感染,稍低于非MGD组的53.85%(21眼);MGD组有19.57%(18眼)为重度感染,明显高于非MGD组的2.56%(1眼);MGD组有7.61%(7眼)为极重度感染,而非MGD组无极重度感染眼。蠕形螨感染数量与FL评分呈正相关(rs=0.299,P=0.004),与BUT呈负相关(rs=-0.281,P=0.007)。结论中重度特别是极重度蠕形螨感染可能是造成MGD的重要因素,且眼部损伤程度与蠕形螨的感染数量密切相关。Objective To analyze the correlation between ocular demodex infestation and meibomian gland dysfunction(MGD)through observation of meibomian gland function,ocular surface condition and ocular demodex infestation of patients with MGD.Methods Eighty-three patients who visited the Ophthalmology Clinic Outpatient of Union Hospital,Tongji Medical College of Huazhong University of Science and Technology were selected and divided into MGD group and non-MGD group from September to November 2017.Ocular surface diseases index(OSDI),tear film lipid layer thickness(LLT),meibomian gland dropout rate,break-up time(BUT),SchirmerⅠtest(SⅠT),cornea fluorescein staining(FL),eyelid margin and meibomian gland opening were detected,and the infestation of ocular demodex was observed via in vivo confocal microscopy(IVCM)successively.Results The BUT was significantly lower in MGD group than in non-MGD group,and the FL score,eyelid margin and meibomian gland score,meibomian gland dropout rate were significantly higher in MGD group than in non-MGD group(all P<0.05).The positive rate of demodex in MGD group was 89.32%,and that in control group was 62.90%.Two groups of demodex positive rate had significant statistical difference(χ2=16.510,P<0.01).In MGD group,28.26%(26 eyes)of the patients with positive demodex infestation were mildly infected,which was significantly lower than that in the non-MGD group [43.59%(17 eyes)].44.56%(41 eyes)of the MGD group had moderate infestation,slightly lower than 53.85%(21 eyes)of the non-MGD group.19.57%(18 eyes)in MGD group had severe infestation,which was significantly higher than 2.56%(1 eye)in the non-MGD group.In MGD group,7.61%(7 eyes)had extremely severe infection,while non-MGD group had no extremely severe infestation.The number of demodex infestation was positively correlated with FL score(rs=0.299,P=0.004),and negatively correlated with BUT(rs=-0.281,P=0.007).Conclusion Moderate to severe,especially extremely severe demodex infestation may be an important factor causing MGD,and the degree of

关 键 词：蠕形螨 睑板腺功能障碍 活体共聚焦显微镜 

分 类 号：R777.13[医药卫生—眼科]