Ⅱ型糖尿病患者眼表改变及影响因素的相关性分析  

Correlation analysis of ocular surface changes and influencing factors in type Ⅱ diabetic patients

作　　者：李雪梅 周艳峰[1] LI Xue-mei;ZHOU Yanfeng(Ophthalmology Department of the First Affiliated Hospital of Anhui Medical University,Hefei Anhui 230031,China)

机构地区：[1]安徽医科大学第一附属医院眼科,安徽合肥230031

出　　处：《实用防盲技术》2021年第2期73-76,50,共5页Journal of Practical Preventing Blind

摘　　要：目的观察察糖尿病(Diabetes mellitus, DM)组和正常组眼表情况,比较两组是否有差别,并进一步分析DM组眼表特征与病程、糖基化血红蛋白A1c(Glycosylated hemoglobin A1c, HbA1c)、空腹及餐后2hC肽、空腹及餐后2h血糖、尿微量白蛋白与肌酐比值(urinary microalbumin/creatinine, A/C)的相关性。方法选取123名研究对象入组,其中DM组81例(162眼),正常组42例(84眼),对每个入组对象进行泪河高度(Tear Meniscus Height, TMH)、非侵入性泪膜破裂时间(Non-invasive tear break-up time, NIBUT)、脂质层分级、上睑板腺缺失程度、角膜荧光素染色(Fluorescein staining of cornea, FL)检查,比较两组受试者各项眼表参数,进一步行spearman相关性分析研究DM组各个眼表特征与病程、HbA1c、空腹及餐后2hC肽、空腹及餐后2h血糖、A/C的相关性。结果与正常组相比,DM组TMH明显降低,首次和平均NIBUT明显缩短,两组比较差异有统计学意义(Z=-3.711、Z=-5.079、Z=-4.432, P<0.05),DM组薄脂质层的比例较高、正常脂质层的比例较低,上睑板腺完整的比例较低、上睑板腺轻、重度缺失的比例较高,FL阳性率较高,两组比较差异均有统计学意义(x2=26.719、x2=9.490、x2=4.027,P<0.05)。相关性分析示:TMH与HbA1c呈负相关,与餐后2hC肽呈正相关(P<0.05),NIBUT与HbA1c、餐后2h血糖呈负相关,与餐后2hC肽呈正相关(P<0.05);上睑板腺缺损程度与病程呈正相关(P<0.05),脂质层分级与HbA1c、空腹和餐后2h血糖呈负相关(P<0.05);FL阳性率与病程、HbA1c、A/C呈正相关,与空腹和餐后2hC肽呈负相关(P<0.05)。结论 DM患者眼表各参数情况与正常人相比明显异常,其相关因素包括病程、HbA1c、空腹及餐后2hC肽、空腹及餐后2h血糖、A/C。Objetive To observe the ocular surface conditions of type 2 diabetes group and normal group and compare whether there was any difference between the two groups and analyze the correlation of ocular surface parameters with disease course,HbA1 c,fasting and 2-hour postprandial C-peptide,fasting and 2-hour postprandial blood glucose and A/C in DM group. Methods 123 subjects were selected, including 81 diabetic patients(162 eyes) and 42 healthy people(84 eyes).Tear meniscus height(TMH), non-invasive tear break-up time(NIBUT), lipid layer classification and upper meibomian glands loss degree and fluorescein staining of cornea(FL) were measured for each subject to compare the ocular surface parameters of the two groups, and Spearman correlation analysis was further performed to analyze the correlation of ocular surface parameters with disease course, HbA1 c, fasting and 2-hour postprandial C-peptide, fasting and 2-hour postprandial blood glucose and A/C in DM group. Results Comparison between the DM group and normal group: the TMH of DM group was lower,and the first and average NIBUT of DM group were shorter,and the difference between the two group were statistically significant(Z=-3.711、Z=-5.079、Z=-4.432, P<0.05).The proportion of thin lipid layer of DM group was higher, and the proportion of normal lipid layer was lower;the proportion of complete upper meibomian glands of DM group was lower, and the proportion of light and severe loss of upper meibomian glands were higher;the positive rate of FL of DM group was higher,All of them between the two groups were different statistically(x2=26.719、x2=9.490、x2 =4.027,P<0.05).Correlation analysis: The TMH was negatively correlated with HbA1 c and positively correlated with 2-hour postprandial Cpeptide(P<0.05). NIBUT was negatively correlated with HbA1 c and 2-hour postprandial blood glucose,and positively correlated with 2-hour postprandial C-peptide( P<0.05).The upper meibomian glands loss degree was positively correlated with disease course(P<0.05).Lipid layer class

关 键 词：糖尿病 眼表 角膜 睑板腺 泪膜 

分 类 号：R587.2[医药卫生—内分泌]