2型糖尿病干眼患者与正常干眼患者睑板腺及泪膜脂质层特征比较  

Comparison of meibomian glands and tear film lipid layers between patients with type 2 diabetes combined with dry eye and patients with dry eye

作　　者：李科军[1] 赵智华[1] 樊芳[1] 李晓丹 贾志旸[1] LI Kejun;ZHAO Zhihua;FAN Fang;LI Xiaodan;JIA Zhiyang(Hebei Provincial People’s Hospital,Shijiazhuang 050051,Hebei Province,China)

机构地区：[1]河北省人民医院眼科,河北省石家庄市050051 [2]石家庄市第一医院眼科,河北省石家庄市050000

出　　处：《眼科新进展》2022年第3期222-225,共4页Recent Advances in Ophthalmology

基　　金：河北省卫计委医学研究课题基金资助(编号:20190252)。

摘　　要：目的观察不同病程的2型糖尿病干眼患者与正常干眼患者睑板腺结构及泪膜脂质层厚度变化,探讨糖尿病患者干眼的发病特点,进一步指导临床治疗。方法经泪膜破裂时间(BUT)测定和眼表疾病指数(OSDI)量表确诊的糖尿病干眼患者130例(130眼,糖尿病组)及正常干眼患者46例(46眼,正常对照组),其中糖尿病组以病程为界再分为A组(病程≤10年)或B组(病程>10年),对比三组受检者经Lipiview;眼表面干涉仪测量的泪膜脂质层厚度(LLT)、睑板腺缺失率(MGP)、睑板腺开口数量(MGYLS)及睑板腺分泌物评分(MGYSS)。所有受检者进行Schirmer I试验(SIt)。结果糖尿病组干眼患者与正常对照组干眼患者相比,LLT、MGP、MGYLS、MGYSS、BUT及SIt差异均有统计学意义(均为P<0.05),其中糖尿病组中的B组干眼患者MGP、MGYLS、MGYSS相对于正常对照组及A组均明显下降,且差异均有统计学意义(均为P<0.05)。糖尿病组和正常对照组干眼患者OSDI量表评分比较,差异无统计学意义(P>0.05)。结论2型糖尿病干眼患者病程越长,MGP越高,睑板腺正常开口数量更少,MGYSS更低,这也是糖尿病患者干眼发病率更高的原因。Objective To observe the changes in the meibomian gland structure and tear film lipid layer thickness(LLT) between patients with type 2 diabetes combined with dry eye and patients with dry eye, and explore the clinical characteristics of dry eye in diabetic patients to guide clinical treatment.Methods A total of 130 patients with diabetes mellitus(DM) and dry eye diagnosed by break-up time(BUT) and ocular surface disease index(OSDI) were selected into the DM group, and 46 normal dry eye patients were selected into the normal control(NC) group. Patients in the DM group were subdivided into group A(course of the disease<10 years) and group B(course of the disease>10 years). All patients’ LLT, percentage of meibomian glands(MGP), meibomian glands yielding liquid secretion(MGYLS), and meibomian gland yielding secretion score(MGYSS) were evaluated and compared using the LipiView;Ocular Surface Interferometer. Schirmer’s I test(SIt) was performed on all patients.Results There were significant differences in LLT, MGP, MGYLS, MGYSS, BUT, and SIt between the DM group and the NC group(all P<0.05). The MGP, MGYLS, and MGYSS in group B were significantly lower than those in the NC group and group A(all P<0.05). The OSDI showed no significant difference between the DM group and the NC group(P>0.05). Conclusion For type 2 DM patients with dry eye, the longer the course of the disease is, the higher the MGP is, the smaller the MGYLS is, and the lower the MGYSS is. That’s why DM patients have a higher prevalence of dry eye.

关 键 词：2型糖尿病 泪膜脂质层厚度 睑板腺功能 干眼 

分 类 号：R777.3[医药卫生—眼科]