长期点用抗青光眼药物对合并2型糖尿病的青光眼患者眼表结构的影响  

Influence of long-term topical anti-glaucoma medication on ocular surface structure and function of glaucoma patients with diabetes

作　　者：乔淑琴 王雪琼 关静 Qiao Shuqin;Wang Xueqiong;Guan jing(Department of the Ophthalmology,the First People’s Hospital of Lanzhou City,Lanzhou 730050,China)

机构地区：[1]兰州市第一人民医院眼科,730050

出　　处：《临床眼科杂志》2022年第4期330-333,共4页Journal of Clinical Ophthalmology

基　　金：甘肃省自然科学基金项目(20JR5RA617)。

摘　　要：目的观察合并2型糖尿病的青光眼患者长期局部点用抗青光眼药物后,泪膜及睑板腺功能改变情况。方法回顾性病例对照研究。2018年6月至2020年12月我科诊治的长期点用抗青光眼药物53例(66只眼)青光眼患者,根据是否合并糖尿病分为两组。糖尿病组23例(29只眼),对照组30例(37只眼),糖尿病组患者根据点药种类分为单药组和多药组。方法所有患者进行Keratograph眼表综合分析仪及角膜荧光素钠染色检查。统计各项指标数据,分析差异性。主要指标首次非侵入性泪膜破裂时间(NI-TBUT)、平均非侵入性泪膜破裂时间(NI-TBUTavg)、泪河高度(TMH)、睑板腺缺失评分、角膜荧光素染色(FL)评分。结果总体分析发现糖尿病组NI-TBUTf、NI-TBUTavg、TMH均低于对照组,睑板腺缺失问题评分、FL评分均高于对照组,差异有统计学意义(P均<0.05)。单药组与多药组比较,NI-TBUTf、NI-TBUTavg、FL染色比较差异有统计学意义(均P<0.05),TMH、睑板腺缺失情况比较差异无统计学意义(均P>0.05)。结论合并2型糖尿病的青光眼患者,长期点用抗青光眼药物,比单纯青光眼患者易造成眼表结构及功能损害,且用药种类越多,越易发生。Objective To observe the changes of ocular surface structure and function after long-term topical application of anti-glaucoma medication in patients with glaucoma and diabetes.Methods A retrospective comparative case series.66 eyes of 53 patients with glaucoma who treated with long-term topical anti-glaucoma medication in our department from June 2018 to December 2020 were collected.They were divided into two groups on the basis of whether or not they suffered from diabetes,with 23 patients(29 eyes)for the diabetic group,and 30 patients(66 eyes)for the control group.According to the types of drugs,diabetic group was divided into the single-drug group and the multi-drug group.All patients were examined by Keratograph ocular surface comprehensive analyzer and fluorescein staining of cornea(FL).Statistics of various index data were made to analyze the differences.The first non-invasive tear film break-up time(NI-TBUTf),the average non-invasive tear film break-up time(NI-TBUTavg),the tear meniscus height(TMH),and the meibomian glands loss score and FL score.Results The overall analysis showed that NI-TBUTf,NI-TBUTavg and TMH in diabetic group were lower than those in control group.The score of meibomian gland loss and FL score were higher than those in control group,the difference was statistically significant(P<0.05).There was significant difference in NI-TBUTf,NI-TBUTavg and FL staining between single-drug group and multi-drug group(P<0.05),but there was no significant difference in TMH and meibomian gland loss(P>0.05).Conclusions Long-term topical anti-glaucoma medication in patients with glaucoma and diabetes are more likely to cause damage to ocular surface structure and function than in patients with glaucoma alone,and the more kinds of drugs,the greater the possibility of ocular surface structure and function damage.

关 键 词：抗青光眼药物 2型糖尿病 眼表综合分析仪 眼表 

分 类 号：R587.1[医药卫生—内分泌] R775[医药卫生—内科学]