血糖水平对2型糖尿病干眼患者眼表的影响  

Effects of blood glucose levels on the ocular surface in patients with dry eye complicated by type 2 diabetes mellitus

作　　者：李科军[1] 牛佳琳 樊芳[1] 贾志旸[1] LI Kejun;NIU Jialin;FAN Fang(Hebei Provincial People’s Hospital,Hebei,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院眼科,石家庄市050051

出　　处：《河北医药》2022年第18期2776-2779,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题(编号:20190252)。

摘　　要：目的观察不同血糖水平的2型糖尿病干眼患者的睑板腺及泪膜脂质层厚度变化,并与正常干眼患者对比分析,探讨糖尿病干眼的发病特点,进一步指导临床治疗。方法经过泪膜破裂时间(tear break up time,TBUT)测定和眼表疾病问卷(OSDI)评分后确诊为干眼的糖尿病患者130例及正常干眼患者46例,其中糖尿病组中根据糖化血红蛋白水平将糖尿病患者分为1组(<7%,44例),2组(≥7%,86例)。对比分析3组受试者经Lipiview眼表面干涉仪测量出的泪膜脂质层厚度(lipid layer thickness,LLT)、睑板腺照相观察缺失率(percentage of partial glands,MGP),并观察睑板腺开口数量(meibomian gland yielding liquid secretion,MGYLS)以及睑板腺分泌物评分(meibomian gland yielding secretion score,MGYSS),同时进行SchirmerⅠ(SⅠt)试验。结果糖尿病干眼患者中血糖偏低的1组患者与正常干眼患者比较,LLT、BUT差异无统计学意义(P>0.05),而MGP、MGYLS、MGYSS及SIt结果差异均有统计学意义(P<0.05);血糖高的2组患者LLT、BUT、SIt、MGP、MGYLS、MGYSS相对于正常对照组明显下降,且差异有统计学意义(P<0.05);2组干眼患者LLT、MGP、MGYLS差异有统计学意义(P<0.05)。3组干眼患者在眼表疾病问卷评分中无明显差异。结论2型糖尿病干眼患者中,血糖水平越高,LLT变薄,MGP越高,MGYLS更少,MGYSS评分更低,这也是糖尿病患者中干眼症发病更多的原因。Objective To investigate the changes of the meibomian gland and lipid layer thickness in patients with dry eye complicated by type 2 diabetes mellitus(DM),and to explore the disease characteristics in order to guide clinical treatment further.Methods A total of 130 patients with dry eye complicated by type 2 diabetes mellitus(observation group)and 46 patients with dry eye(control group)were enrolled in the study.Accoring to the levels of glycosylated hemoglobin,the patients in observation group were redivided into group 1(<7%,n=44)and group 2(≥7%,n=86).The lipid layer thickness(LLT),and percentage of partial glands(MGP),and meibomian gland yielding liquid secretion(MGYLS)as well as meibomian gland yielding secretion score(MGYSS)were observed and compared among the three groups.Moreover Schirmer1(SⅠt)test was performed.Results There were no significant differences in age,sex and OSDI among the three groups(P>0.05).There were no significant differences in the levels of LLT and BUT between group 1 and control group(P>0.05),however,there were significant differences in the levels of MGP,MGYLS,MGYSS as well as Sit results between the btwo groups(P<0.05).Moreover the levels of LLT,BUT,SⅠt,MGP,MGYLS,MGYSS in group 2 were significantly lower than those in control group(P<0.05),moreover,there were significant differences in the levels of LLT,MGP,MGYLS between the two groups(P<0.05).There were no significantly differences in the questionnaire scores of eye surface diseases among the three groups(P>0.05).Conclusion In the patients with dry eye complicated by type 2 diabetes mellitus,the higher levels of blood glucose,the thinner the LLT,the higher levels of MGP,the less the MGYLS,and the lower scores of MGYSS,which may be the reason of the higher incidence of dry eye in patients with type 2 diabetes mellitus.

关 键 词：2型糖尿病 糖化血红蛋白 泪膜脂质层厚度 干眼 

分 类 号：R587.1[医药卫生—内分泌]