中国干眼诊断标准诊断干眼与亚洲干眼诊断标准的符合率  

Concordance between Chinese dry eye diagnostic criteria and Asian dry eye diagnostic criteria

作　　者：欧阳维杰 刘祖国 孙旭光[2] 邓应平[3] 李青松[4] 黄彩虹 林祥 朱莉 Ouyang Weijie;Liu Zuguo;Sun Xuguang;Deng Yingping;Li Qingsong;Huang Caihong;Lin Xiang;Zhu Li(Xiamen Eye Center of Xiamen University,The Affiliated Xiang'an Hospital of Xiamen University,Eye Institute of Xiamen University,Fujian Provincial Key Laboratory of Ophthalmology and Visual Science,Xiamen 361102,China;Department of Ophthalmology,Beijing Tongren Hospital,Capital Medical University,Beijing 100069,China;Department of Ophthalmology,West China Hospital of Sichuan University,Chengdu 610044,China;Department of Ophthalmology,Putuo District Center Hospital,Shanghai 200062,China)

机构地区：[1]厦门大学附属厦门眼科中心、厦门大学附属翔安医院、厦门大学眼科研究所、福建省眼科与视觉科学重点实验室,厦门361102 [2]首都医科大学附属北京同仁医院眼科,北京100069 [3]四川大学华西医院眼科,成都610044 [4]上海市普陀区中心医院眼科,上海200062

出　　处：《中华实验眼科杂志》2022年第11期1038-1045,共8页Chinese Journal Of Experimental Ophthalmology

基　　金：国家重点研发计划项目(2018YFA0107304);国家自然科学基金项目(81870627)。

摘　　要：目的对首诊的干眼患者临床表现和体征进行分析,探讨中国干眼诊断标准诊断干眼与亚洲干眼诊断标准的符合情况。方法采用横断面研究方法,于2016年12月至2018年5月在厦门大学附属厦门眼科中心、首都医科大学附属北京同仁医院、四川大学华西医院、上海市普陀区中心医院4个临床研究中心连续纳入首次就诊的干眼患者141例141眼。所有患者均自行完成中国干眼问卷,眼表疾病指数量表(OSDI)和干眼相关生活质量评分问卷(DEQS)调查以评估干眼相关症状,患者均接受泪膜破裂时间(BUT)、角结膜荧光素钠染色、睑板腺形态和功能检查、无麻醉泪液分泌试验(SchirmerⅠ试验)检查以评估干眼相关体征,评估受检眼干眼症状与体征之间的关联;根据有无角膜荧光素染色将受检眼分为角膜染色阳性组和角膜染色阴性组,采用各问卷评分方法评估两个组受检眼干眼症状情况。根据《干眼临床诊疗专家共识》标准将受检眼分为水液缺乏型干眼组、蒸发过强型干眼组、混合型干眼组和泪液动力学异常型干眼组,比较组间受检眼干眼相关体征的差别。结果受检眼中国干眼问卷总评分为12.00(7.00,16.00)分,OSDI问卷总评分为25.00(17.50,36.93)分,DEQS问卷总评分为32.02(15.77,52.34)分。最常见的症状是受检眼中有眼干燥感者130眼,占92.2%;有眼疲劳症状者109眼,占77.3%;有异物感者108眼,占76.6%。眼干、异物感、畏光评分与角膜染色评分均呈弱正相关(r=0.177、0.297、0.172,均P<0.05);受检眼眼痛不适、畏光、视力波动评分与泪液分泌量呈弱负相关(r=-0.178、-0.197、-0.174,均P<0.05)。43.3%(61眼)患者使用视频终端。蒸发过强型干眼75眼,占53.2%;混合型干眼43眼,占30.5%;水液缺乏型干眼18眼,占12.8%;泪液动力学异常型干眼3眼,占2.1%。结论首次就诊的干眼患者以轻中度干眼为主,症状与体征具有一定关联。蒸发过强型干眼�Objective To analyze the clinical manifestations and signs of the first diagnosed dry eye patients,and to explore the concordance between the Chinese dry eye diagnostic criteria and the Asian dry eye diagnostic criteria.Methods A cross-sectional multicenter study was conducted.One hundred and forty-one eyes of 141 patients who were diagnosed as dry eye for the first time were included in Xiamen Eye Center of Xiamen University,Beijing Tongren Hospital,West China Hospital of Sichuan University and Shanghai Putuo District Center Hospital from December 2016 to May 2018.All patients completed the Chinese Dry Eye Questionnaire,Ocular Surface Disease Index(OSDI)and Dry Eye-Related Quality-of-life Score Questionnaire(DEQS)to evaluate the symptoms of dry eye.Tear film breakup time(BUT),keratoconjunctival fluorescein staining,meibomian gland morphology and function examination,and SchirmerⅠtest were performed to evaluate dry eye signs and the association between dry eye symptoms and signs.The eyes were divided into corneal staining positive and negative group according to the presence or absence of corneal fluorescein staining,and the dry eye symptoms of the two groups were assessed by the three questionnaires.The eyes were divided into tear-deficient dry eye,evaporative dry eye,mixed dry eye and abnormal tear dynamics dry eye to compare the difference of dry eye signs among the groups.This study adhered to the Declaration of Helsinki.The study protocol complied with Chinese regulations and rules on clinical trial research and was approved by Ethics Committees of Xiamen Eye Center of Xiamen University(No.2017003),Beijing Tongren Hospital,Capital Medical University(No.TREC2016-29),West China Hospital of Sichuan University(No.2016310)and Shanghai Putuo District Center Hospital(No.PTEC-A-2016-18-1).Written informed consent was obtained from patients before entering the cohort.Results The total score of Chinese Dry Eye Questionnaire,OSDI questionnaire and DEQS questionnaire was 12.00(7.00,16.00),25.00(17.50,36.93)and 32.02(1

关 键 词：干眼 干眼症状/诊断 干眼体征/诊断 亚洲干眼协会 

分 类 号：R777.34[医药卫生—眼科]