蠕形螨睑缘炎患者眼表改变及功能的变化研究  

Changes of ocular surface and function in patients with Demodex blepharitis

作　　者：田笑雨 崔兵杰 梁沛 冯俊丽 柴雪 马一铭 TIAN Xiao-yu;CUI Bing-jie;LIANG Pei(Department of Ophthalmology,Cangzhou Central Hospital,Cangzhou Hebei 061000,China)

机构地区：[1]沧州市中心医院眼科,河北沧州061000 [2]沧州眼科医院眼科,河北沧州061000

出　　处：《临床和实验医学杂志》2023年第24期2686-2689,共4页Journal of Clinical and Experimental Medicine

基　　金：沧州市科技计划项目(编号:213106093);河北省医学科学研究课题计划项目(编号:20220402)。

摘　　要：目的研究蠕形螨睑缘炎患者的眼表改变及功能的变化。方法前瞻性选取2021年12月至2023年3月沧州市中心医院收治的70例(140只眼)蠕形螨睑缘炎患者,将其设为研究组,同时选取同一时期入院进行眼科检查的70名(140只眼)健康人群,将其设为对照组。两组研究对象均接受眼表疾病指标问卷(OSDI)调查、蠕形螨镜检,记录其OSDI得分和蠕形螨感染数量;同时接受泪液分泌试验(SIT)、泪膜破裂时间测定(BUT)、角膜荧光素钠染色(FL)检查,通过PAS加苏木素-伊红染色与结膜印迹细胞学对结膜上皮鳞状化生程度予以联合分析,比较研究组与对照组OSDI评分、SIT、BUT、鳞状化生级别。根据不同蠕形螨感染程度将研究组患者分为轻度感染组23例(46只眼),中度感染组28例(56只眼),重度感染组19例(38只眼)。同时比较不同蠕形螨感染程度患者OSDI评分、圆柱状鳞屑分级、SIT、BUT、鳞状化生级别。结果研究组患者的OSDI得分为(45.58±7.96)分,明显高于对照组[(8.47±3.39)分],SIT平均值和BUT平均值为(8.05±2.34)mm、(6.61±2.29)s,均明显低于对照组[(16.11±3.13)mm、(12.25±2.11)s],差异均有统计学意义(P<0.05)。轻度感染组、中度感染组、重度感染组患者之间OSDI评分、SIT平均值及BUT平均值比较,差异均有统计学意义(P<0.05),OSDI评分随感染程度加重而升高,SIT平均值及BUT平均值随感染程度加重而降低。轻度感染组、中度感染组、重度感染组患者之间圆柱状鳞屑分级比较,差异有统计学意义(P<0.05)。研究组的鳞状化生级别明显高于对照组,差异有统计学意义(P<0.05);轻度感染组、中度感染组、重度感染组患者之间鳞状化生级别比较,差异有统计学意义(P<0.05)。结论蠕形螨睑缘炎不仅可引起患者泪膜不稳定,还可致使泪液分泌量下降,并诱发炎症,造成结膜细胞学出现变化,进一步升高结膜上皮鳞状化生级别,且症状随感染程度加�Objective To study the changes of ocular surface and function in patients with demodex blepharitis.Methods Seventy patients(140 eyes)with demodex blepharitis admitted to Cangzhou Central Hospital from December 2021 to March 2023 were selected as the study group,while 70 healthy people(140 eyes)admitted for eye examination during the same period were selected as the control group.The two groups were investigated by the Ocular Surface Disease Index questionnaire(OSDI)and demodex microscopic examination.OSDI scores and the number of demodex infections were recorded in detail.At the same time,both groups were examined by tear secretion test(SIT),tear film rupture time determination(BUT)and corneal fluorescein sodium staining(FL).The degree of squamosis of conjunctival epithelium was analyzed by PAS plus hematoxylin-eosin staining and conjunctival blotting cytology.OSDI score,SIT,BUT,squamosis grade were compared between the study group and the control group.According to different levels of demodex infection,the study group patients were divided into the mild infection group of 23 cases(46 eyes),the moderate infection group of 28 cases(56 eyes),and the severe infection group of 19 cases(38 eyes).At the same time,OSDI score,cylindrical scale grading,SIT,BUT and scale metaplasia levels were compared in patients with different degrees of demodex infection.Results The OSDI score of the study group was(45.58±7.96)points,which was significantly higher than that of the control group[(8.47±3.39)points],the average SIT and BUT values were(8.05±2.34)mm,(6.61±2.29)s,which were significantly lower than those of the control group[(16.11±3.13)mm,(12.25±2.11)s],and the differences were statistically significant(P<0.05).There were statistically significant differences in OSDI scores,SIT mean values,and BUT mean values among patients in the mild infection group,moderate infection group and severe infection group(P<0.05),OSDI scores increased with the severity of infection,while SIT mean values and BUT mean values decreased with

关 键 词：蠕形螨睑缘炎 眼表改变 眼表功能 鳞状化生 结膜上皮 

分 类 号：R777.1[医药卫生—眼科]