系统性红斑狼疮患者睑板腺形态和功能的异常及其对泪膜的影响  

Abnormalities of morphology and function of meibomian gland and their effects on tear film in patients with systemic lupus erythematosus

作　　者：康随芳 王迎雪[2] 张琪晨 王志仑[2] 尹哲[2] 肖娟[3] 陈国玲[1] KANG Suifang;WANG Yingxue;ZHANG Qichen;WANG Zhilun;YIN Zhe;XIAO Juan;CHEN Guoling(Department of Ophthalmology,The Second Hospital of Shandong University,Jinan 250033,Shandong,China;Department of Rheumatology,The Second Hospital of Shandong University,Jinan 250033,Shandong,China;Department of Hospital Infection Management,The Second Hospital of Shandong University,Jinan 250033,Shandong,China)

机构地区：[1]山东大学第二医院眼科,山东济南250033 [2]山东大学第二医院风湿免疫科,山东济南250033 [3]山东大学第二医院感染管理部,山东济南250033

出　　处：《山东大学学报（医学版）》2024年第6期65-70,共6页Journal of Shandong University:Health Sciences

摘　　要：目的观察系统性红斑狼疮(systemic lupus erythematosus,SLE)患者睑板腺形态和功能的异常及其对泪膜的影响。方法纳入SLE患者41例(82眼)作为SLE组、健康志愿者26例(52眼)作为对照组。采用Keratograph 5M眼表综合分析仪评估睑板腺缺失程度、LipiView干涉仪测量泪膜脂质层厚度(tear film lipid layer thickness,TFLLT)、双通道视觉质量分析系统(the double-pass Optical Quality Analysis System,OQAS II)测量泪膜动态客观散射指数(objective scatter index,OSI),采用裂隙灯显微镜观察睑缘、睑板腺分泌物、荧光素钠角膜染色(fluorescein cornea staining,FCS)及荧光素钠染色泪膜破裂时间(fluorescein breakup time,FBUT)。采用标准泪液检测滤纸条行泪液分泌试验Ⅰ(SchirmerⅠtest,SⅠt)。用Spearman秩相关分析评估睑板腺相关指标与泪膜功能相关指标间的相关性。结果与对照组相比,SLE组睑板腺缺失程度评分(meibomian gland dropout score,MGDS)、睑板腺分泌物评分(meibomian gland secretion score,MGSS)、睑缘评分(eyelid margin score,EMS)、泪膜动态OSI、FCS均较高,TFLLT、FBUT均较低,两组之间差异均有统计学意义(P均<0.05)。SLE组与对照组的SⅠt差异无统计学意义(P>0.05)。SLE组MGDS、MGSS、EMS均与FBUT呈负相关(r_(MGDS)=-0.335,r_(MGSS)=-0.424,r_(EMS)=-0.318,P<0.05),MGDS与泪膜动态OSI呈正相关(r=0.254,P<0.05)。结论系统性红斑狼疮可引起睑板腺形态和功能的异常,从而导致泪膜脂质层变薄、泪膜稳定性下降。Objective To observe the abnormalities of morphology and function of meibomian gland and their effects on tear film in systemic lupus erythematosus(SLE)patients.Methods Eighty-two eyes of 41 SLE patients were recruited as SLE group and 52 eyes of 26 healthy volunteers were recruited as control group.The grade of meibomian gland dropout was evaluated by Keratograph 5M ocular surface analyzer,the tear film lipid layer thickness(TFLLT)was measured by LipiView interferometer,the dynamic tear film objective scatter index(OSI)was measured by the double-pass Optical Quality Analysis System(OQAS II).The eyelid margin,meibomian gland secretion,fluorescein breakup time(FBUT)and fluorescein cornea staining(FCS)were observed under slit lamp microscope.SchirmerⅠtest(SⅠt)was conducted using standard Schirmer paper strip.The correlations between meibomian gland parameters and tear film function were assessed by Spearman rank correlation analysis.Results Compared with the control group,the meibomian gland dropout score(MGDS),meibomian gland secretion score(MGSS),eyelid margin score(EMS),dynamic tear film OSI and FCS were higher,while FBUT and TFLLT were lower in SLE group(all P<0.05).There was no significant difference in the SⅠt between SLE group and control group(P>0.05).MGDS,MGSS,and EMS were negatively correlated with FBUT(r_(MGDS)=-0.335,r_(MGSS)=-0.424,r_(EMS)=-0.318,P<0.05),while MGDS was positively correlated with dynamic tear film OSI(r=0.254,P<0.05).Conclusion Abnormalities in the morphology and function of meibomian glands can be caused by SLE,leading to decreased TFLLT and tear film stability.

关 键 词：系统性红斑狼疮 自身免疫性疾病 睑板腺 泪膜 眼表疾病 

分 类 号：R771.3[医药卫生—眼科]