2型糖尿病患者眼表变化及影响因素分析  

Analysis of Ocular Surface Changes and Influencing Factors in Patients with Type 2 Diabetes

作　　者：卢静雯 管一鸣 桂思语 曹凡 蒋正轩[1] Lu Jingwen;Guan Yiming;Gui Siyu;Cao Fan;Jiang Zhengxuan(The Second Hospital of Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学第二附属医院眼科,合肥230000

出　　处：《临床眼科杂志》2024年第4期314-319,共6页Journal of Clinical Ophthalmology

基　　金：国家自然科学基金(82371080,82171043,82070986)。

摘　　要：目的探讨2型糖尿病患者眼表功能的变化及影响因素分析。方法回顾性病例对照研究。收集2022年9月至2023年9月在我院确诊的2型糖尿病患者61例(122只眼)为病例组,年龄(61.44±7.14)岁;同年龄段健康人群为对照组61例(122只眼),年龄(64.52±6.93)岁。所有受试者均采用Keratograph 5M眼表综合分析仪检测平均泪膜破裂时间(ATBUT)、泪河高度(TMH)及上下睑板腺缺失评分,泪液分泌检测滤纸条行基础泪液分泌检查(sIt),荧光素钠眼科检测试纸行角膜染色检查(FL),眼表疾病指数量表(OSDI)主观评分。2型糖尿病患者记录糖尿病病程,并行糖化血红蛋白(HbA1c)检查。根据患者年龄及HbA1c进行分组,分析不同分组条件下以上指标有无差异。结果病例组与对照组的ATBUT、TMH、上下睑板腺缺失评分、sIt、FL、OSDI评分组间比较差异有统计学意义(P<0.05);在2型糖尿病患者中,HbA1c≥7.5%患者的ATBUT、sIt、TMH、FL、上下睑板腺缺失评分与HbA1c<7.5%的患者之间存在差异,差异均有统计学意义(P<0.05);以ATBUT为因变量进行回归分析发现HbA1c(P<0.001)、睑板腺缺失评分(P=0.014)对ATBUT具有影响,HbA1c值每增加1%,ATBUT减小1.635 s,而睑板腺缺失评分每增加1分,ATBUT减少0.747 s。结论与同年龄段健康人群相比,2型糖尿病患者易出现ATBUT缩短、泪液分泌量下降、泪河高度降低、睑板腺缺失增加、角膜荧光素染色评分增高,且血糖控制水平与泪膜破裂时间密切相关。Objective To explore the changes and influencing factors of ocular surface function in patients with type 2 diabetes.Methods Retrospective case-control study,A total of 61 patients(122eyes)with type 2 diabetes diagnosed in our hospital from 2022~09 to 2023~09 were collected as observation group,aged(61.44±7.14)years old.The control group consisted of 61 healthy patients(122eyes)aged(64.52±6.93)years old.All subjects were tested for average tear break-up time(ATBUT),tear meniscus height(TMH),and meibomian gland absence score using Keratograph 5M ocular surface comprehensive analyzer.Schirmer 1 test(SIT)was performed using tear secretion filter strips,corneal fluorescent stain test(FL)was performed using fluorescein sodium ophthalmic test strips,and subjective scores were obtained using the Ocular Surface Disease Index(OSDI).Record the duration of diabetes and perform glycated hemoglobin(HbA1c)testsin type 2 diabetic patients.Group patients according to their age and HbA1c,and analyze whether there are differences in the above indicators under different grouping conditions.Results The overall comparison between the case group and the control group showed statistically significant differences in ATBUT,TMH,meibomian gland absence score,SIT,FL,and OSDI scores(P<0.05);There were significant differences in ATBUT,SIT,TMH,FL,meibomian gland absence score between type 2 diabetes patients with HbA1c≥7.5%and type 2 diabetes patients with HbA1c<7.5%(P<0.05);Regression analysis using tear break-up time as the dependent variable revealed that glycosylated hemoglobin(P<0.001)and meibomian gland absence score(P=0.014)had an impact on tear break-up time.For every 1%increase in glycosylated hemoglobin value,tear break-up time decreased by 1.635 seconds,while meibomian gland analysis showed a decrease of 0.747 seconds for every 1 unit increase.Conclusions Compared with healthy people of the same age group,patients with type 2 diabetes are more likely to have shorter tear break-up time,lower tear secretion,lower tear meniscus hei

关 键 词：糖尿病 眼表综合分析仪 糖化血红蛋白 泪液分泌试验 角膜染色 眼表疾病指数 

分 类 号：R587.2[医药卫生—内分泌] R77[医药卫生—内科学]