2型糖尿病患者干眼症发生的影响因素分析  

Analysis of related factors of dry eye in patients with type 2 diabetes mellitus

作　　者：牛佳琳 李焕丽[1] 张茵 李科军[1] 王建民 NIU Jialin;LI Huanli;ZHANG Yin;LI Kejun;WANG Jianmin(Hebei General Hospital,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北省人民医院,河北石家庄050000

出　　处：《现代中西医结合杂志》2024年第19期2660-2664,2738,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省卫健委医学科学研究课题(20230403)

摘　　要：目的观察不同糖尿病病程、糖化血红蛋白(HbA1c)水平及中医证型2型糖尿病患者干眼症相关指标的差异,探讨糖尿病患者发生干眼症的影响因素。方法选取2019年1月—2021年1月在河北省人民医院就诊的2型糖尿病患者130例,按照糖尿病病程分为病程<10年组(62例)和病程≥10年组(68例),根据入组时HbA1c水平将患者分为HbA1c<7%组(44例)和HbA1c≥7%组(86例),根据中医证型将患者分为阴虚内热组(36例)、气阴两虚组(68例)、阴阳两虚组(26例);另选取同期体检健康者46例作为对照组。比较各组间性别、年龄及干眼相关指标[快速干眼评分问卷(SPEED)评分、泪膜脂质层厚度(LLT)、不完全瞬目比(PB)、睑板腺缺失率(MGP)、泪膜破裂时间(BUT)、泪液分泌功能(SIt)、睑板腺开口数量评分(MGYLS)及睑板腺分泌物评分(MGYSS)]。结果各组间性别、年龄比较差异均无统计学意义(P均>0.05)。不同病程和不同HbA1c分组糖尿病患者MGP均明显高于对照组(P均<0.05),MGYLS评分和MGYSS评分均明显低于对照组(P均<0.05);且病程≥10年组患者SPEED评分明显高于对照组(P<0.05),病程≥10年组和HbA1c≥7%组患者BUT均明显低于对照组(P均<0.05)。不同病程分组患者的LLT、SIt、PB比较差异均无统计学意义(P均>0.05);病程≥10年组患者的SPEED评分和MGP均明显高于病程<10年组(P均<0.05),BUT和MGYSS评分均明显低于病程<10年组(P均<0.05)。不同HbA1c分组患者的PB比较差异均无统计学意义(P均>0.05);HbA1c≥7%组患者的BUT、SIt、MGYSS评分均明显低于HbA1c<7%组(P均<0.05)。不同中医证型分组患者SPEED评分、SIt、PB比较差异均无统计学意义(P均>0.05);与阴虚内热组比较,气阴两虚组患者BUT明显降低而MGP明显升高(P均<0.05);阴阳两虚组患者LLT明显降低而MGP明显升高(P均<0.05);与气阴两虚组比较,阴阳两虚组患者MGYLS评分和MGYSS评分均明显升高(P均<0.05)。结论2型糖尿病患者睑板腺�Objective It is to observe the differences in related factors of dry eye in patients with type 2 diabetes mellitus(T2DM)with different disease course HbA1c and TCM syndrome,and to explore the influence factors of dry eye in T2DM.Methods A total of 130 T2DM patients treated in Hebei General Hospital from January 2019 to January 2021 were selected and divided into<10 year group(n=62)and≥10 year group(n=68)according to their courses of T2DM,and divided into Yin deficiency internal heat group(n=36),Qi-yin deficiency group(n=68),Yin-Yang deficiency group(n=26)according to their TCM syndromes,and 46 non-diabetic patients were set as control group.The gender,age and dry eye related indexes[SPEED score,lipid layer thickness(LLT),partial blink(PB),meibomian gland percentage(MGP),break-up time(BUT),tear secretion function(SIt),MGYLS score,MGYSS score]were compared among the groups.Results There was no significant difference in gender and age among the groups(all P>0.05).The MGP of diabetic patients with different disease duration and HbA1c were significantly higher,while the MGYLS scores and MGYSS scores were significantly lower than those of the control group(all P<0.05),and the SPEED scores of patients whose disease coures≥10 years were significantly higher than the control group(P<0.05),and BUT of patients whose disease coures≥10 years and HbA1c≥7%were significantly lower than the control group(all P<0.05).The LLT,SIt,PB and MGYLS scores of patients in different disease duration subgroups were not significant(all P>0.05);the SPEED scores and MGP of patients in the≥10 year group were significantly higher while BUT and MGYSS scores were significantly lower than those in the<10 year group(all P<0.05).The PB of patients in different HbA1c subgroups were not significant(all P>0.05);the BUT,SIt and MGYSS scores of patients with HbA1c≥7%were significantly lower than those of patients with HbA1c<7%(all P<0.05).The SPEED scores,SIt,and PB in patients of different TCM syndrome subgroups were not significant(all P>0.05

关 键 词：2型糖尿病 干眼症 泪膜 睑板腺功能 

分 类 号：R587.2[医药卫生—内分泌]