神经退行性疾病患者泪膜稳定性和角膜敏感性改变的临床研究  

Changes in tear film stability and corneal sensitivity in patients w ith neurodegenerative diseases

作　　者：王凡 何钰嵩 吉玲 于晴 牟宁 王雨蒙 孙妍 陈荔 李明新 王贺 Fan Wang;Yusong He;ling Ji;Qing Yu;Ning Mu;Yumeng Wang;Yan Sun;Li Chen;Mingxin Li;He Wang(Department of Ophthalmology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China;the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院眼科,221000 [2]徐州医科大学附属医院,221000

出　　处：《中华眼科医学杂志(电子版)》2025年第1期13-20,共8页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：江苏省中医药科技发展计划项目(QN202330)。

摘　　要：目的探讨神经退行性疾病(ND)患者的角膜敏感性和泪膜稳定性。方法选取2023年1月至12月于徐州医科大学附属医院神经内科招募诊断为ND患者145例(145只眼),同期招募非ND患者182例(182只眼)。其中,男性150例(150只眼),女性177例(177只眼);年龄30~82岁,平均年龄(51.7±7.8)岁。按疾病类型,ND患者分为包括阿尔茨海默病(AD)、弗里德赖希共济失调(FA)、帕金森病(PD)、多发性硬化(MS)及亨廷顿舞蹈症(HD)组;对照组按ND组患者年龄和性别配对。使用Cochet-Bonnet触觉计测量角膜敏感性,LipiView眼表面干涉仪检测瞬目频率。泪液检测包括眼表疾病指数量表(OSDI)评分评分、泪河高度(TMH)、非接触式泪膜破裂时间(NIBUT)、角膜荧光素染色评分及泪膜脂质层厚度(LLT)。OSDI、TMH、NIBUT、角膜荧光素染色评分、LLT、瞬目频率及角膜敏感性符合正态分布,以±s描述,比较采用独立样本t检验;性别为二分类变量,以例数和百分比表示,采用卡方检验。结果ND患者145例(145只眼)中,AD、MS、PD、FA及HD者分别有36例(36只眼)、30例(30只眼)、50例(50只眼)、13例(13只眼)及16例(16只眼),分别占24.83%、20.69%、34.48%、8.97%及11.03%。非ND患者182例(182只眼)中,AD、MS、PD、FA及HD对照组分别有43例(43只眼)、33例(33只眼)、50例(50只眼)、28例(28只眼)及28例(28只眼),分别占23.63%、18.13%、27.47%、15.39%及15.39%。AD、FA、PD、MS及HD组患者OSDI评分、TMH、NIBUT、角膜荧光素染色评分、LLT、瞬目频率及角膜敏感性分别为(27.97±8.12)分、(27.30±6.89)分、(24.94±5.79)分、(26.31±6.78)分、(25.38±5.71)分、(0.16±0.02)mm、(0.22±0.02)mm、(0.17±0.01)mm、(0.23±0.02)mm、(0.17±0.02)mm、(5.25±1.27)s、(5.33±1.21)s、(5.84±1.42)s、(6.23±1.48)s、(6.19±1.42)s、(2.03±0.14)分、(1.77±0.77)分、(1.26±0.63)分、(1.31±0.48)分、(1.31±0.48)分、(68.50±11.57)μm、(70.60±10.96)μm、(69.90±9.25)μm、(71.31±6.13)μm、(71.38±7ObjectiveThe aim of this study is to investigate corneal sensitivity and tear film stability in patients with neurodegenerative diseases(ND).MethodsA total of 145 clinically diagnosed ND patients(145 eyes)and 182 age-and gender-matched non-ND controls(182 eyes)from the Department of Neurology,Affiliated Hospital of Xuzhou Medical University between January and December 2023.The cohort comprised 150 males and 177 females with an average age of(51.7±7.8)year-old(ranging from 30 to 82 year-old).According to the disease type,patients were divided into Alzheimer′s disease(AD),multiple sclerosis(MS),Parkinson′s disease(PD),Friedreich′s ataxia(FA),Huntington′s disease(HD),and control groups were established with matched demographics.Ocular assessments included corneal sensitivity measurement using Cochet-Bonnet esthesiometer.Blink frequency analysis via LipiView ocular surface interferometer tear film evaluation through ocular surface disease index(OSDI),tearmeniscus height(TMH),non-invasive tear film breakup time(NIBUT),corneal fluorescein staining(CFS),lipid layer thickness(LLT).OSDI,TMH,NIBUT,corneal fluorescein staining score,LLT,blink frequency and corneal sensitivity were all in line with normal distribution,and were described by(±s),and the comparison between groups was performed with t test.Gender was a dichotomous variable,expressed in cases and percentages,using chi-square test.ResultsND subgroups included AD patients with 36 cases(36 eyes),MS patientswith 30 cases(30 eyes),PD patients with 50 cases(50 eyes),FA patients with(13 cases)13 eyes and HD patients with 16 cases(16 eyes);AD patients control with 43 cases(43 eyes),MSpatients controlwith 33 cases(33 eyes),PD patients controlwith 50 cases(50 eyes),FA patients controlwith 28 cases(28 eyes),and HD patients control with 28 cases(28 eyes).OSDI scores TMH,NIBUT,corneal fluorescein staining score,LLT,the blink frequency and corneal sensitivity of patients in AD,FA,PD,MSand HD groupswere(27.97±8.12)score,(27.30±6.89)score,(24.94±5.79)score,(26.31±

关 键 词：神经退行性疾病 角膜敏感性 干眼 泪膜 

分 类 号：R741[医药卫生—神经病学与精神病学]