干眼患者115例的临床特点分析  

Clinical characteristics of patients with dry eye syndrome

作　　者：张梅[1] 陈家祺[1] 刘祖国[1] 罗丽辉[1] 肖启国[1] 姚勇[1] 陈龙[1] 张志红[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《中华眼科杂志》2003年第1期5-9,共5页Chinese Journal of Ophthalmology

基　　金：卫生部重点临床专项基金资助项目 ( 2 0 0 1-172 );广东省科委重点科技项目 ( 2KM0 5 2 0 45 );中山医科大学"2 11工程"基金资助项目

摘　　要：目的　分析各种类型干眼患者的临床特点。方法　回顾性分析 115例 ( 2 2 9只眼 )干眼患者的临床资料 ,包括症状、病因、全身病、裂隙灯检查、泪膜破裂时间检查 (break uptime,BUT)、基础泪液分泌试验 (SchirmerⅠtest,SⅠt)、反射泪液分泌试验 (SchirmerⅡtest,SⅡt)、角结膜荧光素(fluorescent,Fl)染色、虎红 (rosebangle ,Rb)染色及睑板腺功能的检查。对Sj gren综合征 (Sj grensyndrome,SS)者行血清类风湿因子、自身抗体及涎腺分泌功能检查。结果　 115例中 ,水液缺乏性干眼(aqueousteardeficiency ,ATD)者 5 6例 ( 48 7% ) ,蒸发过强型干眼者 40例 ( 34 8% ) ,混合型干眼者 16例( 13 9% ) ,结膜松弛综合征者 4例 ( 3 5 % )。SS患者 13例 ( 11 3% )。在各型干眼患者中 ,女性多于男性 ,尤其是ATD患者 ,原发性SS ATD患者 10 0 %为女性 ,43例非SS水液缺乏性干眼 (non SSaqueousteardeficiency ,NSTD)者中女性 35例 ( 81 4% )。临床特点 :干涩症状者 6 3例 ( 84 0 % ) ,视疲劳者 5 4例( 72 0 % ) ,异物感者 48例 ( 6 4 0 % ) ,视力波动者 42例 ( 5 6 0 % ) ,睑板腺功能障碍 (meibomainglanddysfunction ,MGD)者 35例 ( 30 4% )。各类型干眼患者的BUT、Rb、Fl间均有明显的相关性 ,Rb与Fl间相关性高 (rObjective To learn the clinical characteristics of patients with dry eye syndrome. Methods The following items were recorded in 115 patients (229 eyes) with dry eye, including symptoms, causation, systematic diseases, slit-lamp examination, tear break-up time, basal and reflex Schirmer′s test, vital staining (fluorescent and rose bangle) and meibomian gland dysfunction examination. Rheumatoid factor and auto-antibody detection were performed in Sjgren′s syndrome suspected patients. Results Aqueous tear deficiency (ATD, 48.7%) ranked the most common type, followed by over-evaporation dry eye (34.8%), mixed type (13.9%) and conjunctivochalasis (3.5%). In all the causes of the dry eye, about 11.3% had Sjgren syndrome (SS). Females suffering from dry eye were more than males, especially SS. Dryness was the most common symptom (84.0%), especially in ATD patients, then followed by ocular fatigue (72.0%), foreign body sensation (64.0%) and impairment of vision (56.0%). The ocular irritation was more severe in meibomain gland dysfunction (MGD) patients than in ATD patients. Among the results of tear break-up time (BUT), rose bangle (Rb) staining and fluorescent (Fl) staining in all types of dry eye, significant relationship was found among them, especially between Rb and Fl score (r= 0.612,P=0.000). SS patients had much more severe abnormality in all the four signs than non-SS aqueous tear deficiency (NSTD) and MGD patients. However, in the comparisons of BUT, Rb and Fl between NSTD and MGD patients, there were no significant differences. Conclusion Symptoms combined with examinations of BUT, Schirmer′s test, Fl and Rb staining and meibomian gland function are the necessary means to diagnose most of the dry eye patients.

关 键 词：干眼 临床特点 干燥综合征 睑板腺功能障碍 

分 类 号：R777.2[医药卫生—眼科]