2型糖尿病病程對干眼的影響

吳志航　李淑婷　吳靖怡　潘恂

[摘要] 目的 探討2型糖尿病病程對干眼的影響。 方法 收集蘇州大學附屬第三醫院2019年3—9月內分泌科住院患者中確診為2型糖尿病的患者共101例202眼，其中糖尿病病程≤5年的有51例102眼（B組），病程>5年的有50例100眼（C組），另外收集同期無糖尿病健康體檢者49例98眼（A組），對比測量各組患者的淚膜破裂時間（BUT）、淚液分泌試驗（SIt）、角膜熒光素染色（FL）評分，比較不同病程糖尿病患者之間干眼指標的差異。結果ABC 3組的 FL評分差異無統計學意義（P>0.05），A組BUT為（6.99±2.15）s，B組為（6.86±2.03）s，C組為（5.97±1.56）s，A、B兩組與C組相比差異有統計學意義（P（AvsC）=0.006，P（BvsC）=0.006）;A組SIt為（7.4±1.8）mm，B組為（7.0±4.0）mm，C組為（5.9±2.4）mm，A、B兩組與C組相比差異有統計學意義（P（AvsC）=0.009，P（BvsC）=0.032）。 結論 糖尿病干眼的發生與嚴重程度與糖尿病病程有關，當糖尿病病程>5年時，患者的干眼相關指標明顯變差。

[關鍵詞] 2型糖尿病;病程;干眼

[中圖分類號] R587.1? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1672-4062（2020）02（b）-0009-03

[Abstract] Objective To explore the effect of type 2 diabetes on dry eye. Methods A total of 101 patients of 202 eyes with type 2 diabetes were diagnosed among inpatients in the endocrinology department of the Third Affiliated Hospital of Soochow University from March 2019 to September 2019. Of these， 51 cases of 102 eyes with a course of diabetes ≤ 5 years （group B）， 50 patients with 100 eyes （group C） with a course of disease> 5 years， and 49 patients with 98 eyes （group A） with no diabetes during the same period were collected， and the tear film rupture time （BUT） and tear fluid of the patients in each group were compared and measured. The secretory test （SIt） and corneal fluorescein staining （FL） scores were used to compare the differences in dry eye indicators among patients with different durations of diabetes. Results There was no significant difference in FL scores among the three groups of ABC （P>0.05）. The BUT in group A was （6.99± 2.15） s， group B was （6.86±2.03） s， and group C was （5.97±1.56） s. Compared with group C， the differences between group A and B are significantly statistically significant. P（AvsC）=0.006， P（BvsC）=0.006; SIt in group A was （7.4±1.8） mm， and group B was （7.0±4.0） mm， group C was （5.9±2.4） mm， and the differences between groups A and B compared with group C were statistically significant（P（AvsC）=0.009， P（BvsC）=0.032. Conclusion The occurrence and severity of diabetic dry eye are related to the duration of diabetes. When the duration of diabetes is more than 5 years， the dry eye-related indicators of patients become significantly worse.

[Key words] Type 2 diabetes; Course of disease; Dry eye

干眼是淚液和眼表的一種多因素疾病，主要表現為眼部不適感、視力障礙、淚膜不穩定等癥狀[1]。干眼較為嚴重時會影響視力，影響正常的生活和工作。糖尿病則是目前最常見的慢性病之一，會引起各種慢性代謝性疾病如糖尿病視網膜病變、糖尿病腎病、糖尿病周圍神經病變等。越來越多的研究表明[2]，糖尿病與干眼之間存在緊密的聯系，尤其是在亞洲地區，糖尿病是導致干眼的主要危險因素。我國目前的干眼病人基數龐大，因此，探究糖尿病相關因素對干眼的影響對解決這一公共衛生問題有較為深遠的社會意義。多項研究指出，糖尿病患者干眼癥發生可能與血糖控制不佳有關，而糖尿病病程與干眼的相關性目前尚無明確定論，該研究通過比對不同病程糖尿病患者的眼表情況，旨在探尋糖尿病病程對患者眼表功能的影響。