糖尿病短淚膜破裂時間型干眼患者的癥狀和體征分析

李玲　李越虹

【摘要】 目的：研討糖尿病短淚膜破裂時間型干眼患者的具體癥狀和體征。方法：從2018年3-11月筆者所在醫(yī)院選取60例糖尿病短淚膜破裂時間型干眼患者作為觀察組，另選取40例非糖尿病短淚膜破裂時間型干眼患者作為對照組，對比分析糖尿病短淚膜破裂時間型干眼患者的具體癥狀和體征。結(jié)果：兩組眨眼頻率及角膜熒光素鈉染色評分比較差異無統(tǒng)計學(xué)意義（P>0.05），觀察組SPEED評分高于對照組，差異有統(tǒng)計學(xué)意義（P<0.05）;觀察組平均脂質(zhì)層厚度薄于對照組，瞼板腺拍照評分高于對照組，差異均有統(tǒng)計學(xué)有意義（P<0.05）。結(jié)論：在干眼癥患者中，有糖尿病病史的患者瞼板腺缺失或短縮的程度更大，從而讓平均脂質(zhì)層厚度變得更薄，進一步導(dǎo)致淚膜破裂時間更短，在臨床上值得研究探討。

【關(guān)鍵詞】 短淚膜破裂時間 糖尿病 干眼 癥狀體征

doi：10.14033/j.cnki.cfmr.2020.16.054 文獻標識碼 B 文章編號 1674-6805（2020）16-0-03

Analysis of Symptoms and Signs of Diabetic Dry Eye Patients with Short Tear Film Rupture Time/LI Ling， LI Yuehong. //Chinese and Foreign Medical Research， 2020， 18（16）： -134

[Abstract] Objective： To study and analyze the specific symptoms and signs of diabetic dry eyes with short tear film rupture time. Method： From March to November 2018， 60 cases of diabetic short tear film rupture time dry eye patients were selected as the observation group， and 40 cases of non diabetic short tear film rupture time dry eye patients were selected as the control group. The specific symptoms and signs of diabetic short tear film rupture time dry eye patients were compared and analyzed. Result： There was no significant difference in blink frequency and corneal fluorescein sodium staining scores between the two groups （P>0.05）， the SPEED score in the observation group was higher than that in the control group， the difference was statistically significant （P<0.05）. The mean lipid layer thickness in the observation group was thinner than that in the control group， and meibomian gland photography score was higher than that in the control group， the differences were statistically significant （P<0.05）. Conclusion： In patients with xerophthalmia， the degree of loss or shortening of meibomian gland is greater in patients with a history of diabetes， which makes the average lipid layer thickness thinner and further leads to shorter tear film rupture time， which is worthy of clinical study.

[Key words] Short tear film rupture time Diabetes Dry eyes Symptoms and signs

First-authors address： Beijing Zhongguancun Hospital， Beijing 100190， China

干眼是一種非常常見的疾病，可因很多因素引起，其主要癥狀表現(xiàn)為眼睛干澀，是淚液量或質(zhì)的不正常狀態(tài)導(dǎo)致的淚液分泌障礙性的眼部疾病，根據(jù)國際方面最新干眼的定義，干眼概述為眼部表面的多因素疾病，所伴有的眼部癥狀常有眼部有氧感、畏光視物模糊等[1-3]。干眼主要的發(fā)病進程是由于具有不穩(wěn)定和高滲特征的淚液、眼部淺表炎癥性疾病和非正常的眼部神經(jīng)感覺一同參與表達的，通過醫(yī)院大數(shù)據(jù)顯示，逐年遞增的患者因異常流淚、畏光等眼部不適來院就診，在診療的過程中發(fā)現(xiàn)，有一半或以上的干眼患者均曾患有糖尿病或檢查過程中發(fā)現(xiàn)患有糖尿病，由此引起了重視[4-5]。根據(jù)世界衛(wèi)生組織數(shù)據(jù)調(diào)查顯示，中國普通工薪階層家庭有9.4%為糖尿病患者，值得注意的是眾所周知的糖尿病并發(fā)癥的眼部方面主要是白內(nèi)障及視網(wǎng)膜的病變，很少方向研究糖尿病對于眼部淺表狀況的影響。為了……