糖尿病與非糖尿病患者干眼癥的臨床研究

任秉儀，鄭永征，林 穎，林 晨

?

·臨床報告·

糖尿病與非糖尿病患者干眼癥的臨床研究

任秉儀，鄭永征，林 穎，林 晨

Foundation item:Research Topics in Traditional Chinese Medicine of Fujian (No.wzhw201305)

Department of Ophthalmology, the Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou 350004, Fujian Province, China

?METHODS: Ninety patients with dry eye were collected from Jun.2014 to Feb.2016 in our hospital. A total of 45 cases of patients (90 eyes) with dry eye in diabetics and 45 cases of patients (90 eyes) with dry eye in non-diabetics were included. Patients in the two groups were provided with questionnaire survey of ocular surface disease index scale Chinese Version (COSDI). And tear break-up time (BUT), Schirmer Ⅰ test (Schirmer Ⅰ), corneal fluorescein staining (FL) were measured.

?RESULTS:The OSDI index of dry eye in the diabetic group (46.88±18.51) was higher than that in the non-diabetic group (39.76±13.62). The difference was statistically significant (P<0.05). The corneal fluorescein staining score (1.57±1.33) in the diabetic group was higher than that in the non-diabetic group (1.19±0.82). The difference was statistically significant (P<0.05). The value of Schirmer Ⅰ test in the diabetic group (4.30±1.80) was lower than that in the non-diabetic group (4.80±1.52). The difference was statistically significant (P<0.05). The different value of BUT between two groups was not statistically significant (P>0.05).

?CONCLUSION: Based on symptoms, tear secretion and corneal epithelial defects, the influence is more serious inthe diabetic group than that in the non-diabetic group. Eye screening in patients with diabetes mellitus should include dry eye related clinical indexes of examination. So the patients with dry eye in diabetics would be provided timely and effective suggestion and treatment. The symptoms of dry eye and the quality of life would be improved.

目的：通過對糖尿病與非糖尿病患者干眼癥的癥狀及各項臨床指標的綜合分析，初步探討糖尿病干眼癥的臨床特點。

方法：選取干眼癥患者90例180眼，其中非糖尿病患者45例90眼，經內科確診為2型糖尿病的干眼癥患者45例90眼，對兩組患者分別進行眼表疾病指數量表中文版(COSDI)問卷調查、淚膜破裂時間(BUT)、淚液分泌試驗(Schirmer Ⅰ test)、角膜熒光素染色(FL)指標的測定，對兩組結果進行統計學分析。

結果：兩組干眼癥指標比較，糖尿病組干眼癥OSDI指數(46.88±18.51)高于非糖尿病組(39.76±13.62)，差別有統計學意義(P<0.05)；糖尿病組角膜熒光素染色評分(1.57±1.33分)高于非糖尿病組(1.19±0.82分)，差別有統計學意義(P<0.05)；糖尿病組干眼癥Schirmer Ⅰ試驗(4.30±1.80mm/5min)低于非糖尿病組(4.80±1.52mm/5min)，差別有統計學意義(P<0.05)；而在淚膜破裂時間中，兩組比較差別無統計學意義(P>0.05)。

結論：糖尿病組干眼癥在癥狀、淚液的基礎分泌及角膜上皮缺損方面均較非糖尿病組嚴重。對糖尿病患者的眼部篩查應包括干眼相關臨床指標的檢查，以便對糖尿病干眼患者提供及時有效的建議和治療，改善其干眼癥狀，以提高其生活質量。

干眼癥；2型糖尿??；臨床研究

引用：任秉儀，鄭永征，林穎，等.糖尿病與非糖尿病患者干眼癥的臨床研究.國際眼科雜志2016;16(12):2345-2347

0引言

糖尿病是一種以高血糖為特點的慢性代謝性疾病，已成為影響全球居民身心健康的主要疾病之一，且其發病在全球各個地區呈逐漸加重的流行趨勢[1]。隨著2型糖尿病發病率的增高，其在眼部的并發癥也受到越來越多的重視，如糖尿病性白內障、糖尿病性視網膜病變、葡萄膜炎、視神經病變等，而近年來糖尿病引起的眼表并發癥尤其是干眼癥也受到越來越多的重視?！?br>