2型糖尿病患者的泪膜功能

Tear Film Function of Patients with Type 2 Diabetes

目的评价2型糖尿病患者泪膜功能并探讨其影响因素。方法对111例2型糖尿病患者和100例健康对照者进行泪膜功能评价。2型糖尿病患者分别按年龄、糖尿病病程、血糖控制情况、眼底病变进行分组。分别进行眼干症状询问、泪膜破裂时间(BUT)测定、角膜荧光素染色、基础泪液分泌试验(SchirmerI试验,SIt)和泪膜脂质层形态观察。根据上述检查结果进行干眼评分。结果2型糖尿病组的干眼评分(3.28±1.56)高于对照组(2.31±1.50,P<0.01);BUT(6.50±4.84)s低于对照组(12.26±7.16)s(P<0.01);SIt(10.61±6.86)mm与对照组(10.92±7.05)mm差异无显著性(P>0.05)。2型糖尿病组的干眼症患病率为19.8%,高于对照组8.0%(P<0.05)。对2型糖尿病患者按照眼底分为3组无糖尿病性视网膜病变组、背景性糖尿病性视网膜病变组、增殖性糖尿病性视网膜病变组,3组的干眼评分分别为2.95±1.50、3.38±1.48和4.11±1.60(P<0.01);SIt分别为(10.95±6.89)mm、(11.71±7.30)mm和(7.63±5.20)mm(P>0.05);BUT分别为(7.53±5.23)s、(5.88±4.10)s和(4.47±4.17)s(P<0.05);对有眼底病变者分为已行激光治疗组和未行激光治疗组,两组的干眼评分分别为4.71±1.14和3.26±1.15(P<0.01);BUT分别为(2.93±2.06)s和(6.26±4.36)s(P<0.01);SIt分别为(7.21±6.

Objective To study the tear film function of patients with type 2 diabetes and to investigate the risk factors of dry eye in these patients. Methods Totally 111 patients with type 2 diabetes and 100 age-and sex-matched control subjects were studied. Tear film function was evaluated by dry eye syndrome tear breaking up timeBUT corneal fluorescein staining Schirmer I testSIt and tear film lipid layer observation with tear scope. Dye eye score was calculated with the results of these tests. ResultsWhen compared with the controls patients with type 2 diabetes showed higher dry eye score(diabetics 3.28 ± 1.56,control 2.31 ± 1.50,P < 0.01)and faster BUTdiabetics6.50 ± 4.84s,control12.26 ± 7.16s P < 0.01 but similar SItdiabetics10.61 ± 6.86s,control10.92 ± 7.05s P > 0.05. More diabetic patients were diagnosed as dry eyediabetics 19.8%,control 8.0% P < 0.05. According to their retinopathy the diabetic patients were divided into three groups without diabetic retinopathyDR with background DR and with proliferative DR. For these three groups the dry eye scores were 2.95 ± 1.50 3.38 ± 1.48 and 4.11±1.60 respectivelyP < 0.01 the SIt were10.95 ± 6.89mm11.71±7.30mm and7.63 ± 5.20mm respectivelyP > 0.05 the BUT were7.53 ± 5.23s5.88 ± 4.10s and4.47 ± 4.17sP < 0.05. Patients with DR were then devided into two groups with photocoagulation and without photocoagulation. For these two groups the dry eye scores were 4.71 ± 1.14 and 3.26 ± 1.15 respectivelyP < 0.01 the BUT were2.93 ± 2.06s and6.26 ± 4.36s respectivelyP < 0.01 the SIt were7.21 ± 6.51mm and11.33 ± 6.73mm respectivelyP < 0.05;the rates of corneal fluorescein staining were 50.0% and 17.9% respectivelyP < 0.05. Dry eye score had a good correlation with diabetic retino-pathy and photocoagulationP < 0.01 but was poorly correlaed with age gender insulin duration of diabetes mellitus and metabolic control(P > 0.05). Conclusions Patients with type 2 diabetes tend to develop tear film dysfunction. The disorders of tear film quantity and quality seem relevant to the stage of diabetic retinopathy and photocoagulation.