慢性睑缘炎与蒸发过强性干眼症的临床观察

Clinical investigation of chronic blepharitis and evaporative loss dry eye

目的探讨慢性睑缘炎与蒸发过强性干眼的关系。方法选择2002年11月至2003年4月北京同仁眼科中心门诊诊断为慢性睑缘炎患者41例(82只眼),其中男性22例、女性19例,观察其外眼情况,进行泪液分泌试验(SchirmerⅠtest,ST)、泪膜破裂时间(BUT)检测、泪液镜分析以及睑板腺分泌物的细菌学和药敏试验。选择同期门诊青光眼、白内障、准分子激光原位角膜磨镶术术前检查的患者30例(60只眼)设为对照组,其中男性16例、女性14例,对其睑板腺分泌物进行细菌培养和药敏试验,并且对比两组细菌种类和药敏情况。结果41例(82只眼)慢性睑缘炎患者中,30只眼(36.6%)ST<10mm,56只眼(68.3%)BUT<10s,46只眼(56.1%)泪液镜分级3级以上。两组睑板腺分泌物中培养出表皮葡萄球菌、金黄色葡萄球菌及棒状杆菌。两组细菌阳性率和金黄色葡萄球菌阳性率比较,差异有统计学意义(P<0.05)。两组表皮葡萄球菌和棒状杆菌药物敏感性比较,差异有统计学意义(P<0.05)。结论慢性睑缘炎是导致蒸发过强性干眼的重要病因之一。

Objective To investigate the relationship between chronic blepharitis and evaporative loss dry eye. Methods Forty-one patients （82 eyes） were diagnosed as chronic blepharitis from November 2002 to April 2003 in Beijing Tongren Eye Center, of which 22 cases were male and 19 female. All patients＇ ocular surface was judged by Schirmer Ⅰ test, tear film break up time （BUT） and Tearscope. Meibomian gland secretion was used for bacteria culture and antibiotic sensitivity test. Thirty patients （60 eyes ） of glaucoma, cataract and LASIK before surgery were used as control, which included 16 male and 14 female. Microbiological results of meibomian gland secretion were compared and the statistical difference was evaluated by x^2 test. Results Of the blepharitis group, ST value was less than 10 mm in 30 eyes （36. 6% ） , BUT less than 10 s in 56 eyes （68.3%） and tear film tearscope evaluation more than 3 grade in 46 eyes （ 56. 1% ）. The bacteria spectrum of meibomian secretion in both groups was similar, which included staphylococcus epidermidis, staphylococcus aureus and corynebacterium. However, the bacterium culture positive rate and antibiotic sensitivity showed significant difference （ P 〈 0. 05 ）. Conclusion The chronic blepharitis is one of important cause in evaporative loss dry eyes.