糖尿病性眼表病变的临床研究

Clinical study of diabetic ocular surface diseases

目的本研究通过对糖尿病患者眼表病变进行临床观测,旨在探讨糖尿病眼表并发症发生的可能机制,以寻找检测和控制糖尿病眼部并发症的可行方法。方法选取2型糖尿病患者25例,50眼为病例组;非糖尿病健康体检者(性别、年龄匹配)25例,50眼为对照组。对所有实验对象进行角膜敏感度测定、基础泪液分泌试验、泪膜破裂时间、角膜荧光素染色、结膜虎红染色及眼底血管荧光造影检查。所有实验结果量化后,通过SPSS10.0统计分析软件进行数据分析。结果糖尿病患者角膜敏感度下降、BUT值缩短、SchirmerI试验值下降、角膜荧光素染色阳性率增加、结膜粘膜退变及坏死细胞增多,与对照组均有显著差异(P<0.05),且随糖尿病视网膜病变的程度加重而加重。糖尿病患者角膜敏感度的下降以周边角膜更显著。结论糖尿病患者眼表泪膜稳定性显著下降,是引起干眼症的主要原因。对糖尿病患者进行常规的角膜敏感度测定、基础泪液分泌试验、泪膜破裂时间、角膜荧光素染色等检查,有利于糖尿病性眼表病变的早期发现及治疗。

Objective To investigate the diabetic ocular surface diseases, in order to discover the possible pathological mechanism. Methods 25 patients with type 2 DM and 25 non-diabetic controls（age and sex matched） were involved in this study and were examined by corneal sensitivity measurement, Schirmer＇s I test, tear film break up time（BUT） measurement, fluorescein staining of the cornea, rose bengal staining of the conjunctiva, slit-light microscope, ophthalmolscope were performed to them. All the patients and controls received fundus photography and fluorescein angiography. All the results were quantified, and analysed by SPSS 10.0 statistical analysis software. Results The corneal sensitivity, Schirmer＇s test values and BUT were significantly lower in the diabetic cases. The fluorescein staining and rose bengal staining points increased in the diabetic group. The descent of corneal sensitivity in the diabetic group was more significant in the edge of the cornea. Conclusion The tear film dysfunction in non-insulin dependent diabetics makes these persons getting dry eye more commonly. The corneal sensitivity measurement, Schirmer＇s I test, tear film break up time （BUT）measurement and fluorescein staining of the cornea should become routine tests of ophthalmology in diabetes mellitus,