中老年干眼患者临床特征分析

Clinical feature analysis of middle-and old-age patients with dry eye

目的:探讨中老年干眼患者的发病特点及临床特征。方法:收集2005-06/2006-07于吉林大学中日联谊医院眼科门诊以眼不适为主诉就诊的40岁以上患者70例140眼进行干眼症问卷调查和检查,并对临床资料进行分析。结果:在70例患者中,男22例,女48例。男∶女=1∶2.2,平均年龄53.7±10.0岁。确诊干眼症者54例92眼,发病率65.7%。其中男15例22眼,男性发病率15.7%。女39例70眼,女性发病率50.0%。男女发病率有极显著性差异(P<0.01)。且随着年龄增长干眼症的发病率明显增加。干涩感(95.6%)、异物感(71.4%)及眼疲劳(70.3%)为干眼症最常见的症状。随年龄增长,SchirmerⅠ及BUT结果明显降低,各组间存在显著性差异(P<0.05)。工作及生活环境、眼部的慢性炎症、全身性疾病可促进干眼症的发生。屈光不正(尤其是远视)及老视会明显导致眼不适症状的出现。结论:干眼症好发于中老年人,尤其为女性,发病率随年龄增长而增加。随年龄增长,泪液基础分泌量减少,泪膜稳定性下降,角膜上皮细胞缺损程度增加。主诉眼不适的患者中,一部分是由于屈光不正(尤其是远视)及老视导致,注意屈光学检查,以防误诊。绝经后女性干眼症的发病率明显增加。眼干涩、异物感及眼疲劳为干眼症最主要症状。

AIM： To explore the morbidity characteristics and clinical feature of middle- and old-age patients with dry eye. METHODS： Seventy patients （140 eyes） aged over 40 years, complaining eye uncomfortable, were analyzed in Jilin University, China-Japan Union Hospital from June, 2005 to July, 2006. RESULTS： A total of 70 patients, 31.4% （22 cases） of the patients were male and 69.6% （48 cases） were female. The average age was 53.7＋ 10.0 years. Fifty-four cases （92 eyes） were diagnosed DES at last, the morbidity was 65.7%. Among DES, 15 cases （22 eyes） were male, which morbidity was 15.7%, 39 cases （70 eyes） were female, which morbidity was 50.0%. There was no significant difference of morbidity between male and female （P〈0.01）, and the DES morbidity was obviously increased with ages. The most common symptoms of DES were dryness, foreign body sensation and asthenopia. As ages increasing, the result of Schirmer test I and break up time （BUT） were obviously decreased, and there was no significant difference in groups （P〈0.05）. The DES could be severed by the environment of working and living, the ocular chronic inflammation, and the systemic diseases. Ametropia （especially farsightedness） and presbyopia could exacerbate the symptoms. CONCLUSION： The morbidity of DES increases in the people over 40 years, especially in women. As age increased, the basal secretion of both tear fluid and stability of tear film are decreased, and the degree of ocular epithelium defection is aggravated. A lot of symptoms are related with ametropia（especially farsight） and presbyopia. Therefore, we pay attention to the examination of refraction, to avoid misdiagnosis. There is an obviously increase of DES morbidity in postmenopausal women. Dryness, foreign body sensation and asthenopia are the most common symptoms of DES.