2型糖尿病与干眼症的相关性分析

Analysis of correlation between type 2 diabetes mellitus and dry eye

目的探讨2型糖尿病(DM)患者的泪膜功能和干眼症的患病率。方法对2型DM患者55例(110眼)进行前瞻性研究。对照组为非DM患者40例(80眼)。所有受试者均接受干眼症状问询及相关检查。结果DM组干眼症的患病率50.91%(56/110)明显高于对照组15.00%(3/20),差异有统计学意义(P<0.01)。DM组泪膜功能相关检查:泪液分泌试验(SIt)(9.48±4.02)mm,低于对照组(11.73±3.81)mm(P<0.05),泪膜破裂时间(BUT)(6.64±3.18)s,与对照组(12.30±2.79)s比较差异有统计学意义(P<0.01),角膜荧光素染色(FL)20%(22/110),高于对照组5.00%(4/80)(P<0.01)。泪膜功能改变与糖尿病视网膜病变(DR)程度和血糖控制不佳有关,与病程无关。结论2型DM患者泪膜功能发生改变,是干眼症的易患人群。

Objective Dry eye is a frequent disease of ocular surface at present. The ocular surface changes in diabetes mellitus arouse more attention increasingly in ophthalmology. This paper was to investigate tear film function and prevalence rate of dry eye in type 2 diabetes mellitus. Methods The primary research was carried in 55 patients with type 2 diabetic （ 110 eyes） and 40 non-diabetic individuals with matching age and gender as controls （80 eyes）. All patients were inquired about dry eye syndrome and received the examinations as follows ： tear film function,Schirmer I test （Sit） , tear break-up time （BUT） and corneal fluorescein staining（FL）. Results The diabetic group showed higher prevalence rate of dry eye syndrome （50. 91% ） than that of the control group（ 15.00% ） ,showing a significant difference between two groups （ P 〈 0. 01 ）. Type 2 diabetes mellitus showed lesser Sit（9.48 ±4.02） mm than controls （ 11.73 ± 3.79） mm （ P 〈 0.05 ） , faster BUT （ 6. 64 ± 3.18 ） s in diabetics patients and （ 12. 30 ± 2.78） s in controls （P 〈 0. 01 ） and higher rate of FL（20% ） in diabetics patients and 5% in controls （ P 〈 0. 01 ）. There was a good correlation in tear film function with diabetic retinopathy and metabolic controls rather than duration of diabetes mellitus. Conclusion The patients with type 2 diabetics show a tendency to develop tear film dysfunction. They are susceptible population of dry eye. SIt,BUT and FL should be routinely examined in the patients with type 2 diabetes mellitus.