2型糖尿病患者泪液及眼表改变的临床观察

Clinical observation of tear and ocular surface changes in type 2 diabetes

目的通过对2型糖尿病患者眼表病变进行临床检测,旨在探讨2型糖尿病与泪液及眼表改变的相关性。方法对90例(180眼)2型糖尿病患者和90例(180眼)无糖尿病的健康体检者行对照检查,包括裂隙灯检查、眼底检查、角膜荧光素钠染色、泪膜破裂时间测定及Schirmer试验、泪河线高度、角膜地形图等,并对结果进行统计学分析。结果糖尿病组泪膜破裂时间(6.46±5.00)s低于对照组(12.30±6.90)s(P<0.01),泪液分泌试验(10.20±7.83)mm低于对照组(18.30±7.05)mm(P<0.01),角膜荧光素染色阳性率24.4%,高于对照组14.4%(P<0.01)。糖尿病组的角膜表面规则指数和表面不对称指数值较正常人明显升高。预测视力值明显降低,2组比较差异有显著统计学意义(P<0.01)。结论2型糖尿病患者较正常人易出现泪膜完整性的破坏及干眼症候群。

Objective To explore the relationship between type 2 diabetes and tears or ocular surface changes through clinical examination of ocular disease in type 2 diabetes. Methods Totally 90 patients （ 180 eyes） with type 2 diabetes and 90 control subjects （ 180 eyes） were studied. The ocular fimction was evaluated by examination with slitlamp microscope, ophthalmoscopy, tear breaking up time （ BUT ）, corneal fluorescein staining, Schirmer I test（Sit） ,the height of tear meniscus and the indices of OPTICON corneal topography system. The results were statistical analyzed. Results When compared with the controls, patients with type 2 diabetes showed faster BUT（ diabetics 6.46 s ± 5.00 s, control 12.30 s ± 6.90 s,P 〈 0.01） ,but similar Sit（diabetics 10.20 mm ±7.83 mm, control 18.30 mm ± 7.05 mm, P 〈 0. 01 ）. More diabetic patients were diagnosed as dry eye（ diabetics 24.4% , control 4.4% ,P〈0.01 ）. The surface regular index and surface anomalism index were significantly elevated and the predict visual acuity was remarkably decreased in type 2 diabetes compared to that of mormal subject（P〈0.01 ）. Conclusion Patients with type 2 diabetes tend to appear tear film dysfimction and dryeye syndrome.