酚红棉线试验在诊断干眼中与Schirmer's I试验及BUT一致性的比较

The comparative study of phenol red thread test vs Schirmer's I test and BUT in diagnosing dry eye

目的:比较在诊断干眼方法中酚红棉线,Schirmer's I试验及泪膜破裂时间测量泪膜的一致性。方法:110只白内障术眼术前分别用酚红棉线试验,Schirmer's I试验测量泪液分泌量,两种方法间隔5min,然后均行泪膜破裂时间测定(break up time,BUT),所有资料均采用Kappa统计学方法,分析其一致性。结果:酚红棉线测量泪液分泌试验,棉线湿长<10mm的患者,占总眼数的36.4%,湿长<20mm者,占总眼数的89.1%;Schirmer's I试验滤纸湿长<5mm者,占总眼数的10.9%,湿长<10mm者,占总眼数的40.0%。BUT<5s者占总眼数的23.6%,<10s者占总眼数的65.5%。酚红棉线试验与Schirmer's I试验,BUT的一致性Kappa值分别为从0.03到0.29,从-0.028到0.13,酚红棉线试验与Schirmer's I试验及BUT的一致性较差。同样Schirmer's I试验与BUT的一致性Kappa值从0.12到0.31,两者的一致性较差。结论:酚红棉线试验与Schirmer's I试验,BUT试验在测试泪液量方面的一致性较差,而且Schirmer's I试验与BUT试验相比较一致性也较差,因此诊断干眼患者需要联合多种检查方法。

Objective： To compare the agreement of phenol red thread test vs Schirmer＇sⅠ test and BUT in diagnosing dry eyes. Methods： 110 preoperative cataract eyes were measured by phenol red thread test, Schirmer＇sⅠ test to be followed by BUT. Two methods were separated five minutes. All available data were analyzed using Kappa statistics to assess the agreement of all the three tests. Results： 36.4% of patients was positive using phenol red thread test with a cutoff point of 10mm, and 89.1% was positive with a cutoff point of 20mm. Schirmer＇sⅠ test was 10.9% positive with a cutoff point of 5mm and 40.0% positive with a cutoff point of 10mm. BUT was 23.6% positive with a cutoff point of 5s and 65.5% positive with a cutoff point of 10s. Kappa ranged from 0.03 to 0.29 between phenol red thread test and Schirmer＇sⅠ test, from -0.028 to 0.13 between phenol red thread test and BUT, and from 0.12 to 0.31 between Schirmer＇sⅠ test and BUT. Conclusion： The agreement is weak not only between phenol red thread test but also Schirmer＇sⅠ test and between phenol red thread test and BUT. Similarly the agreement is also between Schirmer＇s Ⅰ test and BUT. So it should combine with different tests in diagnosing dry eye.