糖尿病眼表病变的临床分析

Clinical analysis of diabetic ocular surface diseases

目的:观察和分析糖尿病患者眼表受损害的情况。方法:对40例(80眼)糖尿病住院患者和25例(50眼)无糖尿病者(年龄匹配)做眼表检查,包括泪膜破裂时间(tear breaku time,BUT),泪液分泌试验(SchirmerⅠtest),角膜荧光素染色,结膜印迹细胞学检查。结果:糖尿病组有82%的患者主诉眼干涩和异物感,对照组为44%;糖尿病组和对照组的BUT分别为4.49±1.95s和6.76±4.11s(t检验,P=0.000)。糖尿病组的SchirmerⅠ试验值为4.48±2.68mm,明显低于对照组6.28±3.65mm(t检验,P=0.003)。Schirmer值<5mm者,糖尿病组占65%,对照组占30%(χ2=15.09,P=0.000)。角膜荧光素染色:糖尿病组阳性率为56%,对照组为26%(χ2=11.39,P=0.001)。糖尿病组的杯状细胞数明显少于对照组(P=0.000)。结论:糖尿病也容易引起患者的眼表损害,会诊时应该予以重视。

AIM： To observe and analyze damage of the ocular surface of diabetic patients. METHODS： Eighty eyes of 40 patients with diabetes, and 50 eyes of 25 patients without diabetes （age matched） were involved in the study. Ocular surface, examinations included tear film tear breakup time（ BUT）,Sehirmer Ⅰ test, corneal fluorescence staining, and conjunctival impression cytology. RESULTS： There were 82% in the diabetic group and 44% in the control group complaining the dry and foreign body sensation. BUT was 4. 49 ± 1. 95s in the diabetic group and 6.76 ± 4.11s in the control（ t test, P= 0. 000）, respectively. Sehirmer＇s I test was 4.48 ± 2.68mm in the diabetic group,and 6.28 ± 3.65mm in the control（ t test, P = 0.003）. 65% of the diabetic group and 30% of the control group were less than 5ram of Sehirmer Ⅰ test（X^2 = 15.09, P = 0. 000）. 56% of the diabetic group and 26% of the control group were positive of corneal epithelia staining （X^2 = 11.39, P= 0. 001）. Compared with the contro I group,conjunctival cup cell of the diabetic group was less obviously（P=0.000）. CONCLUSION： Diabetic patients are subject to have ocular surface damage, a particular attention should be given in the consultation.