糖尿病角结膜上皮病变的临床研究

Clinic study of diabetic keratoconjunctival epithelium diseases

目的通过对2型糖尿病患者的泪膜和眼表病变进行临床检测，探讨2型糖尿病与泪膜和角结膜E皮改变的相关性。方法对25例（50只眼）糖尿病住院患者和25例（50只眼）无糖尿病者（年龄匹配）做眼表检查，包括泪膜破裂时间（BUT），泪液分泌试验（SehirmerⅠ），角膜荧光素染色，结膜印迹细胞学检查，并对结果进行统计学分析。结果糖尿病组98．0％的眼泪膜破裂时间小于10s，泪膜破裂时间（4．56±2．02）s低于对照组（6．76±4．11）s；66．0％的患者泪液分泌试验小于5mm，泪液分泌值（4．52±2．84）mm低于对照组为（6．28±3．65）mm；角膜上皮着色占58．0％，结膜杯状细胞密度下降，鳞状上皮化生程度加重。结论糖尿病患者泪膜稳定性显著下降，是引起干眼症的主要原因。对糖尿病病人进行泪膜破裂时间、泪液分泌试验、角膜荧光素染色、结膜印记细胞学检查有助于早期发现糖尿病的角结膜上皮病变。

Objective To investigate the diabetic tear film function and ocular surtace diseases in order to discover the possible pathological mechanism of keratoconjunctival epithelium diseases.Methods Twenty-five patients with type 2 DM and 25 non-diabetic controls （age and sex matched） were included in this study.Corneal sensitivity measurement, Schirmer＇s I test, tear film break up time （BUT） measurement, fluorescein staining of the cornea, and conjuctival impression cytologic analysis （CIC） were examined.Results The corneal sensitivity, Schirmer＇s test values and BUT were significantly lower than the control group, con- junctival goblet cell density lower in the diabetic cases.The fiuorescein staining increased in the diabetic group. Average score of FL and the grade ofconjunctival squamous metaplasia were higher than healthy subjects, and the difference between two groups was statistical significance （P〈 0.05 ）.Conclusions The tear film dysfunction in non-insulin dependent diabetics makes these persons getting dry eye morecommonly.The corneal sensi- tivity measurement, Schirmer＇s I test, tear film break up time （ BUT ） measurement and fluorescein staining of the cornea should become routine tests in diabetes mellitus patients,