干燥综合征患者眼部症状和体征的一致性分析

Association between symptoms and signs of dry eye with Sjgren syndrome

目的分析干燥综合征患者眼部症状的特点并研究症状和体征之间的一致性。设计前瞻性病例系列。研究对象北京大学第一医院内科诊断为干燥综合征的患者36例。方法对患者进行干眼症状问卷调查,包括干涩感、异物感、疼痛或刺痛感、烧灼和流泪感等;对患者进行泪膜破裂时间、角膜荧光素钠染色、结膜丽丝胺绿染色、SchirmerI试验等体征的客观检查。统计症状的阳性率,分析症状和体征之间的一致性。主要指标泪膜破裂时间、角膜荧光素钠染色、结膜丽丝胺绿染色、SchirmerI试验。结果干燥综合征患者的症状明显,除异物感与角膜荧光素钠染色、结膜丽丝胺绿染色及泪膜破裂时间有关,差异有统计学意义(P<0.05)外,其他症状的出现均和体征无关(P>0.05)。体征和症状严重程度的一致性较差。结论干燥综合征患者除异物感和体征有关外,其他症状和体征的一致性差。

Objective To analyze the characteristics of ocular symptoms of Sjogren syndrome and to examine the relation between signs and symptoms. Design Prospective case series. Participants 36 patients with Sjogren syndrome diagnosed by rheumatisms. Methods A self-designed questionnaire was used to investigate 4 symptoms of patients including dryness, grittiness, soreness or irrita- tion, burning or watering. A series of clinic tests were completed as follows： break-up time, fluorescein corneal staining, lissamine green conjunctival staining, Schirmer I test. The positive rate of such symptoms was calculated. The consistency of the symptoms and signs were compared. Main Outcome Measures Break-up time, fluorescein corneal staining, lissamine green conjunctival staining, Schirmer I test. Results Patients with Sjogren syndrome were marked by ocular symptoms. There were efficient statistically significant correlations between grittiness and fluorescein corneal staining, lissamine green conjunctival staining, break-up time （P〈0.05）. No rela- tions were found between other signs and symptoms. There was a poor relation between dry eye tests and severity of symptoms in Sjogren syndrome. Conclusion There is a poor relation between dry eye symptoms and signs except for grittiness in Sjogren syndrome dry eye.