绝经后女性行激素替代治疗的干眼症调查分析

Dry eye syndrome in menopausal women treated by hormone replacement therapy

目的探讨激素替代治疗（HRT）与干眼患病的关系。方法分析性横断面研究。将就诊于两家医院的绝经后妇女按是否进行激素替代治疗或治疗时长分成三组：超过12个月的中长期HRT组25人，3至12个月的短期HRT组20人，未治疗的对照组40人。根据患者干眼主观症状、泪膜破裂时间（BUT）、角膜荧光素染色（FL）和泪液分泌实验（SIT）指标来确诊干眼患者，并测量眼压、中央角膜厚度和血雌激素值。各组干眼患者人数比较采用卡方检验，各组眼压、中央角膜厚度和血雌激素值比较采用单因素方差分析，两两比较采用Bonferroni法。结果各组干眼患病率为：中长期HRT组72．0％（18／25）、短期HRT组45．0％（9／20）和对照组35．0％（14／40），中长期HRT组的干眼患病率高于对照组（χ^2=8．427，P：O．004）。眼压、中央角膜厚度各组间差异均无统计学意义（F=2．130，P：0．125）和（F=1．903，p=0．156）．。血雌激素值中长期HRT组、短期HRT组均高于对照组（F=26．310，23．251；均P〈O．01）。结论中长期的激素替代治疗可能与干眼高发相关，临床医生需正确评估其风险，合理用药。

Objective To investigate the effect of hormone replacement therapy on dry eye. Methods Analytical cross-sectional study. The menopausal patients from two hospitals were divided into three groups judged by whether they were treated by hormone replacement therapy or the time of therapy. Group 1： twenty-five patients applied with HRT more than 12 months; Group 2： twenty patients treated by HRT from 3 months to 12 months; Group 3; forty untreated patients （control group）. According to the subjective symptom of dry eye, BUT, FL and SIT, the researcher decided the number of patients of each group and measured intraocular pressure, central corneal thickness and blood estrogen value. Chi-square test was used to compare the number of dry eye patients of each group. One-way ANOVA was adopted to compare intraocular pressure, central corneal thickness and blood estrogen value. Bonferroni was used to get further comparison. Results The dry eye rate of each group were as the following： group one： 72.0% （18/25）; group two： 45.0% （9/20）; group three： 35.0% （14/40）. The dry eye rate of group 1 was higher than that of group 3 （χ^2=8.427, P 0.004）. As for intraocular pressure and central corneal thickness there was no statistic significance among the three groups （F =2.130, P =0.125）, （F =1.903, P =0.156）. As to blood estrogen value, group 1 and group 2 were both higher than group 3 （F =26.130, 23.251, P 〈 0.01）. ConclusionsMedium and long-term HRT is probably relevant to the dry eye symptom. Clinical doctor should take the risk seriously and use the medicine properly.