儿童干眼的临床研究

Clinical survey of dry eye in children

目的了解儿童干眼的临床特点及相关因素。方法临床病例对照研究。对2011年2月至2012年2月在江西省人民医院眼科中心以干眼的诊断标准将112例疑似干眼儿童的病因、临床特点进行分析；并对病例治疗前后追踪半年分别做SchirmerTest（泪液分泌试验）、BUT（泪膜破裂时间）、FL（角膜荧光素染色）及视力及屈光检查。结果112例患儿的主要症状为频繁瞬目40例（35．7％），眼痒36例（32％），眼红16例（14．3％），干涩感12例（10．7％），畏光10例（9％），对风、烟、空调敏感8例（7％），分泌物增多6例（5．3％），丝状角膜炎2例（1．8％）。治疗前后BUT检查有显著性改善差异有统计学意义（P〈O．01），而Schirmer试验比较差异无统计学意义（P〉0．05）。112例患儿就诊时95例（85％）视力在0．8以上，6例（5％）近视配戴着眼镜，追踪半年后，65例（58％）视力在0．8以上，36例近视（32％）配戴上了眼镜（P〈0．01）。结论儿童干眼的主要症状为频繁瞬目，主要体征是泪膜稳定性下降；干眼是否引起或加速近视发展，值得进一步研究。

Objective To investigate the clinical features and the related factors of dry eye disease. Methods The symptom and pathogeny of 112 suspected dry eye children were analyzed; and the Schirment Test, BuT, FL and eye examination on those children for half a year before and after the therapy were examined. Results The main clinical symptoms of the 112 children was： frequent blinking （40 cases, 35.7%）, eye itching （36 cases, 32%）, redness （16 cases, 14.3%）, dryness （12 cas- es, 10.7）, photophobia （10 cases, 9%）, wind, smoke and air conditioners sensations （8 cases, 7%）, ex- cretions-increased （6 cases, 5.3%）, filamentary keratitis （2 cases, 1.8%）. The results of BUT was im- proved significantly after the therapy （P 〈0.01）, while the improvement of Schirmer was not remarkable （P 〉0.05）. Among the 112 children, 95 cases （85%） came to the doctor with the vision beyond 0.8, 36 cases （32%） were wearing glasses （P 〈0.01）. Conclusions The main symptom of children dry eye is frequent blinking, the main sign is the stable decrease of tear films; whether dry eye disease has led and deteriorated myopia needs further research.