抗青光眼药物对青光眼患者泪液胰岛素水平的影响及其与眼表改变的关系

Effects of anti-glaucoma medicine on insulin in glaucoma tear and its relationship with ocular surface changes

目的分析抗青光眼药物对青光眼患者泪液胰岛素水平的影响及其与眼表改变评分之间的关系。方法选择我院青光眼患者27例(30眼)为青光眼组,所有患者均局部使用抗青光眼药物降眼压治疗≥3个月。另选择无角膜接触镜配戴史的健康志愿者30人(30眼)为对照组。2组均行基础泪液分泌试验、泪膜破裂时间、角膜荧光素染色检查及眼表改变评分,放射免疫分析法测定2组基础泪液中胰岛素的含量。结果对照组基础泪液胰岛素含量为13.40～193.40(70.66±38.16)μIU·mL-1,青光眼组为1.90～137.90(31.49±25.90)μIU·mL-1,差异有显著统计学意义(t=-4.65,P<0.01)。未诊断为干眼者泪液胰岛素含量为20.30～193.40(70.56±37.63)μIU·mL-1,诊断为干眼者为1.90～68.60(23.79±13.90)μIU·mL-1,差异有显著统计学意义(t=6.74,P<0.01)。对照组眼表改变评分为1～3(1.73±0.58)分,青光眼组为1～12(3.57±2.06)分,差异有显著统计学意义(t=-4.67,P<0.01)。泪液胰岛素含量和眼表改变评分之间呈负相关关系(r=-0.78,P<0.01)。结论局部药物治疗可引起干眼,从而影响眼表基础泪液胰岛素的含量;泪液胰岛素含量和眼表改变评分呈负相关关系。

Objective To explore the effects of anti-glaucoma medicine on insu lin in glaucoma tear and its relationship with ocular surface changes score. Methods Twenty-seven patients with glaucoma （30 eyes） were collected in our hospital as glau coma group, and they were all topically treated with anti-glaucoma medicine for more than 3 months. Another 30 healthy volunteers（ 30 eyes） were collected as the control group. Both two groups were examined with the ocular surface changes scoring, Schirmer I test, film break-up time （BUT） and corneal fluorescein staining, and the content of insulin in fundamental tear was determined by radio immunoassay. Results The insulin content in fundamental tear of the control group was 13. 40 - 193. 40 （70. 66 ±38.16） μIU.mL-1 glaucoma group was 1.90 - 137.90 （ 31.49 ± 25, 90 ）μIU.mL-1 and there was significant difference （ t = - 4.65,P 〈 0.01 ）. The tear insulin con tent of the eyes with dry eye was 1.90 -68.60（23.79 ± 13.90） μIU.mL-1, 20.30 ±193.40 （70.56 ± 37.63 ） μIU.mL-1 of the eyes without dry eye, and there was statisticaldifference between the two groups（ t = 5.74 ,P 〈 0.01 ）. The ocular surface changes score of control group was 1 - 3 （ 1.73 ± 0.58） points, glaucoma group 1 - 12（3.57 ±2.05） points, and there was significant difference（ t = -4.57 ,P 〈0.01 ）. The insulin content was negatively correlated with ocular surface changes scoring（ t = -0.78 ,P 〈 0.01 ）. Conclusion Topical anti-glaucoma medication can cause the dry eye and affect the tear insulin content of glaucoma patients; there is negative correlation between the content of insulin and ocular surface changes score,