老年干眼患者眼表改变及其与睑板腺功能障碍的相关性

Ocular surface changes of aged people with dry eye and its correlation with meibomian gland dysfunction

目的探讨老年人干眼的眼表改变及其与睑板腺功能障碍(meibomian gland dysfunction,MGD)的相关性。方法选取2012年1月至10月于本院确诊为干眼、年龄60岁以上的患者83例(83眼)为干眼组,另选择门诊60岁以上同期健康体检者30人作为对照组,两组均进行症状问卷调查及泪膜破裂时间(break-uptime,BUT)、基础泪液分泌试验(SchimerⅠtest,SIt)和MGD检查,对两组检查结果进行分析比较,同时观察BUT、年龄与MGD严重性的相关性。结果干眼组患者BUT为(4.0±2.8)s,SIt为(5.1±4.6)mm,对照组分别为(11.1±6.1)s、(15.4±8.1)mm,差异均有统计学意义(均为P>0.05)。干眼组中伴发MGD者51例(61.4%),对照组中伴发MGD者12例(40.0%),差异无统计学意义(P>0.05)。干眼组、对照组MGD严重性与BUT均呈负相关(r=0.254、0.178,均为P<0.05)。干眼组不同年龄间MGD严重性差异有统计学意义(P=0.012),而对照组无统计学意义(P=0.175)。结论老年人干眼存在眼表改变,MGD可能是其重要病因。

Objective To explore ocular surface changes of aged people with dry eye and its correlation with meibomian gland dysfunction. Methods Eighty-three pa tients（83 eyes） aged over 50 with dry eye in our hospital from January,2012 to Octo ber,2012 were collected as dry eye group,and another 30 normal people also aged over 60 examined at the same time were collected as normal control group. They were all as sessed with a symptom questionnaire and their tear film break-up time（BUT） examina tions, Schirmer I test（ Sit）, and meibomian gland dysfunction were all examined. At the same time, the correlation among BUT, age and severity of MGD was analyzed. Results In dry. eye group,BUT was（4.0 ±2.8） seconds and Sit was（5.1 ±4.6） mm.while in nor-mal group, BUT was （ 11.1 ± 6.1 ） seconds and Sit was （ 15.4 ± 8.1 ） ram, and there was significant difference between them （ both P 〈 0.05 ）. There was 51 cases （ 61.4% ） in dry eye patients with MGD and 12 cases （40.0%） in control group with MGD, and there was no significant difference between two groups （P 〉 0.05 ）. There were negative correlation between the severity of MGD and BUT in dry eye group and normal group（ r = 0.254,0. 178, both P 〈 0.05 ）. The severity of MGD at different ages in dry eye group were significantly different （ P = 0. 012 ）, while there was no significant difference in control group（P =0. 175）. Conclusion The aged people with dry eye have some changes in their ocular surface,and MGD may be their important risk factor.