办公室干眼泪液渗透压和泪液容量特征分析

Characteristics of tear osmolarity and tear volumes in office dry eye

目的:观察办公室干眼患者的泪液渗透压和泪液容量特征,探讨其与症状、体征间的相关性。方法:经过筛选,共招募90名办公室工作人员,分成两组:办公室干眼组(实验组,60名)和对照组(30名)。所有受试对象均随机选择一眼测量泪液渗透压及总泪新月容量(TTMV)。数据采用独立样本t检验、接受者操作特征曲线(ROC曲线)以及Pearson相关等进行分析。结果:实验组的泪液渗透压为(313.4±10.7)mOsm/L,高于对照组的(304.2±8.5)mOsm/L,实验组的TTMV为(0.92±0.21)μL,低于对照组的(1.07±0.20)μL(均P<0.05)。泪液渗透压和TTMV的ROC曲线下面积分别为0.744和0.720,最优诊断敏感性和特异性的截断值分别为309 mOsm/L和0.8μL。在实验组中,泪液渗透压和TTMV均与症状呈弱相关(均P<0.05,r=0.260和r=-0.263)。结论:办公室干眼的泪液渗透压增高和泪液容量减少,这可能是导致其泪膜不稳定和症状出现的主要原因之一。

Objective： To investigate the characteristics of tear osmolarity and tear volumes in office dry eye, and to study their relationship with the symptoms and signs of dry eyes. Methods： Ninety office workers were enrolled as subjects after screening tests. They were divided into two groups： the office dry eye group （experimental group, 60 cases） and the normal group （control group, 30 cases）. The tear osmolarity and the total tear meniscus volume （TTMV） were then measured for one eye of each subject randomly. Data was analyzed by an independent-samples t-test, receiver operating characteristic （ROC） curves and Pearson correlations. Results： The tear osmolarity of the experimental group was （313,4 ± 10.7） mOsm/L, significantly higher than that of the control group, which was （304.2± 8.5 ） mOsm/L. The TTMV in the experimental group was （0.92 ± 0.21） μL, lower than that of the control, which was （1.07 ± 0 20 ） μL （P 〈 0.05）. The area under the ROC curves of the tear osmolarity and TTMV was 0.744 and 0.720, respectively. The cut-off values for the best diagnostic sensitivity and specificity were found to be 309 mOsrn/L and 0.8 μL, respectively. In the experimental group, the tear osmolarity and TTMV were weakly correlated with ocular symptoms （P 〈 0.05, r=0.260 and r=-0.263, respectively）. Conclusion： The increase of tear osmolarity.and the decrease of tear volumes may be one reason for tear film instability and the presentation of ocular symptoms in office dry eyes.