泪膜功能对原发性翼状胬肉活动度的影响

The effect of tear film function on the activity of primary pterygium

目的评价泪膜功能对原发性翼状胬肉活动度的影响。设计前瞻性比较性病例系列。研究对象2012年8月至2013年2月广东省中山市南朗医院原发性单眼翼状胬肉患者53例。方法纳入翼状胬肉静止期患者14例、活动期患者39例。所有患者进行Schirmer试验、泪膜破裂时间(BUT)及结膜印迹细胞学检查。Logistic回归分析胬肉活动性与患者年龄、性别、泪膜检查结果的关系。主要指标Schirmer试验、BUT、结膜杯状细胞计数结果。结果静止期与活动期翼状胬肉患者Schirmer试验分别为(9.43±2.28)mm、(8.67±2.14)mm(P=0.267);BUT分别为(8.79±1.97)s、(5.05±2.14)s(P=0.000);结膜杯状细胞数量分别是(38.79±2.83)个/10个高倍视野、(32.74±3.30)个/10个高倍视野(P=0.000)。Logistic回归分析显示仅BUT对翼状胬肉是否活动有一定影响(P=0.01)。结论翼状胬肉生长状态与患者眼表状态相关,活动期患者较静止期患者泪膜功能差。

Objective To explore the effect of functional tear film on constitutional pterygium. Design Prospective comparative case series. Participants 53 cases of monocular patients with primary pterygium in Nanlang Hospital of Zhongshan City from August 2012 to February 2013. Method 14 pterygium patients with stationary phase and 39 patients with active phase were included in this study. All patients were examined with Schirmer test, tear film break-up time （BUT） and conjunctival impression cytology for golblet cell count. Logistic regression was used to analyze associated factors and ptetygium activity. Main Outcome Measures Schirmer test, BUT and conjunctival golblet cell density. Results The result of Schirmer test in stationary phase and active phase was （9.43±2.28） mm and （8.67±2.14） mm, respectively （P=0.267）. While the result of BUT in stationary phase and active phase was （8.79±1.97）s and （5.05± 2.14）s, respectively （P=0.000）. The mean globlet cell density （numbers/10 fields） in conjunctival impression specimens in stationary phase and active phase was （38.79±2.83） and （32.74±3.30）, respectively （P=0.000）. The logistic regression analysis showed that only BUT could affect the activity of ptetygium. Conclusions The active state of pterygium is associated with ocular surface status of patients. The patients of pterygiumms in active phase suffer poor tear film compared with patients in stationary phase.