睑板腺功能障碍与血糖浓度及脂质代谢水平相关性研究

Clinical research of relationship between meibomian gland dysfunction and blood glucose concentration and lipid metabolism

目的探讨睑板腺功能障碍与血糖浓度及脂质代谢水平之间的相关性。方法临床病例对照研究。收集2014年10月至2015年1月在辽宁医学院武警后勤学院附属医院的84例糖尿病患者为病例组（A组）（根据是否合并心血管疾病分A1组及A2组：A1组为糖尿病不合并心血管疾病；A2组为糖尿病合并心血管疾病）和35例无糖尿病的心血管疾病患者为对照组（B组），分析睑板腺功能障碍与血糖浓度及脂质代谢水平之间的关系。结果睑板腺功能障碍在糖尿病患者中的发生率为75％。睑板腺阻塞评分分析中，A，组与B组、A：组与B组之间有统计学意义（P〈0．05），A1组与A2组之间无统计学意义（P〉0．05）；睑脂性状评分分析中，A2组与B组之间有统计学意义（P〈0.05），余各组之间无统计学意义（P〉0．05）。相关性分析中，睑板腺阻塞评分与空腹血糖差异有统计学意义（P=0．006，rs=0．252），余无统计学意义（P〉0．05）。结论糖尿病患者中睑板腺功能障碍的发生率高达75％，空腹血糖浓度升高是糖尿病患者睑板腺功能障碍进展的高危因素，适当调整血糖浓度有助于提高糖尿病患者并发睑板腺功能障碍的治疗效果。

Objective To analyze the relationship between meibomian gland dysfunction and concentration of blood glucose and lipid metabolism. Methods A randomized and double-mask trial was conducted for 4 months duration. Eighty-four cases of diabetic patients （group A） and 35 controls without diabetic and with history of cardiovascular disease （group B）, accrued from October 2014 to January 2015 were included. Group A was divided into group A1 and A2 according to whether with cardiovascular diseases, group A1 for diabetes with no cardiovascular disease; group A2 for diabetic combined cardiovascular disease. The relationship between meibomian gland dysfunction and concentration of blood glucose and lipid metabolism were analyzed. Results Meibomian gland dysfunction prevalence was 75% in diabetes patients. There were statistically significant difference between the groups A1 and group B, group A2 and group B, while no significant difference between the group A1 and group A2 on analysis of meibomian gland obstruction score. There were statistically significant between the group A2 and group B on analysis of quality of expressed meibum score, no significant difference among the other groups. In correlation analysis, the meibomian gland obstruction score was positively correlated with fasting glucose （P =0.006, r, =0.252）, and the rest had no correlation. Conclusions The prevalence of meibomian gland dysfunction is up to 75% in diabetes patients, the concentration of fasting plasma glucose is a risk factor in diabetic patients with meibomian gland dysfunction development and adjustment of the concentration of fasting plasma glucose can help improvement of therapeutic effect in diabetic patients with meibomian gland dysfunction.