2型糖尿病患者干眼与糖尿病视网膜病变的相关分析

Analysis of correlation between dry eye and diabetic retinopathy in type 2 diabetic patients

目的:调查2型糖尿病患者干眼与不同程度糖尿病视网膜病变(diabetic retinopathy,DR)及黄斑水肿之间的关系。方法:采用横断面研究。选取340例340眼2型糖尿病患者,收集临床资料,分别检测泪河高度、泪液分泌试验(SchirmerⅠtest)、泪膜破裂时间(break-up time,BUT)、角膜荧光素染色。所有患者散瞳检查视网膜,评估DR程度及有无临床意义的黄斑水肿。结果:所有患者中,干眼患病率为49.41%。干眼患者的糖尿病病程为11.15±7.07a,无干眼患者的病程为6.92±5.45a,两者之间的差异具有显著统计学意义(P<0.01)。干眼与DR各分期具有明显关系,轻度非增殖性糖尿病视网膜病变(nonproliferative diabetic retinopathy,NPDR)、中度NPDR、重度NPDR和增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)患者相对于无DR患者的干眼发生可能性分别为1.097倍、1.724倍、2.86倍和5.43倍。黄斑水肿患者较无黄斑水肿患者的干眼发生可能性增加到3.697倍。结论:2型糖尿病患者常常伴发干眼。随着DR的发生及进展,罹患干眼的机会逐步增加。

AIM ： To investigate the correlation between dry eye and different degrees of diabetic retinopathy（ DR） in type 2diabetic patients.METHODS： In the cross-sectional study,340 patients（ 340 eyes） with type 2 diabetes were enrolled. Tear film function tests including tear meniscus height,tear film breakup time（ BUT）,fluorescein staining,Schirmer Ⅰtest were perform ed followed by surveying questionnaires about dry eye. Retinal status was evaluated by retinal color photography and indirect ophthalm oscopy exam with dilated pupils to evaluate DR and whether com panied by macular edem a.RESULTS： The prevalence of dry eye was 49. 41%. The m ean duration of diabetes in patients with dry eye was11. 15±7. 07 a,while 6. 92±5. 45 a without dry eye（ P0. 01）.Dry eye had the positive correlation to the development of DR. The incidence of dry eye in people with mild nonproliferative diabetic retinopathy（ NPDR）,moderate NPDR,severe NPDR and proliferative diabetic retinopathy（ PDR） was 1. 097 times,1. 724 times,2. 86 times and 5. 43 times respectively, com pared with people without DR.The occurrence of dry eye in people with m acular edem a increased by 3. 697 times com pared with people without m acular edem a.CONCLUSION： Dry eye was more prevalent in people with type 2 diabetes. The incidence of dry eye increased gradually with the occurrence and developm ent ofdiabetic retinopathy.