比较各种类型干眼患者的临床特点及评价干眼患者的治疗偏向

Clinical characteristics and treatment bias of different types of dry eyes patients

目的探讨比较各种类型干眼患者的临床特点及评价干眼患者的治疗偏向。方法 100例干眼患者,按原因分为蒸发过快组(20例)、水样液缺乏组(64例)、混合型组(16例),对三组患者的病情严重程度、病因、临床症状、病程和相关各项检查等进行回顾性分析。结果 100例干眼患者中混合型组(MIX)患者16例,占总病例16%;水样液缺乏组64例,占总病例64%,其中干燥综合征(SS)患者33例,占总病例33%,非干燥综合征水样液缺乏(NSTD)患者31例,占总病例31%;蒸发过快组患者20例,占总病例20%,其中幕终端综合征(VDT)患者7例,占总病例7%,脸板腺功能障碍(MGD)患者13例,占总病例13%。在各项症状中最常见的症状依次为干燥感(90%)、异物感(47%)、畏光感(45%)、灼热感(42%)、视物模糊(41%)、刺痛感31例(31%),最少见的为视力波动(13%)。结论干燥感能作为水样液缺乏和蒸发过快两大类干眼的主要鉴别症状,畏光感是诊断VDT的主要鉴别症状,有效结合荧光屏接触史能诊断VDT。人工泪对干眼病的治疗有显著疗效,同时需要其他辅助治疗。

Objective To explore clinical characteristics and treatment bias of different types of dry eyes patients. Methods A total of 100 dry eye patients were divided by sick reasons into rapid evaporation group（20 cases）, aqueous tear deficiency group（64 cases） and mixed type group（16 cases）. Retrospectively analyze disease severity, causes of disease, clinical symptoms, course of disease and related examinations in three groups. Results Among 100 dry eyes cases, there were 16 cases in mixed type（MIX） group, accounting for 16%. 64 cases in aqueous tear deficiency group, accounting for 64%, with 33 sicca syndrome（SS） cases, accounted for 33% and 31 non-sicca syndrome aqueous tear deficiency（NSTD） cases, accounted for 31%. 20 cases in rapid evaporation group, accounted for 20% with 7 visual display terminal（VDT） cases, accounted for 7%, and 13 meibomain gland dysfunction（MGD） cases, accounted for 13%. Most common symptoms in turn were dry sensation（90%）, foreign body sensation（47%）, photaesthesia sensation（45%）, burning heat sensation（42%）, blurred vision（41%） and tingling sensation（31%）. Vision fluctuation was the rarest one. Conclusion Dry sensation can be the main differentiation of symptom between aqueous tear deficiency and rapid evaporation dry eyes. Photaesthesia sensation is main differentiation of symptom for VDT and combined with screen contact history can diagnose VDT. Artificial tear, along with other adjuvant therapy, shows significant effect in treating dry eyes disease.