眼表综合分析仪在儿童早期前睑缘炎临床分析中的应用

The use of an ocular surface analyzer in the clinical analysis of early anterior blepharitis in children

目的 利用眼表综合分析仪对儿童早期前睑缘炎患者的眼表情况进行观察,分析其临床特点.方法 描述性研究.选取2015年7月至2016年5月就诊于山西省眼科医院门诊,经裂隙灯显微镜检查确诊为早期前睑缘炎的儿童患者40例（80眼）,年龄4-14岁.对患儿睑缘炎体征进行评分,利用眼表综合分析仪检查其泪膜破裂时间（BUT）、泪河高度,并进行眼表充血、睑板腺缺失及角膜荧光素钠染色评分,对所得数据进行Spearman秩相关分析.结果80眼中,58眼（72%）BUT缩短;50眼（62%）泪河高度下降;15眼（19%）发生角膜上皮点状缺损;25眼（31%）睑板腺缺失范围〉1/3.睑缘炎体征评分与BUT、泪河高度、角膜荧光染色评分及睑板腺缺失评分不相关;睑板腺缺失评分与BUT呈负相关（r=-0.253,P=0.024）,与角膜荧光染色评分呈正相关（r=0.563,P〈0.001）.结论 儿童早期前睑缘炎患者泪膜稳定性下降,同时合并睑板腺缺失的患者易继发干眼.

Objective To study the clinical features of early anterior blepharitis in children by observing the condition of the ocular surface with an ocular surface analyzer. Methods In this descriptive study, both eyes of 40 patients （age range 4-14 years） who were diagnosed by slit-lamp examination to have anterior blepharitis were selected at Shanxi Eye Hospital （July 2015 to May 2016）. Blepharitis was graded on the presence of signs： tear film break-up time, tear meniscus height, degree of ocular surface hyperemia, extent of meibomian gland absence, and corneal fluorescence staining scores measured by an ocular surface analyzer. Relationships among the measured signs were determined by Spearman correlation tests. Results Among the 80 eyes, 58 eyes （72%） had reduced tear film break-up time, 50 eyes （62%） had lower tear meniscus height, 15 eyes （19%） had corneal epithelial punctate defects, and more than a third of the meibomian glands in 25 eyes （31%） were absent. The score for signs of blepharitis had no obvious correlation with the average tear film break-up time, tear meniscus height, corneal fluorescence staining scores, or the degree of meibomian gland absence. However, the absence of meibomian glands was negatively correlated with the tear film break-up time （r=-0.253, P=0.024） and positively correlated with corneal fluorescence staining scores （r=0.563, P〈0.001）. Conclusion The stability of tear film decreases in children with early blepharitis. Those with some degree of meibomian gland absence are at high risk for secondary dry eye.