睑缘蠕形螨的检查及其感染情况分析

Eyelid examination for Demodex infestation

背景蠕形螨感染引起的睑缘炎在临床上常见，目前中国对蠕形螨检查的相关研究中提及的方法多样，缺乏统一的操作程序介绍和评价。如何为睑缘蠕形螨感染的临床诊断提供快速、准确的检查方法仍需进一步研究。目的建立睑缘蠕形螨临床检查方法及操作流程，并分析睑缘蠕形螨感染情况。方法采用前瞻性研究设计。纳入2015年1—12月于中山大学中山眼科中心诊断为睑缘炎及其他伴眼痒、眼干等症状的患者1052例。裂隙灯显微镜下行患眼睑缘睫毛根部拍照，每眼眼睑拔取3根睫毛行蠕形螨检查，照相记录。3根睫毛中任意1根裂隙灯显微镜下发现蠕形螨或虫卵者，即为睑缘蠕形螨检查阳性。结果1052例睑缘炎患者中发现蠕形螨感染者582例，阳性率为55．3％。随着年龄的增加，睑缘蠕形螨感染率增高，〉60岁组患者感染率最高，各年龄组间整体比较差异有统计学意义（χ^2=10．547，P=0．001）。不同性别间蠕形螨感染率比较差异无统计学意义（P=0．352）；该法室内检验周转时间（TAT）为（11．4±5．2）min。结论建立了裂隙灯显微镜下采样及显微镜观察记录睑缘蠕形螨感染的检查方法和操作规程。该方法简便快速，规程具有操作性，可推广应用于临床睑缘蠕形螨感染疾病的辅助诊断。

Background Blepharitis caused by Demodex infestation is very common in clinical practice. There are various methods mentioned in the study of Demodex infestation in China, but a unified introduction and evaluation of the operating procedures is lacked. A quick and accurate clinical diagnostic method for Demodex infestation needs to be further studied. Objective This study aimed to establish operation procedures for the clinical examination of eyelid Demodex infestation, which were applied to evaluate the conditions of eyelid Demodex infestation in ocular patients with discomfort. Methods One thousand and fifty-two patients with eye dryness, eye itchiness or other symptoms were selected for slit lamp examination and photographing of the eyelid margin area. Three eyelashes with associated scurf from each superior eyelid were plucked out for examination of Demodex under the microscope. Positive findings included observation of Demodex mites or eggs. Their amounts were recorded individually for all eyelash samples. Results A procedure for observing,reeording and reporting eyelid Demodex infestations in patients was successfully established. By using this procedure, 1 052 patients were investigated for the examination of Demodex infestations. Demodex mites or eggs were found in 582 eases （55.3%）. The positive rate of Demodex infestation increased with age, and the population over 60 years group had the highest positive rate, showing a significant differenee among the different age groups （χ^2= 10. 547 ,P=0. 001 ）. There was no significant difference in positive rate between male patients and female patients （ P = 0. 352）. The test turnaround time （TAT） for one examination was （11.4 ± 5.2） seconds. Conclusions The operational procedure for examining the palpebral margin Demodex infestation by the slit-lamp, optical microscope, photographing and laboratory reports is established. It is simple and quick in the appliation for the elinieal diagnosis of eyelid Demodex infestation.