环境湿度与青年人泪膜稳定性的相关性分析

Influence of environmental humidity on the stability of young people's tear film

目的:探讨环境湿度与青年人泪膜稳定性的相关性。方法:选取2015年10月至2016年12月于河南省开封市中心医院接受角膜屈光手术的患者209例(417眼),年龄17~35岁,平均(22.47±4.74)岁;男133例(265眼)、女76例(152眼)。根据四季测得的不同环境湿度,将患者分为3组:环境湿度<40%为低湿度组(n=76,151眼),环境湿度40%~70%为中湿度组(n=75,150眼),环境湿度>70%为高湿度组(n=58,116眼)。患者在各组特定的环境下停留1h后进行干眼主观问卷调查。采用Keratograph眼表综合分析仪测量非侵入性平均泪膜破裂时间、非侵入性泪河高度、脂质层评分,并进行泪液分泌试验。将3组数据进行单因素方差分析,比较不同环境湿度下各参数间的差异。结果:高湿度组患者主观调查评分为(1.37±1.52)分,低于低、中湿度组[(1.92±1.83)分、(1.87±1.76)分],差异有统计学意义(P<0.05)。低湿度组患者泪膜破裂时间为(10.67±4.41)s,短于中、高湿度组[(12.42±4.47)s、(12.81±5.32)s],差异有统计学意义(P=0.001,P=0.000)。高湿度组患者非侵入性泪河高度为(0.26±0.06)mm,高于低、中湿度组[(0.24±0.06)mm、(0.24±0.07)mm],差异有统计学意义(P=0.000,P=0.017)。低湿度组患者脂质层评分为(1.43±1.28)分,高于中、高湿度组[(0.51±0.95)分、(0.36±0.91)分],组间差异有统计学意义(P=0.000,P=0.000)。3组间荧光素染色评分差异均无统计学意义;3组间泪液分泌试验结果差异无统计学意义。结论:环境湿度与泪膜稳定性密切相关,湿度越高泪膜稳定性越好;当湿度>40%时,泪膜破裂时间及脂质层评分明显改善,利于保持泪膜稳定性。

Objective：To explore the relationship between the environmental humidity and the stability in various parameters regarding the tear film of the yong people. Methods：209 patients aging from 17 to 35 years old （417 eyes）, 133 male patients （265 eyes） and 76 female patients （152 eyes） were enrolled in this study from October 2015 to December 2016. Average age was （22.47±4.74） yeras old. According to the different environmental humidity during their treatment, they were divided into 3 groups： environmental humidity〈40% was taken as low humidity group, 76 patients（151 eyes）; that between 40%~70% was taken as middle humidity group, 75 patients （150 eyes）; and that 〉70% was taken as high humidity group , 58 patients （116 eyes）. Keeping the patients staying under the specific environment for 1 hour respectively, and then consulting them regarding the dry eye questionnaire, and measure the average breakup time in non-invasive tear film, the height in non-invasive tear meniscus, the score in lipid layer and the lacrimal secretion test with Keratograph ocular surface synthesis analyzer, three sets of different data were analyzed by one way ANOVA. The difference between the parameters under different environmental humidity was analyzed. Results：The analysis resulting from the dry eye subjective questionnaire indicated that the grading result of high humidity group respectively was （1.37±1.52） s, which was lower than that of the low and middle group, （2.27±2.11） s and （1.97±1.82） s, the difference between two groups had statistical sense （P〈 0.05）. The breakup time of tear film in the low humidity group was （10.67±4.41） s, which was shorter than the other two groups （[12.42±4.47] s and [12.81±5.32] s）, the difference both between these three groups （P=0.001,P〈0.001） were with statistical significance. The results of the height in non-invasive tear meniscus among the high humidity group was （ 0.24± 0.06） mm, higher than the other two groups which were （0.24±0.07） mm, （0.26±0.06） mm, respectively. The difference between three groups（P〈0.001,P=0.017） were statistically significant; the lipid layer grading results of the low humidity group was 1.43±1.28, higher than the other two groups （0.51±0.95 and 0.36±0.91）, both the difference between groups （P〈0.001,P〈0.001） were statistically significant. The fluorescein stain score of the three groups respectively was 0.09± 0.36, 0.05±0.21, and 0.03±0.16, the differences among the three groups were all out of statistic significance. The lacrimal secretion test results of the three groups respectively was （17.65±8.81） mm, （19.13±9.53） mm, and （18.94± 9.62） mm, and the difference among the three groups had no statistic significance. The difference among the three groups of the lacrimal secretion test had no statistic significance. Conclusions：The stability of the tear film is closely related to the environmental humidity, the higher the humidity is, the better stability the tear film has. When the humidity is more than 40%, the stability of the tear film will be maintained in the breakup time of the tear film and the scores in the lipid layer.