干燥综合征患者毛囊蠕形螨感染的相关因素

Analysis of Relevant Factors in Demodex Folliculorum Infection in Sjögren's Syndrome Patients

目的:探讨干燥综合征(SS)患者的睫毛毛囊蠕形螨感染状况及其与眼表特征的相关性。方法:病例对照研究。收集2019年1─6月于北京大学人民医院干眼门诊就诊的SS患者22例(44眼)作为SS组,同期在干眼门诊就诊的非SS的干眼病患者21例(42眼)作为对照组(非SS组)。2组患者均进行5项干眼问卷(DEQ-5)和眼表疾病指数量表、无创伤泪河高度、无创伤泪膜破裂时间、睑板腺缺失比例、荧光素染色角膜评分、睫毛毛囊蠕形螨计数的检查。2组间计量资料比较采用t检验,计数资料比较采用卡方检验和Fisher确切概率法;计量变量间的相关性判定采用Spearman相关性分析。结果:非SS组蠕形螨数量明显高于SS组(Z=-2.41,P=0.021)。SS组患者蠕形螨检出的数量与睑板腺缺失比例(r=0.40,P=0.02)和DEQ-5量表的分数(r=-0.70,P=0.02)存在相关性,而在非SS组患者蠕形螨检出的数量仅与DEQ-5量表的分数存在相关性(r=0.63,P=0.04)。而当按照蠕形螨阳性与阴性分类时,2组间仅睑板腺缺失比例差异有统计学意义(Z=3.214,P=0.002)。结论:相比非SS干眼患者,SS患者睫毛毛囊蠕形螨检出数量更少。DEQ-5量表分数、上睑板腺缺失比例与蠕形螨的检出数量相关。

Objective:To investigate the infection of demodex folliculorum in patients with Sjögren's syndrome(SS),and to determine the correlative relationship between demodexin eyelashes and the ocular surface characteristics.Methods:In this case control study,22 patients(44 eyes)with SS(SS group,study group)and 21 dry eye patients(42 eyes)without SS(non-SS group,control group)were recruited from Peking University People's Hospital from January to June 2019.The 5-item dry eye questionnaire(DEQ-5),ocular surface disease index,non-invasive tear meniscus height,non-invasive break up time,corneal staining score,the drop out of the upper meibomian gland and the number of demodex in eyelashes were examined in both groups.A t test was used to compare the continuous variables differences between the two groups,a Chi-square test and Fisher's exact test were used to compare the categorical variables between the two groups,and Spearman correlation analysis was used to determine the correlation between the continuous variables of the 2 different groups.Results:The number of mites in the non-SS group was significantly higher than that of the SS group(Z=-2.41,P=0.021).The number of mites in the SS group was correlated with the score on the DEQ-5 scale(r=0.40,P=0.02)and the drop out of the upper meibomian gland(r=-0.70,P=0.02),while the number of mites in the non-SS group was only correlated with the score on the DEQ-5 scale(r=0.63,P=0.04).There was a significant difference in the drop out of the upper meibomian gland between the Demodex positive group and Demodex negative group(Z=3.214,P=0.002).Conclusions:The number of demodex in the SS group is lower than that in the non-SS group.The score on the DEQ-5 scale and the drop out of the upper meibomian gland are correlated with demodex in the eyelashes.