Keratograph 5M眼表综合分析仪在观察鼻咽癌放疗患者泪膜及睑板腺功能变化中的应用

Evaluation of tear film and meibomian gland function in nasopharyngeal carcinoma patients before and after radiotherapy using Keratograph 5M

目的用非侵入式眼表综合分析仪来观察鼻咽癌患者放疗前后泪膜及睑板腺功能的变化。方法选取60例鼻咽癌接受放疗的男性患者右眼共60眼,对所有研究对象在放疗前及放疗后分别行OSDI问卷调查,裂隙灯检查及眼表综合分析仪Keratograph 5M检查,比较泪膜及睑板腺功能的变化。结果患者放疗后OSDI评分、睑板腺开口状况评分、睑板腺分泌物性状评分及睑板腺缺失评分均高于放疗前,差异均有统计学意义(Z=5.376,4.914,6.452,5.84,P<0.001),但泪河高度、泪膜首次破裂时间及平均破裂时间均较放疗前下降,差异均有统计学意义(Z=5.67,4.745,4.803,P<0.001)。结论Keratograph 5M眼表综合分析仪可无创客观的评价鼻咽癌患者放疗前后泪膜及睑板腺功能的变化,睑板腺的放射性损伤可能是导致鼻咽癌放疗后患者出现泪膜破裂时间下降、泪河高度降低等改变的原因之一。

Objective Evaluation of tear film and meibomian gland function in nasopharyngeal carcinoma(NPC)patients before and after radiotherapy using Keratograph 5M.Methods A total of 60 male patients(60 right eyes)following radiotherapy for NPC were recruited.All subjects finished following tests or examinations before and after radiotherapy:Ocular Surface Disease Index(OSDI)questionnaire,slit-lamp examination,and Keratograph 5M,tear film and meibomian gland function changes were compared.Results OSDI score,meibomian gland orifice scores,meibomian gland secretion scores,and meibomian gland dropout scoreswere higher than that before radiotherapy,and there were significant differences(Z=5.376,4.914,6.452,5.84,P<0.001),but the tear meniscus height(TMH),the first and average noninvasive tear break-up time become lower than that before radiotherapy,and the differences were statistically significant.(Z=5.67,4.745,4.803,P<0.001).Conclusion The Keratograph 5M appears to provide an effective noninvasive method for assessing the function of tear film and meibomian gland of NPC patients before and after radiotherapy,radiation injury of meibomian gland may be one of the reasons for the change of NIBUT and TMH after radiotherapy for NPC patients.