不同浓度荧光素钠液对检测泪膜破裂时间的稳定性比较

Comparison of the stability of different concentrations of fluorescein sodium on the detection of tear film rupture time

目的:分析不同浓度荧光素钠液对检测泪膜破裂时间(TBUT)的稳定性。方法:回顾性分析2019-08/2021-09来我院干眼门诊配合良好者150例150眼的临床资料,将受试者随机分成0.5%荧光素钠FLS、1.0%FLS、1.5%FLS、2.0%FLS、荧光素钠平行(FLSP)五组,每组30例30眼(均以右眼为受试眼),各组分别滴入对应的荧光素钠液,FLSP组为荧光试纸条检测组。比较不同浓度组裂隙灯图像评分及荧光素钠存活时间,观察各组即时,2、5、10、15、30min的TBUT。结果:0.5%FLS组图像评分明显高于其他四组(t=7.746、21.483、116.190、38.730,均P<0.01),1.0%FLS组图像评分明显高于1.5%FLS组、2.0%FLS组(t=10.742、15.492,均P<0.01)。0.5%FLS组荧光素染色持续时间明显短于其他四组(t=8.226、7.458、9.159、12.347,均P<0.01),1.5%FLS组荧光素存活时间明显长于1.0%FLS组、2.0%FLS组(t=15.428、13.274,均P<0.05)。0.5%FLS组TBUT在2min时明显高于其他四组(t=22.767、22.345、15.494、17.213,均P<0.01),在10min时明显低于其他四组(t=23.266、25.353、10.183、22.025,均P<0.01)。1.5%FLS组平均首次TBUT明显短于其他四组(t=25.236、21.374、19.658、72.341,均P<0.01),FLSP组平均首次TBUT明显长于其他四组(t=22.487、30.267、60.247、40.857,均P<0.01)。TBUT与眼表疾病指数(OSDI)、泪河高度无相关(r=-0.072、0.219,P=0.689、0.112),TBUT与泪液分泌呈正相关(r=0.674,P<0.01)。结论:0.5%FLS图像质量较高,但只适合在5min内观察染色,FLSP组更适合临床较长时间观察角膜荧光染色;1.5%FLS是最为稳定和可靠的浓度和剂量,可用于TBUT的检测。

AIM: To analyze the stability of different concentrations of fluorescein sodium solution on the detection of tear break-up time(TBUT).METHODS:A retrospective study. A total of 150 cases(150 eyes) who came to our dry eye clinic with good cooperation from August 2019 to September 2021 were selected for the study, and the subjects were randomly divided into five groups, which were fluorescein sodium(FLS, 0.5%), FLS(1.0%), FLS(1.5%), FLS(2.0%) and fluorescein sodium parallel(FLSP), with 30 patients in each group(all the right eyes were the subject eyes). Each group was dripped with the corresponding fluorescein sodium. The FLSP group was the fluorescent test strip detection group. The slit lamp image scores of different concentration groups were compared, the survival time of sodium fluorescein at the instant, 2, 5, 10, 15 and 30 min points was observed in each group, and the mean value of TBUT in each group was recorded.RESULTS: The image score of FLS(0.5%) group was significantly higher than that of the other four groups(t=7.746, 21.483, 116.190, 38.730, all P<0.01). The image score of FLS(1.0%) group was significantly higher than that of FLS(1.5%) and FLS(2.0%) group(t=10.742, 15.492, all P<0.01). The survival time of fluorescein in FLS(0.5%) group was significantly shorter than that of the other four groups(t=8.226, 7.458, 9.159, 12.347, all P<0.01). The survival time of fluorescein in FLS(1.5%) group was significantly longer than that of FLS(1.0%) and FLS(2.0%) group(t=15.428, 13.274, all P<0.05). TBUT in FLS(0.5%) group was significantly higher than that of the other four groups at 2 min(t=22.767, 22.345, 15.494, 17.213, all P<0.01), and was significantly lower than that of the other four groups at 10 min(t=23.266, 25.353, 10.183, 22.025, all P<0.01). The mean first TBUT of FLS(1.5%) group was significantly shorter than that of the other four groups(t=25.236, 21.374, 19.658, 72.341, all P<0.01), and the mean first TBUT of FLSP group was significantly longer than that of the other four groups(t=22.487, 30.267, 60.247, 40.857, all P<0.01). There was no significant correlation between TBUT and ocular surface disease index(OSDI) and tear river height(r=-0.072, 0.219, P=0.689, 0.112). TBUT was positively correlated with tear secretion(r=0.674, P<0.01).CONCLUSION: FLS(0.5%) had higher image quality but it was only suitable for observing staining within 5 min, and the FLSP group was more suitable for clinical observation of corneal fluorescence staining for a longer period;FLS(1.5%) was the most stable and reliable concentration and dose for the detection of TBUT.