糖尿病患者干眼症的发病机制及治疗研究进展

Research progress on pathogenesis and treatment of dry eye in patients with diabetes mellitus

糖尿病是一种以高血糖为特征的代谢性疾病。糖尿病患者长期血糖控制不佳,可导致多种并发症。糖尿病患者是眼部疾病高发人群,据统计,由于糖尿病引发的眼部并发症患者占糖尿病患者的47%~64%。干眼症是临床常见的糖尿病眼部并发症之一,约占糖尿病眼部疾病的53.6%,这是由于糖尿病人群长期处于高血糖状态,影响患者正常的免疫功能、新陈代谢和细胞凋亡,对其眼表结构产生影响,导致角膜上皮、角膜基层、角膜神经等发生改变,最终引起干眼症。干眼症是以泪膜失衡和眼部不适为主要临床特征,可由多种因素致病,炎症是其发病机制中的最关键因素,此外泪液成分、泪膜稳定性、泪液渗透压和性激素水平的改变以及细胞凋亡等也参与了干眼症的发病过程。本文就糖尿病患者干眼症的发病机制及治疗研究进展进行综述,为临床糖尿病患者干眼症的治疗提供帮助。

Diabetes mellitus is a metabolic disease characterized by hyperglycemia.Poor long-term blood glucose control in patients with diabetes mellitus can lead to many complications.Diabetes mellitus patients are the people with high incidence of eye diseases.According to statistics,eye complications caused by diabetes mellitus account for 47%-64% of diabetes mellitus patients.Dry eye disease is one of the most common ocular complications of diabetes mellitus,accounting for 53.6% of diabetes mellitus ophthalmopathy.This is because diabetes mellitus people are in a state of hyperglycemia for a long time,which affects their normal immune function,metabolism and cell death,and affects their ocular surface structure,leading to changes in corneal epithelium,corneal base and corneal nerve,and finally causes dry eye disease.Dry eye is characterized by tear film imbalance and eye discomfort.It can be caused by many factors.Inflammation is the most critical factor in its pathogenesis.In addition,the changes in tear composition,tear film stability,tear osmotic pressure and sex hormone levels,and cell apoptosis also participate in the pathogenesis of dry eye.This article reviews the pathogenesis and treatment of dry eye in patients with diabetes mellitus,in order to provide help for the treatment of dry eye in patients with diabetes mellitus.