眼表综合分析仪对糖尿病患者睑板腺功能障碍的临床意义

Clinical significance of ocular surface analyzer for meibomian gland dysfunction in diabetic patients

目的:分析眼表综合分析仪对糖尿病(DM)患者睑板腺功能障碍(MGD)的应用价值。方法:选择河北省眼科医院2017-05/2021-05期间收治的2型糖尿病(T2DM)患者,按病程分为3组,短病程组(DM病程<5a)37例,中病程组(5a<DM病程<10a)31例,长病程组(DM病程≥10a)34例。以非DM患者作为对照组,比较四组患者的眼表疾病指数(OSDI)、泪河高度(TMH)、非侵入式泪膜破裂时间(NIBUT)、泪膜脂质层厚度(LLT)及睑板腺缺失情况。结果:不同病程DM患者OSDI显著高于对照组(均P<0.05),TMH、首次NIBUT、平均NIBUT均显著低于对照组(P<0.05),随着DM的病程发展,患者OSDI逐渐上升,TMH、首次NIBUT、平均NIBUT逐渐下降。四组患者LLT分级、睑板腺缺失分级之间均具有等级差异(P<0.05),随着DM的病程发展,LLT 1级患者逐渐增加,LLT 2级患者逐渐减少,睑板腺缺失0级患者逐渐减少,1级患者逐渐增加。结论:眼表综合分析仪评价DM患者MGD应用效果良好,可以精准客观地评价睑板腺的功能与形态,利于DM患者MGD的早期诊断及后续治疗方案制定。

AIM:To analyze the application value of ocular surface analyzer in meibomian gland dysfunction(MGD)of patients with diabetes mellitus(DM).METHODS:Patients with type 2 diabetes mellitus(T2DM)admitted to Hebei Eye Hospital between May 2017 and May 2021 were selected.They were divided into three groups according to the course of disease,with 37 cases in short-term goup(DM course<5a),31 cases in medium-term group(5a<DM course<10a)and 34 cases in long-term group(DM course≥10a).Meanwhile,patients without diabetes mellitus(DM)were selected as the control group.The ocular surface disease index(OSDI),tear meniscus height(TMH),non-invasive first tear film break-up time(NIBUT),lipid layer thickness(LLT)and absence of meibomian gland were compared among the four groups.RESULTS:Patients with different course of DM had significantly higher OSDI than the control group(all P<0.05),and their TMH,first NIBUT,and mean NIBUT were significantly lower than those of the control group(P<0.05).With the progression of DM,the OSDI gradually increased,while TMH,first NIBUT and mean NIBUT decreased.The grades of LLT and absence of meibomian gland were different in the four groups(P<0.05).As DM progressed,patients with grade 1 LLT increased,while patients with grade 2 LLT decreased.Moreover,patients with grade 0 absence of meibomian gland decreased,while those with grade 1 increased.CONCLUSION:Ocular surface analyzer is helpful for evaluating MGD in patients with DM.It can accurately and objectively evaluate the function and morphology of meibomian gland,which is beneficial to early diagnosis and subsequent treatment of MGD in patients with DM.