儿童睑缘炎患者中蠕形螨感染情况的研究

Research on demodex folliculorum infestation in blepharitis in children

目的研究儿童睑缘炎疾病中蠕形螨感染情况。方法前瞻性非随机对照研究。选取武汉爱尔眼科医院汉口医院2020年1月至12月小儿眼科因异常瞬目、揉眼等眼表问题来门诊就诊,临床诊断为睑缘炎的14岁以下眼病患儿73例(73眼)作为观察组,症状较重眼纳入本研究,再选取14岁以下健康体检的非睑缘炎儿童20例作为对照组(右眼纳入研究),所有受试者均使用眼表综合分析仪检查泪河高度、泪膜破裂时间及睑板腺照相,激光扫描共聚焦显微镜检查睫毛及毛囊蠕形螨感染情况。结果观察组睑缘炎患儿中蠕形螨感染60眼,阳性率为82.19%(60/73),对照组非睑缘炎儿童20眼中蠕形螨感染3眼,阳性率为15.00%。两组检出率差异有统计学意义(χ^(2)=4.14,P=0.042);蠕形螨感染患儿干眼症的发生率68.25%(43/63),明显高于非蠕形螨感染患儿13.33%(4/30),差异有统计学意义(χ^(2)=24.52,P<0.001);蠕形螨感染组患儿睑板腺缺失程度明显高于非蠕形螨感染组,差异有统计学意义(Z=3.21,P=0.001)。结论儿童蠕形螨感染导致的睑缘炎发病率高,并可能导致干眼、睑板腺功能障碍等眼表并发症的发生。

Objective To research the prevalence of demodex folliculorum in blepharitis in children.Methods A prospective non-randomized controlled study was done from Jan.to Dec.2020 in Hankou Hospital,Wuhan Aier Eye Hospital.Seventy-three eyes of 73 patients under 14 years old who were clinically diagnosed as blepharitis because of abnormal blinking or eye rubbing were divided into the observation group and 20 patients under 14 years old without blepharitis into the control group,while only the eye with more severe symptoms was included in the observation group and the right eye in the control group.All patients underwent the Oculus Keratograph to detect the first non-invasive tear break-up time(fNITBUT),average non-invasive tear break-up time(avNITBUT),and lower tears meniscus height(TMH).And the meibomian gland loss score was calculated.After that,all of them were examined by the in-vivo confocal microscopy of the demodex folliculorum infection.Results Sixty eyes(82.19%,60/73)with blepharitis in the observation group were infected with demodex folliculorum,while 3 eyes of 20 eyes(15.00%)without blepharitis in the control group were infected.The difference between the two groups was statistically significant(χ^(2)=4.14,P=0.042).The incidence of dry eye in children with demodex folliculorum infection was 68.25%(43/63),which was significantly higher than that in children without demodex folliculorum infection(13.33%,4/30)(χ^(2)=24.52,P<0.001).The degree of meibomian gland loss in demodex folliculorum infection group was significantly higher than that in the non-demodex folliculorum infection group(Z=3.21,P=0.001).Conclusion High prevalence of blepharitis patients caused by demodex folliculorum in children,which may lead to dry eye,meibomian gland dysfunction and other ocular surface complications.