李玲　李越虹

【摘要】 目的：研讨糖尿病短泪膜破裂时间型干眼患者的具体症状和体征。方法：从2018年3-11月笔者所在医院选取60例糖尿病短泪膜破裂时间型干眼患者作为观察组，另选取40例非糖尿病短泪膜破裂时间型干眼患者作为对照组，对比分析糖尿病短泪膜破裂时间型干眼患者的具体症状和体征。结果：两组眨眼频率及角膜荧光素钠染色评分比较差异无统计学意义（P>0.05），观察组SPEED评分高于对照组，差异有统计学意义（P<0.05）;观察组平均脂质层厚度薄于对照组，睑板腺拍照评分高于对照组，差异均有统计学有意义（P<0.05）。结论：在干眼症患者中，有糖尿病病史的患者睑板腺缺失或短缩的程度更大，从而让平均脂质层厚度变得更薄，进一步导致泪膜破裂时间更短，在临床上值得研究探讨。

【关键词】 短泪膜破裂时间 糖尿病 干眼 症状体征

doi：10.14033/j.cnki.cfmr.2020.16.054 文献标识码 B 文章编号 1674-6805（2020）16-0-03

Analysis of Symptoms and Signs of Diabetic Dry Eye Patients with Short Tear Film Rupture Time/LI Ling， LI Yuehong. //Chinese and Foreign Medical Research， 2020， 18（16）： -134

[Abstract] Objective： To study and analyze the specific symptoms and signs of diabetic dry eyes with short tear film rupture time. Method： From March to November 2018， 60 cases of diabetic short tear film rupture time dry eye patients were selected as the observation group， and 40 cases of non diabetic short tear film rupture time dry eye patients were selected as the control group. The specific symptoms and signs of diabetic short tear film rupture time dry eye patients were compared and analyzed. Result： There was no significant difference in blink frequency and corneal fluorescein sodium staining scores between the two groups （P>0.05）， the SPEED score in the observation group was higher than that in the control group， the difference was statistically significant （P<0.05）. The mean lipid layer thickness in the observation group was thinner than that in the control group， and meibomian gland photography score was higher than that in the control group， the differences were statistically significant （P<0.05）. Conclusion： In patients with xerophthalmia， the degree of loss or shortening of meibomian gland is greater in patients with a history of diabetes， which makes the average lipid layer thickness thinner and further leads to shorter tear film rupture time， which is worthy of clinical study.

[Key words] Short tear film rupture time Diabetes Dry eyes Symptoms and signs

First-authors address： Beijing Zhongguancun Hospital， Beijing 100190， China

干眼是一種非常常见的疾病，可因很多因素引起，其主要症状表现为眼睛干涩，是泪液量或质的不正常状态导致的泪液分泌障碍性的眼部疾病，根据国际方面最新干眼的定义，干眼概述为眼部表面的多因素疾病，所伴有的眼部症状常有眼部有氧感、畏光视物模糊等[1-3]。干眼主要的发病进程是由于具有不稳定和高渗特征的泪液、眼部浅表炎症性疾病和非正常的眼部神经感觉一同参与表达的，通过医院大数据显示，逐年递增的患者因异常流泪、畏光等眼部不适来院就诊，在诊疗的过程中发现，有一半或以上的干眼患者均曾患有糖尿病或检查过程中发现患有糖尿病，由此引起了重视[4-5]。根据世界卫生组织数据调查显示，中国普通工薪阶层家庭有9.4%为糖尿病患者，值得注意的是众所周知的糖尿病并发症的眼部方面主要是白内障及视网膜的病变，很少方向研究糖尿病对于眼部浅表状况的影响。为了……