| 新型角膜地形综合分析仪与McMonnies问卷在干眼诊断中的临床应用 |
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| 引用本文： | 李军花,赵云娥,林晓蕾,查亚萍,廉恒丽.新型角膜地形综合分析仪与McMonnies问卷在干眼诊断中的临床应用[J].眼科新进展,2015,0(11):1060-1063. |
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| 作者姓名： | 李军花 赵云娥 林晓蕾 查亚萍 廉恒丽 |
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| 作者单位： | 310000 浙江省杭州市，温州医科大学附属眼视光医院杭州院区角膜病专科 |
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| 摘 要： | 目的 研究各项主、客观干眼检测项目之间的相关性及各项干眼检测项目与干眼诊断之间的相关性。方法 本研究为横断面研究，共纳入１１６例以“眼干”为主诉的连续的门诊患者，按序进行ＭｃＭｏｎｎｉｅｓ问卷调查，角膜地形综合分析仪测量泪河高度、非侵入式泪膜破裂时间（ｎｏｎｉｎｖａｓｉｖｅｔｅａｒｂｒｅａｋｕｐｔｉｍｅ，ＮＩ-ＢＵＴ）及眼红分析，传统的泪膜破裂时间（ｔｅａｒｂｒｅａｋｕｐｔｉｍｅ，ＢＵＴ）测定（荧光素试纸条法），荧光素钠眼表染色，ＳｃｈｉｒｍｅｒＩ试验，并根据检测结果诊断是否患有干眼，将检测值进行相关性统计学分析。结果 １１６例连续病例中８５例诊断为干眼；无论是干眼组还是非干眼组，首次ＮＩ-ＢＵＴ均短于平均ＮＩ-ＢＵＴ，两者之间差异有统计学意义（ｔ＝－６．６３６，Ｐ＜０．００１；ｔ＝－４．６５２，Ｐ＜０．００１）。各项检测项目之间的相关性分析结果:平均ＮＩ-ＢＵＴ与ＮＩ-ＢＵＴ分级呈负相关（ｒ＝－０．９２０，Ｐ＜０．００１）；首次ＮＩ-ＢＵＴ与平均ＮＩ-ＢＵＴ呈正相关（ｒ＝０．８１５，Ｐ＜０．００１）；首次ＮＩ-ＢＵＴ与ＮＩ-ＢＵＴ分级呈负相关（ｒ＝－０．７３８，Ｐ＜０．００１）；平均ＮＩ-ＢＵＴ与角膜荧光素染色评分呈负相关（ｒ＝－０．３４８，Ｐ＜０．００１）；ＮＩ-ＢＵＴ分级与角膜荧光素染色评分呈正相关（ｒ＝０．３４１，Ｐ＜０．００１）；首次ＮＩ-ＢＵＴ与角膜荧光素染色评分呈负相关（ｒ＝－０．２９８，Ｐ＝０．００１）；首次ＮＩ-ＢＵＴ与ＭＱ问卷得分呈负相关（ｒ＝－０．１９６，Ｐ＝０．０３５）；角膜荧光素染色评分与ＭＱ问卷得分呈正相关（ｒ＝０．１８９，Ｐ＝０．０４２）。各项检测项目与干眼诊断之间的相关性分析结果:泪河高度、平均ＮＩ-ＢＵＴ、ＮＩ-ＢＵＴ分级与干眼诊断之间存在相关性，相关性由强至弱的排序为泪河高度（Ｂ＝－１８．１５２，Ｐ＜０．００１）、ＮＩ-ＢＵＴ分级（Ｂ＝７．３８９，Ｐ＜０．００１）、平均ＮＩ-ＢＵＴ（Ｂ＝０．６６５，Ｐ＝０．００５），而首次ＮＩ-ＢＵＴ与干眼诊断之间并无相关性（Ｂ＝－０．１２８，Ｐ＝０．３４４）。结论 泪河高度、平均ＮＩ-ＢＵＴ、ＮＩ-ＢＵＴ分级与干眼诊断之间存在相关性；与首次ＮＩ-ＢＵＴ相比，平均ＮＩ-ＢＵＴ对干眼诊断的意义更大。
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| 关 键 词： | 非侵入式泪膜破裂时间 泪河高度 干眼 相关性 |
Application of a newly developed keratograph and McMonnies questionnair in diagnosis of dry eye disease |
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| LI Jun-Hua,ZHAO Yun-E,LIN Xiao-Lei,ZHA Ya-Ping,LIAN Heng-Li.Application of a newly developed keratograph and McMonnies questionnair in diagnosis of dry eye disease[J].Recent Advances in Ophthalmology,2015,0(11):1060-1063. |
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| Authors: | LI Jun-Hua ZHAO Yun-E LIN Xiao-Lei ZHA Ya-Ping LIAN Heng-Li |
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| Affiliation: | Department of Cornea,the Eye Hospital of Wenzhou Medical University,Hangzhou 310000,Zhejiang Province．China |
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| Abstract: | Objective To investigate the correlation between subjective or objective diagnostic parameters of dry eye disease, and study the correlation between these parameters and the diagnosis of dry eye disease. Methods This cross-sectional study consecutively recruited 116 patients with the chief complaint of eye dryness in the outpatient service. McMonnies questionnair. Keratograph, traditional tear break-up time ( BUT) , Schirmer I test and corneal fluorescein staining were evaluated in sequence. The Keratograph were applied to evaluate tear meniscus height, noninvasive tear break-up time( NI-BUT) and red eye index. Dry eye were diagnosed according to the results and correlation analysis were employed between parameters. Results In the 116 patients , 85 patients were diagnosed as dry eye. The first NI-BUT was significantly lower than the average NI-BUT in both dry eye group and non-dry eye group ( t = - 6. 636 ,P < 0. 001 ; t = - 4. 652 .P < 0. 001 ) . The correlation between the parameters were as follows : The average NI-BUT showed a negative correlation with NI-BUT grading ( r = - 0. 920, P < 0. 001). The first NI-BUT positively correlated with average NI-BUT ( r = 0. 815.P < 0. 001). The first NI-BUT exhibited a negative correlation with NI-BUT grading ( r = - 0. 738 .P < 0. 001 ) . The average NI-BUT showed a negative correlation with corneal fluorescein staining( r = - 0. 348 ,P < 0. 001 ) . The NI-BUT grading positively correlated with corneal fluorescein staining ( r = 0. 341 ,P < 0. 001 ) . The first NI-BUT presented a negative correlation with corneal fluorescein staining ( r = - 0. 298 ,P = 0. 001 ) and McMonnies questionnaire ( r = - 0. 196 ,P = 0. 035 ) . The corneal fluorescein staining demonstrated a positive correlation with McMonnies questionnaire ( r = 0. 189 .P = 0. 042) . The correlation between parameters and diagnosis of dry eye were as follows : The tear meniscus height, average NI-BUT and NI-BUT grading all correlated significantly with the diagnosis of dry eye. The correlation coefficient ranking from strong to weak were the tear meniscus height (B = - 18. 152 .P < 0. 001 ) , the NI-BUT grading (B = 7. 389 ,P < 0. 001) and the average NI-BUT ( B = 0. 665 .P = 0. 005 ) . However , the first NIBUT exhibited no correlation with the diagnosis of dry eye. Conclusion The tear meniscus height, average NI-BUT and NI-BUT grading correlate significantly with the diagnosis of dry eye. The average NI-BUT is a more reliable parameter to diagnose dry eye compared to the first NI-BUT. |
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| Keywords: | nonrnvasive tear break-up time tear meniscus height dry eye correlation |
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