睑板腺分泌异常与干眼症的临床研究

目的：探讨异常睑板腺分泌物和干眼症的关系。方法：在门诊连续观察52例共104眼。常规检查裸眼视力、矫正视力,并行眼球前段及眼底检查。进行泪膜破裂时间（BUT）、Schirmer Ⅰ试验,观察记录睑板腺分泌物的性质。按病情轻重将干眼症分为轻度和重度。结果：透明蛋清样分泌物20眼,奶黄样分泌物20眼,颗粒状分泌物22眼,牙膏状分泌物42眼。本组共有46眼（44%）符合干眼症诊断标准,各组患干眼症的构成比依次升高,透明样（2/20）10%、奶黄样（4/20）20%、颗粒状（6/22）27%、牙膏状（34/42）81%。牙膏状分泌物组的BUT和荧光素钠积分明显高于其他3组（两两比较,P均〈0.01）。各组SchirmerⅠ积分均在1分以下,组间比较差异无统计学意义。透明样和奶黄样分泌物组无重度干眼症患者,6眼颗粒状分泌物中重度干眼症占2眼,而34眼牙膏状分泌物中16眼发生重度干眼症。牙膏状分泌物发生重度干眼症高于非牙膏状类型分泌物（P〈0.05）。结论：异常睑板腺分泌物影响眼表面的稳定性,其中牙膏状分泌物患者干眼症程度较其它分泌物组重。

Abnormal Property of Meibomian Secretion and Dry Eye Syndrome

Objective：To study the relationship between meibomian secretion and dry eye.Methods：To observe 52 outpatients（104 eyes）consecutively.Routine check upincluded vision,anterior segment and fundus,scoring of tear break up time（BUT）,Schirmer Ⅰ test and fluorescein staining.Recorded the property of meibomian secretion.Defined the dry eye as mild and severe.Results：Meibomian secretion was sorted as egg-white-1ike secretion（n=20）,milk yellowish secretion（n=20）,granular secretion（n=22）and toothpaste-like secretion
（n = 42）. 46 eyes（44 % ）met the criteria of dry eye syndrome. The incidence of dry eye stepped up in groups as egg - white - like secretion （ 2/20 ） 10 %、 milk - yellowish secretion （4/20） 20 % 、 granular secretion （ 6/22 ） 27 % and toothpastelike secretion（34/42）81%. The result declared that BUT and fluorescein scoring was higher in toothpaste - like secretion than in other groups（all P 〈 0.01）. Schirmer Ⅰscoring was below 1 in all groups, and there was no difference in the groups. The incidence was higher in granular secretion than in egg - white - like secretion（P 〈 0.05）, while the incidence was higher in toothpastelike secretion than in any of other 3 groups （P 〈 0.01 ）. There was no severe dry eye in egg - white - like secretion and milk - yellowish secretion, while dry eye was found in 2 out of 6 in granular secretion, and in 16 out of 34 in toothpaste - like secretion. Incidence of severe dry eye was found higher in toothpastelike secretion than in non toothpastelike secretion （P 〈 0.05）. Conclusion： Abnormal meibomian secretion affects the stability of ocular surface. The patients with toothpaste - like secretion are prone to dry eye and tend to have a worse dry eye than other secretion groups.