2型糖尿病患者脂代谢异常和干眼的相关性研究

目的:探讨2型糖尿病患者脂代谢异常和干眼的相关性。方法:收集2型糖尿病患者77例（154只眼），分为A组（脂代谢异常）40例和B组（脂代谢正常）37例，所有受试者全部进行眼表疾病指数问卷（OSDI量表）、泪膜破裂时间（ BUT）、泪液分泌试验（Schirmer Ⅰ test）、角膜荧光素钠染色、眼表分析[睑板腺缺失评分、泪河高度（TMH）、非侵入性平均泪膜破裂时间（NIBUT）]、脂质层厚度分析等干眼相关检查，对两组结果进行统计学分析，分析2型糖尿病患者合并脂代谢异常和干眼的关系。结果:A组干眼发生率为73.75%，B组为55.41%，两组间有统计学差异（χ2=5.682，P=0.017）。A组干眼OSDI量表指数（t=-8.357，P=0.000）、BUT（Z=-4.245，P=0.000）与B组有统计学差异，OSDI量表指数与总胆固醇（r=0.706，P=0.000）、低密度脂蛋白-胆固醇（r=0.653，P=0.000）以及甘油三酯（r=0.763，P=0.000）呈正相关；BUT与总胆固醇（r=-0.310，P=0.000）、低密度脂蛋白-胆固醇（r=-0.262，P=0.001）以及甘油三酯（r=-0.303，P=0.000）呈负相关；Schirmer与总胆固醇（r=-0.207，P=0.010）、低密度脂蛋白-胆固醇（r=-0.164，P=0.042）以及甘油三酯（r=-0.234，P=0.003）呈负相关。结论:脂代谢异常的2型糖尿病患者干眼发生率明显增加。

Relationship between dyslipidemia and dry eye in patients with early type 2 diabetes mellitus

Objective: To investigate the relationship between dyslipidemia and dry eye in patients with type 2 diabetes mellitus. Methods: A total of 77 patients（154 eyes） with type 2 diabetes were divided into two groups:group A（abnormal lipid metabolism） 40 patients and group B（normal lipid metabolism） 37 patients，all subjects underwent dry eye tests including the ocular surface disease index questionnaire（OSDI），tear film rupture time（BUT），tear secretion test（Schirmer Ⅰ test），corneal fluorescein sodium staining，ocular surface analyzer [tarsal gland deficiency score，tear river height（TMH），non-invasive mean tear film rupture time（NIBUT）]and lipid layer thickness analysis.The relationship between dyslipidemia and the results of dry eye examination in type 2 diabetic patients was analyzed statistically. Results: Incidence of dry eye was 73.75% in group A and 55.41% in group B，there was a significant difference between the two groups（χ2=5.682，P=0.017）.There were significant differences in OSDI index（t=-8.357，P=0.000） and tear film rupture time（Z =-4.245，P=0.000） between group A and group B.OSDI was positively correlated with total cholesterol（r=0.706，P=0.000），low-density lipoprotein- cholesterol（r=0.653，P=0.000） and triglyceride（r =0.763，P=0.000）；BUT was negatively correlated with total cholesterol（r=-0.310，P=0.000），low-density lipoprotein-cholesterol（r=-0.262，P=0.001） and triglycerides（r =-0.303，P= 0.000）; Schirmer was negatively correlated with total cholesterol（r=-0.207，P=0.010），low-density lipoprotein-cholesterol（r =-0.164，P=0.042） and triglycerides（r=-0.234，P=0.003）. Conclusion:Incidence of dry eye increses in type 2 diabetic patients with abnormal lipid metabolism.