中老年患者干眼症临床分析

目的探讨中老年患者干眼症的临床特点及诊治要点。方法通过问卷调查、泪膜破裂时间（BUT）、SchirmerⅠ试验、角膜荧光素染色以及DR-1泪膜干涉成像仪的检查，分析了60例（97只眼）中老年干眼症患者的临床资料。结果干眼症患者主要的眼部不适症状依次为眼疲劳（50．49％）、眼红（49．48％）、异物感（47．42％）、干涩感（39．18％）、分泌物（38．14％）、痒（29．90％）、水分过多感（21．65％）、烧灼感（9．28％）。SchirmerⅠ试验结果为（11．10±3．14）mm，BUT试验结果为（3．12±1．05）s，角膜荧光素染色评分结果为1．26±0．37。干眼仪的敏感度为63．75％，特异度为49．84％。泪液蒸发过强型、泪液分泌减少合并泪液蒸发过强型、单纯泪液分泌减少型所占比例依次为63．92％、30．93％、5．15％。60例患者中曾经误诊为其他眼病者43例（71．7％）。结论眼科医生应掌握中老年患者干眼症的临床特点，重视症状、病史的询问以及传统的三项检查（Schii-merⅠ试验、BUT试验、角膜荧光素染色），避免误诊误治。

Clinical analysis of dry eye patients in elders

Ojbeictve To probe the clinic characteristics and diagnostic points of dry eye syndrome in alders. Methods A study was performed in 60 elder dry eye patients （ ≥45 years old） who were randomly selected in the clinic of our hospital from January 15 to July 15, 2007. Questionnaire pertaining to dry eye symptoms, DR- tear film lipid layer interferometry, Schirmer＇ s Ⅰ test, BUT test and Fluorescein staining test were underwent. Treatments were performed on the patients. Results The main symptoms of dry eye syndrome were red, foreign body sensation, crust, itching, hyperhy- dration and burning sensation. The sensitivity and specificity of DR-I tear film lipid layer interferametry were 63.75% and 49. 84% respectively. In all dry eye patients, 63.92% were excessive tear evaporation type, 30. 93% were both tear deficient and excessive tear evaporation type and 5.15% were tear deficient type. There were 43 dry eye patients （71.7 %） were misdiagnosed into other diseases. After treatment of 3 to 6 weeks, the complaint of 47 patients disappeared, and that of 13 patients relieved. Conclusion The dry eye syndrome is mere and mere common in the elders. The most common type of the elder dry eye patients is excessive tear evaporation type.