干眼患者115例的临床特点分析

目的　分析各种类型干眼患者的临床特点。方法　回顾性分析 115例 ( 2 2 9只眼 )干眼患者的临床资料 ,包括症状、病因、全身病、裂隙灯检查、泪膜破裂时间检查 (break uptime,BUT)、基础泪液分泌试验 (SchirmerⅠtest,SⅠt)、反射泪液分泌试验 (SchirmerⅡtest,SⅡt)、角结膜荧光素(fluorescent,Fl)染色、虎红 (rosebangle ,Rb)染色及睑板腺功能的检查。对Sj gren综合征 (Sj grensyndrome,SS)者行血清类风湿因子、自身抗体及涎腺分泌功能检查。结果　 115例中 ,水液缺乏性干眼(aqueousteardeficiency ,ATD)者 5 6例 ( 48 7% ) ,蒸发过强型干眼者 40例 ( 34 8% ) ,混合型干眼者 16例( 13 9% ) ,结膜松弛综合征者 4例 ( 3 5 % )。SS患者 13例 ( 11 3% )。在各型干眼患者中 ,女性多于男性 ,尤其是ATD患者 ,原发性SS ATD患者 10 0 %为女性 ,43例非SS水液缺乏性干眼 (non SSaqueousteardeficiency ,NSTD)者中女性 35例 ( 81 4% )。临床特点 :干涩症状者 6 3例 ( 84 0 % ) ,视疲劳者 5 4例( 72 0 % ) ,异物感者 48例 ( 6 4 0 % ) ,视力波动者 42例 ( 5 6 0 % ) ,睑板腺功能障碍 (meibomainglanddysfunction ,MGD)者 35例 ( 30 4% )。各类型干眼患者的BUT、Rb、Fl间均有明显的相关性 ,Rb与Fl间相关性高 (r =

Clinical characteristics of patients with dry eye syndrome

OBJECTIVE: To learn the clinical characteristics of patients with dry eye syndrome. METHODS: The following items were recorded in 115 patients (229 eyes) with dry eye, including symptoms, causation, systematic diseases, slit-lamp examination, tear break-up time, basal and reflex Schirmer's test, vital staining (fluorescent and rose bangle) and meibomian gland dysfunction examination. Rheumatoid factor and auto-antibody detection were performed in Sj?gren's syndrome suspected patients. RESULTS: Aqueous tear deficiency (ATD, 48.7%) ranked the most common type, followed by over-evaporation dry eye (34.8%), mixed type (13.9%) and conjunctivochalasis (3.5%). In all the causes of the dry eye, about 11.3% had Sj?gren syndrome (SS). Females suffering from dry eye were more than males, especially SS. Dryness was the most common symptom (84.0%), especially in ATD patients, then followed by ocular fatigue (72.0%), foreign body sensation (64.0%) and impairment of vision (56.0%). The ocular irritation was more severe in meibomain gland dysfunction (MGD) patients than in ATD patients. Among the results of tear break-up time (BUT), rose bangle (Rb) staining and fluorescent (Fl) staining in all types of dry eye, significant relationship was found among them, especially between Rb and Fl score (r = 0.612, P = 0.000). SS patients had much more severe abnormality in all the four signs than non-SS aqueous tear deficiency (NSTD) and MGD patients. However, in the comparisons of BUT, Rb and Fl between NSTD and MGD patients, there were no significant differences. CONCLUSION: Symptoms combined with examinations of BUT, Schirmer's test, Fl and Rb staining and meibomian gland function are the necessary means to diagnose most of the dry eye patients.