干眼患者泪膜脂质层厚度检测及其与眼表体征的相关性分析

目的 检测干眼患者泪膜脂质层厚度(lipid layer thickness,LLT),并分析LLT与眼表体征之间的相关性.方法 纳入130例(130眼)干眼患者为本研究研究对象,其中睑板腺功能障碍(meibomian gland dysfunction,MGD)患者64例,非MGD患者66例,进行LLT检测、泪膜破裂时间(break-up time,BUT)检查、角膜荧光素染色(fluorescein staining,FL)、Marx线(Marx line,ML)评分及Schirmer Ⅰ试验.分析不同年龄段LLT分布情况,及其与其他检查之间的相关性.结果 不同年龄段之间LLT差异有统计学意义(P =0.007),各年龄段男性与女性之间LLT差异均无统计学意义(均为P＞0.05).LLT与年龄呈正相关(r =0.334,P＜0.001),LLT与性别无显著相关性(r=0.107,P=0.226).LLT与上睑ML评分(r=0.295,P=0.001)、下睑ML评分(r=0.233,P=0.008)呈正相关,与BUT、FL及泪液分泌量均无显著相关性(均为P＞0.05).MGD组LLT与上睑ML评分、下睑ML评分呈正相关(均为r=0.306,P=0.014),与其他检查指标均无显著相关性(均为P＞0.05).非MGD组LLT与其他检查指标均无显著相关性(均为P＞0.05).多元线性回归分析结果显示,干眼患者中,年龄、上睑ML评分与LLT存在线性关系(年龄:β=0.254,P=0.005;上睑ML评分:β=0.207,P=0.022),在MGD组中,仅年龄与LLT存在线性关系(β=0.382,P=0.002).MGD组上睑ML评分及下睑ML评分均高于非MGD组(均为P＜0.001).结论 干眼患者LLT与年龄、ML评分呈正相关.泪膜LLT检测作为干眼诊断的辅助检查时,需结合年龄等影响因素进行综合分析.

Measurement of tear film lipid layer thickness in dry eye patients and its relationship with ocular surface signs

Objective To measure the tear film lipid layer thickness (LLT) in dry eye patients and investigate the correlations of LLT with ocular surface signs.Methods One hundred and thirty dry eye patients (130 eyes),including 64 meibomian gland dysfunction (MGD) patients and 66 non-MGD patients,were included in this study.LLT,break-up time (BUT),fluorescein staining (FL),Marx's line (ML) score and Schirmer I test were performed and examined.The distribution of LLT in different age groups and the correlations between LLT and other examinations were analyzed.Results There was significant difference in LLT among different age groups (P =0.007),while LLT was not significantly different between male and female in each age group (P ＞ 0.05).LLT was positively correlated with age (r =0.334,P ＜ 0.001) and was not correlated with sex (r =0.107,P =0.226).LLT was positively correlated with upper eyelid ML score (r =0.295,P =0.001) and lower eyelid ML score (r =0.233,P =0.008).There was no significant correlation of LLT with BUT,FL or Schirmer Ⅰ test (all P ＞0.05).In the MGD group,there were positive correlations of LLT with upper eyelid ML score and lower eyelid ML score (all r =0.306,P =0.014),and no correlation of LLT with other examinations (all P ＞ 0.05).In the non-MGD group,there was no correlation of LLT with other examinations (all P ＞ 0.05).In a multivariate linear regression analysis,age and upper eyelid ML score were significantly related to LLT (β =0.254,P =0.005 for age and β =0.207,P =0.022 for upper eyelid ML score) in all dry eye patients.Age was the only factor related to LLT (β =0.382,P =0.002) in the MGD group.Upper eyelid ML score and lower eyelid ML score were higher in the MGD group than the non-MGD subgroup (all P ＜ 0.001).Conclusion LLT is positively correlated with age and ML score in dry eye patients.The measurement of tear film LLT,as an auxiliary examination in the diagnosis of dry eye disease,should be analyzed with the influential factors including age.