糖尿病病程与合并周围神经病变患者眼表的关系

目的:探讨糖尿病病程与合并糖尿病周围神经病变（DPN）患者眼表的关系。方法:收集2型糖尿病合并周围神经病变患者79例。按糖尿病病程分为A组（＜10年）及B组（≥10年）。比较两组HbA1c、眼表疾病指数（OSDI）量表、角膜知觉、泪膜破裂时间（BUT）、角膜荧光素染色（FL）评分、基础泪液分泌（SIt）、足部震动感觉阈值（VPT）检查。分析糖尿病病程与眼表指标及VPT的关系。结果:不同糖尿病病程患者的年龄、HbA1c、OSDI、BUT、SIt以及角膜染色评分差异均无统计学意义（均P＞0.05），而干眼发生率（χ2=33.785，P=0.000）、角膜知觉（t=3.457，P=0.001）及VPT（Z=-2.221，P=0.026）差异有统计学意义。糖尿病病程与角膜知觉（r=-0.440，P＜0.05）呈负相关，与OSDI（r=0.246，P＜0.05）以及VPT（r=0.372，P＜0.05）呈正相关。结论:合并DPN的糖尿病患者干眼发生率高，且随着糖尿病病程的延长，角膜知觉明显减退，VPT及OSDI评分升高。

The relationship between the course of diabetes mellitus and ocular surface in patients with peripheral neuropathy

Objective: To explore the relationship between the course of diabetes mellitus and ocular surface in patients with diabetic peripheral neuropathy (DPN).Methods: A total of 79 patients with type 2 diabetes mellitus complicated with peripheral neuropathy in our hospital were collected. According to the course of diabetes, they were divided into group A(< 10 years) and group B(≥10 years). HbA1c, ocular surface disease index(OSDI), corneal sensitivity，tear break up time(BUT), corneal fluorescein(FL),schirmer I test(SIt), foot vibration perception thresholds(VPT) in two groups were compared. The relationship between the course of diabetes mellitus and ocular surface index and VPT was analyzed. Results: There were not statistically significant in age, HbA1c,OSDI,BUT,SIt and corneal staining score among patients with different course of diabetes(all P＞0.05), while the incidence of dry eye（χ2=33.785, P=0.000）, corneal perception（t=3.457, P=0.001） and VPT（Z=-2.221, P=0.026） were statistically significant. The course of diabetes was negatively correlated with corneal perception（r=-0.440, P＜0.05） and positively correlated with OSDI（r=0.246, P＜0.05） and VPT（r=0.372, P＜0.05）.Conclusion: The incidence of dry eye is high in diabetic patients with DPN, and with the extension of diabetes, corneal perception decreases significantly, and VPT and OSDI scores increase.