眼表综合分析仪评价干眼患者相关指标的临床分析

目的 评价眼表综合分析仪在干眼患者中的应用价值。方法 横断面研究。选择70例（135眼）干眼患者作为研究对象。检查指标包括眼表疾病指数（OSDI）评分、泪液分泌试验（SⅠT）、睑板腺分泌物性质检查，以及利用眼表综合分析仪系统--Keratograph 5M进行泪河高度测量、泪膜破裂时间（BUT）测定以及睑板腺检查。Keratograph 5M与传统检查方法之间的相关性、干眼患者睑板腺状况评分与OSDI评分及BUT的相关性用Pearson相关及线性回归进行分析，Keratograph 5M分析眼表状况的重测信度用组内相关系数评价。结果 70例（135眼）患者OSDI评分为（15.8±3.4）分，SⅠT为（6.0±7.7）mm，泪河高度为（0.27±0.13）mm，BUT为（7.9±5.5）s。睑板腺分泌物评分为（3.3±1.4）分，睑板腺缺失面积评分为（3.4±1.6）分。测得的BUT时间越短，SⅠT越短（r=0.474，P＜0.01）；泪河高度越低，SⅠT越短（r=0.432，P＜0.01）。睑板腺分泌物评分、睑板腺照相评分与OSDI评分呈正相关（r=0.673、0.752，P<0.05），与BUT呈负相关（r=-0.638、-0.603，P<0.05）。眼表综合分析仪的检查结果具有较好的重测信度（ICC值在0.84~0.89之间）。结论 眼表综合分析仪能够直观地评价干眼患者眼表状况，是一种非接触性、无创、可重复性强的快速检查手段，具有实际临床应用价值。

Clinical analysis of the Keratograph 5M in the evaluation of dry eye patients

Objective To assess the clinical application of the Keratograph 5M in dry eye patients. Methods In a noninterventional， cross-sectional study， 135 eyes from 70 patients who were diagnosed with dry eye from October to November 2013 were recruited. The ocular surface disease index （OSDI）， Schirmer Ⅰ test （SⅠT） and meibomian secretion were measured. Tear meniscus height， tear film break-up time （BUT） and the meibomian glands were observed with the Keratograph 5M. A Pearson correlation and linear regression were used to study the correlation between the Keratograph 5M and traditional examinations， and the relationship between scores for the meibomian gland status compared to the ocular surface disease index and tear film break-up time. An interclass correlation coefficient was used to evaluate the repeatability of the Keratograph 5M. Results Scores for all subjects were OSDI， 15.8±3.4； SⅠT， 6.0±7.7 mm； tear meniscus height， 0.27±0.13 mm； BUT， 7.9±5.5 s； the meibomian secretion score， 3.3±1.4； and meiboscore 3.4±1.6. Both BUT and tear meniscus height were positively correlated with SⅠT （r=0.474， 0.432， P<0.01）. Both the meibomian secretion score and meiboscore had a positive correlation with OSDI （r=0.673， 0.752， P<0.05） and a negative correlation with BUT （r=-0.638， -0.603， P<0.05）. The Keratograph 5M showed fine test-retest reliability （ICC=0.84-0.89）. Conclusion The Keratograph 5M can directly evaluate the ocular surface condition of dry eye patients. The Keratograph 5M is a non-contact， noninvasive and reliable examination with practical clinical application.