中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2010年
12期
1300-1304
,共5页
甲状腺相关眼病%泪膜破裂时间%泪液分泌试验%眼表
甲狀腺相關眼病%淚膜破裂時間%淚液分泌試驗%眼錶
갑상선상관안병%루막파렬시간%루액분비시험%안표
Thyroid associated ophthalmopathy%Tear film break-up time%Tear secretion test%Ocular surface
目的 观察甲状腺相关眼病患者的眼表功能变化.方法 对68例(136只眼)甲状腺相关眼病患者和39例(78只眼)正常对照组,详细记录甲亢治疗、糖皮质激素治疗、眼球突出度、睑裂、眼球运动、眼表相关症状、体征、泪液分泌试验(基础Schirmer Ⅰ试验,SIt)、泪膜破裂时间(break up time,BUT)、角膜荧光素染色等项目检查,并作统计学分析.结果 (1)病例组BUT均值6.97/s,低于对照组9.77s,(P=0.006).(2)病例组SIt均值8.10mm/min,与对照组8.18mm/min,无明显差异(P=0.935).(3)病例组BUT与SIt存在正相关(P=0.034);与眼球突出度存在负相关(P=0.024)关系.(4)病例组SIt与睑裂高度(P=0.006)、眼球突出度(P=0.050)、上睑退缩程度(P=0.02)、下睑退缩程度(P=0.005)、上睑迟落程度(P=0.045)、眼睑闭合不全程度(P=0.002)、眼球上转受限程度(P=0.005)、眼球运动受限程度(P=0.002)、TAO的NOSPECS分级(P=0.004)存在正相关关系.结论 (1)甲状腺相关眼病继发蒸发过强型干眼.(2)甲状腺相关眼病患者基础泪液分泌降低,反射性泪液分泌增强.
目的 觀察甲狀腺相關眼病患者的眼錶功能變化.方法 對68例(136隻眼)甲狀腺相關眼病患者和39例(78隻眼)正常對照組,詳細記錄甲亢治療、糖皮質激素治療、眼毬突齣度、瞼裂、眼毬運動、眼錶相關癥狀、體徵、淚液分泌試驗(基礎Schirmer Ⅰ試驗,SIt)、淚膜破裂時間(break up time,BUT)、角膜熒光素染色等項目檢查,併作統計學分析.結果 (1)病例組BUT均值6.97/s,低于對照組9.77s,(P=0.006).(2)病例組SIt均值8.10mm/min,與對照組8.18mm/min,無明顯差異(P=0.935).(3)病例組BUT與SIt存在正相關(P=0.034);與眼毬突齣度存在負相關(P=0.024)關繫.(4)病例組SIt與瞼裂高度(P=0.006)、眼毬突齣度(P=0.050)、上瞼退縮程度(P=0.02)、下瞼退縮程度(P=0.005)、上瞼遲落程度(P=0.045)、眼瞼閉閤不全程度(P=0.002)、眼毬上轉受限程度(P=0.005)、眼毬運動受限程度(P=0.002)、TAO的NOSPECS分級(P=0.004)存在正相關關繫.結論 (1)甲狀腺相關眼病繼髮蒸髮過彊型榦眼.(2)甲狀腺相關眼病患者基礎淚液分泌降低,反射性淚液分泌增彊.
목적 관찰갑상선상관안병환자적안표공능변화.방법 대68례(136지안)갑상선상관안병환자화39례(78지안)정상대조조,상세기록갑항치료、당피질격소치료、안구돌출도、검렬、안구운동、안표상관증상、체정、루액분비시험(기출Schirmer Ⅰ시험,SIt)、루막파렬시간(break up time,BUT)、각막형광소염색등항목검사,병작통계학분석.결과 (1)병례조BUT균치6.97/s,저우대조조9.77s,(P=0.006).(2)병례조SIt균치8.10mm/min,여대조조8.18mm/min,무명현차이(P=0.935).(3)병례조BUT여SIt존재정상관(P=0.034);여안구돌출도존재부상관(P=0.024)관계.(4)병례조SIt여검렬고도(P=0.006)、안구돌출도(P=0.050)、상검퇴축정도(P=0.02)、하검퇴축정도(P=0.005)、상검지락정도(P=0.045)、안검폐합불전정도(P=0.002)、안구상전수한정도(P=0.005)、안구운동수한정도(P=0.002)、TAO적NOSPECS분급(P=0.004)존재정상관관계.결론 (1)갑상선상관안병계발증발과강형간안.(2)갑상선상관안병환자기출루액분비강저,반사성루액분비증강.
Objective To observe ocular surface changes in patients with thyroid associated ophthalmopathy (TAO). Methods Tear film break-up time (BUT), tear secretion test (Schirmer Ⅰ test, SIt) in 68 patients (136 eyes) with thyroid associated ophthalmopathy and 39 normal subjects (78 eyes, control group) without eye and systemic diseases who were selected randomly in same period were evaluated. Relevant parameters,such as age, gender, palpebral fissure width, degree of proptosis, ocular motility, concomitant diseases, previous treatment for Graves disease, symptoms and signs, severity scores of the disease, the methods of treatments were retrieved and analyzed. Corneal fluorescein staining (FL) in patients with TAO was also determined. Results Compared with the normal controls, patients with TAO showed statistically significant decrease in BUT (TAO 6.97s, controls 9.77s, P =0.006). The TAO group showed no significant difference in SIt with the control group (TAO 8.10mm/min, controls 8.18 mm/min, P =0.935). The BUT in TAO patients correlated positively with the SIt (P =0.034) and negatively with exophthalmus (P =0.024). The SIt in TAO patients correlated positively with palpebral fissure width (P =0.006), exophthalmus (P =0.050), superior eyelid retraction (P =0.02),inferior eyelid retraction (P =0.005), lid lag (P =0.045), lagophthalmus (P =0.002), restrictive motility (P =0.002) and TAO severity score (P =0.004). Conclusions Thyroid associated ophthalmopathy is complicated with evaporative dry eye secondly. Foundation tear secretion of patients with TAO may decrease, but reflexive tear secretion of patients of TAO may increase.
