CAJ | 학술논문

目的研究手术前后翼状胬肉合并糖尿病对患者泪膜功能的影响.方法选取单侧翼状胬肉患者90例,其中单纯翼状胬肉患者(治疗组A)30例、翼状胬肉合并1型糖尿病患者(治疗组B)30例、翼状胬肉合并2型糖尿病患者(治疗组C)30例；另选取90例非翼状胬肉者作为对照,其中健康人(对照组A)30例、单纯1型糖尿病患者(对照组B)30例、单纯2型糖尿病患者(对照组C) 30例.观察各组术前3周(术前)泪膜功能差异,观察治疗组B和治疗组C术后3个月(术后)与术前泪膜功能的差异.结果术前各组泪液分泌试验比较差异无统计学意义(P＞0.05)；除对照组A外,各组泪膜破裂时间(BUT)均异常；角膜荧光素染色(CFS)评分治疗组B[(9.08±0.48)分]与对照组B[ (3.43±0.51)分]比较差异有统计学意义(P＜0.05),治疗组C[(10.31±0.94)分]与对照组C[(7.91±0.51)分]比较差异有统计学意义(P＜0.05)；泪液羊齿状物试验(MFT)治疗组B与对照组B比较差异有统计学意义(P＜0.05)；术前泪液清除率(TCR)除对照组A外均异常.治疗组B和治疗组C术后与术前比较,泪液分泌试验差异无统计学意义(P＞0.05)；BUT、CFS评分及MFT与术前比较差异均有统计学意义(P＜ 0.05或＜0.01)；TCR正常.结论翼状胬肉合并糖尿病加重患者泪膜功能损伤,行翼状胬肉切除联合角膜缘干细胞移植术治疗后泪膜功能得到修复.
목적 연구수술전후익상노육합병당뇨병대환자루막공능적영향.방법 선취단측익상노육환자90례,기중단순익상노육환자(치료조A)30례、익상노육합병1형당뇨병환자(치료조B)30례、익상노육합병2형당뇨병환자(치료조C)30례；령선취90례비익상노육자작위대조,기중건강인(대조조A)30례、단순1형당뇨병환자(대조조B)30례、단순2형당뇨병환자(대조조C) 30례.관찰각조술전3주(술전)루막공능차이,관찰치료조B화치료조C술후3개월(술후)여술전루막공능적차이.결과 술전각조루액분비시험비교차이무통계학의의(P＞0.05)；제대조조A외,각조루막파렬시간(BUT)균이상；각막형광소염색(CFS)평분치료조B[(9.08±0.48)분]여대조조B[ (3.43±0.51)분]비교차이유통계학의의(P＜0.05),치료조C[(10.31±0.94)분]여대조조C[(7.91±0.51)분]비교차이유통계학의의(P＜0.05)；루액양치상물시험(MFT)치료조B여대조조B비교차이유통계학의의(P＜0.05)；술전루액청제솔(TCR)제대조조A외균이상.치료조B화치료조C술후여술전비교,루액분비시험차이무통계학의의(P＞0.05)；BUT、CFS평분급MFT여술전비교차이균유통계학의의(P＜ 0.05혹＜0.01)；TCR정상.결론 익상노육합병당뇨병가중환자루막공능손상,행익상노육절제연합각막연간세포이식술치료후루막공능득도수복.
Objective To study tear film functions of diabetes mellitus with pterygium before and after surgery.Methods Ninety patients with single side pterygium were divided into 3 groups with 30 cases each:simple pterygium (treatment group A ),pterygium combination with type 1 diabetes mellitus (treatment group B) and pterygium combination with type 2 diabetes mellitus (treatment group C).Ninety patients without pterygium were divided into 3 groups with 30 cases each:normal (control group A),type 1 diabetes mellitus (control group B) and type 2 diabetes mellitus (control group C ).Tear film functions were compared in each group before surgery,while tear film functions in treatment group B and C were compared between before and after surgery.Results Before surgery,there was no significant difference among each group in lacrimal secretion test.Every group's tear film break-up time (BUT) was abnormal except control group A.Cornea fluorescein staining (CFS) score in treatment group B compared with control group B,and treatment group C compared with control group C were significant differences [ (9.08 ± 0.48 ) scores vs.(3.43 ± 0.51 )scores and (10.31 ±0.94) scores vs. (7.91 ±0.51 ) scores,P＜0.05].There was significant difference in mucus fern test (MFT) between treatment group B and control group B (P＜0.05).Tear clearance rate (TCR) were all abnormal except control group A.Before surgery compared with after surgery between treatment group B and treatment group C,there was no significant difference in lacrimal secretion test (P＞0.05 ),but there were significant differences in BUT,CFS score and MFT,the TCR were normal.Conclusion Diabetes mellitus with pterygium will aggravate damage in tear film functions,and these damaged functions could be recovered through pterygium surgery with conjunctival limbal autograft.