中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2014年
4期
247-253
,共7页
姚卫兰%梁庆丰%孙旭光%王宁利%LABBE Antoine
姚衛蘭%樑慶豐%孫旭光%王寧利%LABBE Antoine
요위란%량경봉%손욱광%왕저리%LABBE Antoine
眼睑疾病%睑板腺%诊断技术%睑板腺功能障碍%敏感性与特异性
眼瞼疾病%瞼闆腺%診斷技術%瞼闆腺功能障礙%敏感性與特異性
안검질병%검판선%진단기술%검판선공능장애%민감성여특이성
Eyelid diseases%Meibomian glands%Diagnostic techniques%MGD%Sensitivity and specificity
目的 比较睑板腺功能障碍(MGD)相关检查方法的敏感性及特异性.方法 前瞻性病例对照研究.选取2013年1至8月在北京同仁眼科中心就诊的MGD患者52例(52只眼)及对照组32例(32只眼),所有被检查者均按如下顺序进行检查:(1)眼表疾病评分指数(OSDI)问卷调查;(2)睑缘及眼表裂隙灯显微镜检查;(3)红外线睑板腺照相;(4)角膜知觉检测;(5)BUT;(6)角结膜荧光素染色;(7)基础泪液分泌试验(Schirmer Ⅰ)检测.采用独立样本t检验比较MGD组与正常对照组的各项参数;MGD组中各参数间相关性分析及敏感性、特异性计算使用Spearman相关分析法、受试者工作特征(ROC)曲线及ROC曲线下面积(AUC)完成.结果 MGD组患者OSDI评分、睑缘评分、睑板腺缺失率、角结膜染色评分[分别为(36.13±14.71)分、(2.37±0.937)分、(52.64±17.23)％、(1.06±1.75)分]明显高于对照组[分别为(5.22±11.97)分、(0.94 ±0.564)分、(23.97±6.36)％、(0.03±0.18)分],差异均具有统计学意义(t值分别为10.019、7.808、8.796、3.293,P均＜0.01).MGD组患者BUT、Schirmer Ⅰ、角膜知觉检查结果[分别为(4.57 ±2.13)s、(6.04±7.09) mm、(5.77 ±0.38) cm]明显低于对照组[(13.31±2.54)s、(12.56±6.99) mm、(5.98±0.07)cm],差异均具有统计学意义(t值分别为-16.97、-4.119、-3.018,P均＜0.01).MGD组患者各项检查的AUC值相比:BUT最大(0.995),之后是睑板腺缺失率(0.944)、OSDI (0.925)及睑缘评分(0.811);BUT诊断MGD的敏感性和特异性分别为90.4％、100.0％,睑板腺缺失率的敏感性和特异性分别为76.9％、100.0％,优于其他检查.结论 BUT及睑板腺缺失率对MGD诊断价值最大,在临床中考虑MGD的患者可进行此两项检查明确诊断.
目的 比較瞼闆腺功能障礙(MGD)相關檢查方法的敏感性及特異性.方法 前瞻性病例對照研究.選取2013年1至8月在北京同仁眼科中心就診的MGD患者52例(52隻眼)及對照組32例(32隻眼),所有被檢查者均按如下順序進行檢查:(1)眼錶疾病評分指數(OSDI)問捲調查;(2)瞼緣及眼錶裂隙燈顯微鏡檢查;(3)紅外線瞼闆腺照相;(4)角膜知覺檢測;(5)BUT;(6)角結膜熒光素染色;(7)基礎淚液分泌試驗(Schirmer Ⅰ)檢測.採用獨立樣本t檢驗比較MGD組與正常對照組的各項參數;MGD組中各參數間相關性分析及敏感性、特異性計算使用Spearman相關分析法、受試者工作特徵(ROC)麯線及ROC麯線下麵積(AUC)完成.結果 MGD組患者OSDI評分、瞼緣評分、瞼闆腺缺失率、角結膜染色評分[分彆為(36.13±14.71)分、(2.37±0.937)分、(52.64±17.23)％、(1.06±1.75)分]明顯高于對照組[分彆為(5.22±11.97)分、(0.94 ±0.564)分、(23.97±6.36)％、(0.03±0.18)分],差異均具有統計學意義(t值分彆為10.019、7.808、8.796、3.293,P均＜0.01).MGD組患者BUT、Schirmer Ⅰ、角膜知覺檢查結果[分彆為(4.57 ±2.13)s、(6.04±7.09) mm、(5.77 ±0.38) cm]明顯低于對照組[(13.31±2.54)s、(12.56±6.99) mm、(5.98±0.07)cm],差異均具有統計學意義(t值分彆為-16.97、-4.119、-3.018,P均＜0.01).MGD組患者各項檢查的AUC值相比:BUT最大(0.995),之後是瞼闆腺缺失率(0.944)、OSDI (0.925)及瞼緣評分(0.811);BUT診斷MGD的敏感性和特異性分彆為90.4％、100.0％,瞼闆腺缺失率的敏感性和特異性分彆為76.9％、100.0％,優于其他檢查.結論 BUT及瞼闆腺缺失率對MGD診斷價值最大,在臨床中攷慮MGD的患者可進行此兩項檢查明確診斷.
목적 비교검판선공능장애(MGD)상관검사방법적민감성급특이성.방법 전첨성병례대조연구.선취2013년1지8월재북경동인안과중심취진적MGD환자52례(52지안)급대조조32례(32지안),소유피검사자균안여하순서진행검사:(1)안표질병평분지수(OSDI)문권조사;(2)검연급안표렬극등현미경검사;(3)홍외선검판선조상;(4)각막지각검측;(5)BUT;(6)각결막형광소염색;(7)기출루액분비시험(Schirmer Ⅰ)검측.채용독립양본t검험비교MGD조여정상대조조적각항삼수;MGD조중각삼수간상관성분석급민감성、특이성계산사용Spearman상관분석법、수시자공작특정(ROC)곡선급ROC곡선하면적(AUC)완성.결과 MGD조환자OSDI평분、검연평분、검판선결실솔、각결막염색평분[분별위(36.13±14.71)분、(2.37±0.937)분、(52.64±17.23)％、(1.06±1.75)분]명현고우대조조[분별위(5.22±11.97)분、(0.94 ±0.564)분、(23.97±6.36)％、(0.03±0.18)분],차이균구유통계학의의(t치분별위10.019、7.808、8.796、3.293,P균＜0.01).MGD조환자BUT、Schirmer Ⅰ、각막지각검사결과[분별위(4.57 ±2.13)s、(6.04±7.09) mm、(5.77 ±0.38) cm]명현저우대조조[(13.31±2.54)s、(12.56±6.99) mm、(5.98±0.07)cm],차이균구유통계학의의(t치분별위-16.97、-4.119、-3.018,P균＜0.01).MGD조환자각항검사적AUC치상비:BUT최대(0.995),지후시검판선결실솔(0.944)、OSDI (0.925)급검연평분(0.811);BUT진단MGD적민감성화특이성분별위90.4％、100.0％,검판선결실솔적민감성화특이성분별위76.9％、100.0％,우우기타검사.결론 BUT급검판선결실솔대MGD진단개치최대,재림상중고필MGD적환자가진행차량항검사명학진단.
Objective To evaluate the sensitivity and specificity of clinical examinations in meibomian gland dysfunction (MGD).Methods A prospective case-controlled study.Fifty-two patients with MGD and 32 healthy age-and sex-matched control subjects were included from January to August 2013.All subjects were underwent the examinations sequentially as follows:evaluation of ocular surface disease symptoms using the Ocular Surface Disease Index (OSDI) ; lid margin and ocular surface examination by slit lamp microscrope; infrared meibomian photography; cornea sensation testing using the Cochet-Bonnet esthesiometer; tear film break-up time (BUT); corneal and conjunctival staining (Oxford scale); and Schirmer Ⅰ test.One eye of each subject was included in the study.The parameters between MGD group and the control group were compared using the independent-samples T test.Spearman's correlation analysis was used to analyze the correlation of each parameter of MGD group.Receiver operating characteristic curve (ROC curve)and area under the curve (AUC) were used to describe the accuracy of each parameter to differentiate MGD from normal eyes.Results OSDI score,lid margin abnormality score,miss rate of meibomian glands and corneal and conjunctival staining score were obviously higher in MGD group (36.13 ±14.71,2.37 ±0.937,(52.64 ± 17.23)％,1.06 1.75) than those in control group(5.22 ± 11.97,0.94± 0.564,(23.97 ± 6.36) ％,0.03 ± 0.18) (t =10.019,7.808,8.796,3.293,respectively ; P ＜ 0.01).BUT,schirmer Ⅰ value and corneal sensitivity score were significantly lower in MGD group (4.57 ±2.13,6.04 ± 7.09,5.77 ± 0.38) than those in control group (13.31 ± 2.54,12.56 ± 6.99,5.98 ±0.07) (t=-16.97,-4.119,-3.018,respectively; P＜0.O1).AUC value of BUT was the largest (0.995),and the followings were the miss rate of meibomian (0.944),OSDI (0.925)and lid margin abnormalities(0.811).The sensitivity and the specificity of BUT were 90.4％ and 100.0％ ; the miss rate of meibomian were 76.9％ and 100.0％ ; OSDI were 97.4％ and 87.1％ ; and lid margin abnormalities were 79.5％ and 79.4％.The diagnostic value of these four parameters were better than the rest ones.Conclusion BUT and the miss rate of meibomian have great value in diagnosis of MGD.Patientsconsidered MGD can be performed these examinations to confirm the diagnosis.
