CAJ | 학술논문

目的研究青少年屈光不正患者在合并眼睑刷上皮病变状态下的泪膜变化情况.方法临床病例对照研究.对2013年1～8月在承德医学院附属医院眼科就诊的青少年屈光不正伴干眼患者78例中,进一步筛选出眼睑刷上皮病变阳性者56例,分为治疗组34例,对照组22例.使用干眼评估问卷来评价干眼症状;使用眼表染色的方法来进行眼睑刷上皮病变程度分级,分别观察治疗2周前后的泪膜破裂时间(BUT)、Schirmer Ⅰ试验和角膜荧光染色情况来评估泪膜变化情况.结果治疗组在治疗前后比较干眼症状评分(t =27.45,P=0.00,P＜0.05)、眼睑刷染色评分(t=19.41,P=0.00,P＜0.05)、Schirmer Ⅰ试验(t=16.45,P=0.00,P＜0.05)及角膜荧光染色评分(t=10.35,P=0.00,P ＜0.05)等均呈下降趋势,差异有统计学意义,BUT(t=-24.57,P=0.00,P＜0.05)呈上升趋势,差异有统计学意义;对照组在治疗前后比较干眼症状评分(t =4.86,P=0.18,P＞0.05)、眼睑刷染色评分(t =3.18,P=0.07,P＞0.05)、Schirmer Ⅰ试验(t=2.07,P=0.09,P＞0.05)及角膜荧光染色评分(t =4.05,P=0.21,P＞0.05),其差异均无统计学意义,BUT(t=-3.59,P=0.12,P ＞0.05),各观察指标前后比较无明显变化趋势;治疗组与对照组在治疗后比较,干眼症状评分(t =-0.89,P=0.00,P＜0.05)、眼睑刷染色评分(t=-6.68,P=0.00,P＜0.05)、角膜荧光染色评分(t =-5.14,P=0.00,P＜0.05)及Schirmer Ⅰ试验(t=-3.94,P=0.00,P＜0.05)呈现下降趋势,其差异均有统计学意义,BUT(t=8.39,P=0.00,P＜0.05)呈上升趋势,差异有统计学意义.结论眼睑刷上皮病变是导致青少年屈光不正患者泪膜稳定性下降的一个重要因素.
목적 연구청소년굴광불정환자재합병안검쇄상피병변상태하적루막변화정황.방법 림상병례대조연구.대2013년1～8월재승덕의학원부속의원안과취진적청소년굴광불정반간안환자78례중,진일보사선출안검쇄상피병변양성자56례,분위치료조34례,대조조22례.사용간안평고문권래평개간안증상;사용안표염색적방법래진행안검쇄상피병변정도분급,분별관찰치료2주전후적루막파렬시간(BUT)、Schirmer Ⅰ시험화각막형광염색정황래평고루막변화정황.결과 치료조재치료전후비교간안증상평분(t =27.45,P=0.00,P＜0.05)、안검쇄염색평분(t=19.41,P=0.00,P＜0.05)、Schirmer Ⅰ시험(t=16.45,P=0.00,P＜0.05)급각막형광염색평분(t=10.35,P=0.00,P ＜0.05)등균정하강추세,차이유통계학의의,BUT(t=-24.57,P=0.00,P＜0.05)정상승추세,차이유통계학의의;대조조재치료전후비교간안증상평분(t =4.86,P=0.18,P＞0.05)、안검쇄염색평분(t =3.18,P=0.07,P＞0.05)、Schirmer Ⅰ시험(t=2.07,P=0.09,P＞0.05)급각막형광염색평분(t =4.05,P=0.21,P＞0.05),기차이균무통계학의의,BUT(t=-3.59,P=0.12,P ＞0.05),각관찰지표전후비교무명현변화추세;치료조여대조조재치료후비교,간안증상평분(t =-0.89,P=0.00,P＜0.05)、안검쇄염색평분(t=-6.68,P=0.00,P＜0.05)、각막형광염색평분(t =-5.14,P=0.00,P＜0.05)급Schirmer Ⅰ시험(t=-3.94,P=0.00,P＜0.05)정현하강추세,기차이균유통계학의의,BUT(t=8.39,P=0.00,P＜0.05)정상승추세,차이유통계학의의.결론 안검쇄상피병변시도치청소년굴광불정환자루막은정성하강적일개중요인소.
Objective To research the changes of tear film in teenagers refractive error patients with lid-wiper epitheliopathy.Methods In the preliminary screening of teenagers refractive error with dry eye patients in 78 cases,further screening of 56 cases of LWE (+),34 cases were divided into treatment group,22 cases in the control group.The use of dry eye questionnaire to evaluate the symptoms of dry eye; ocular surface staining method used to grade the severity of LWE were observed before and after 2 weeks treatment,the tear break-up time (BUT),Schirmer Ⅰ test and corneal fluorescence staining to evaluate the tear film changes.Results In the treatment group before and after the treatment of dry eye symptoms score (t =27.45,P =0.00,P ＜0.05),lid-wiper staining score (t =19.41,P =0.00,P ＜0.05),Schirmer Ⅰ test (t =16.45,P =0.00,P ＜0.05) and corneal fluorescein staining scores (t =10.35,P =0.00,P ＜0.05) were decreased,BUT (t =-24.57,P =0.00,P＜ 0.05); the control group before and after the treatment of dry eye symptoms score (t =4.86,P =0.18,P ＞0.05),lid-wiper staining score (t =3.18,P =0.07,P ＞0.05),Schirmer Ⅰ test (t =2.07,P =0.09,P ＞0.05) and corneal fluorescein staining scores (t =4.05,P =0.21,P ＞0.05),BUT (t =-3.59,P =0.12,P ＞0.05); the treatment group and the control group after treatment,dry eye symptoms score (t =-0.89,P =0.00,P ＜0.05),lid-wiper staining score (t =-6.68,P =0.00,P ＜0.05),Schirmer Ⅰ test (t =-3.94,P =0.00,P ＜0.05) and corneal fluorescein staining scores (t =-5.14,P =0.00,P ＜0.05) were decreased,BUT (t =8.39,P =0.00,P ＜0.05).Conclusions Lid-wiper epitheliopathy is an important cause of the decline in teenagers refractive error patients tear film stability.