中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2015年
2期
165-169
,共5页
祁媛媛%赵少贞%黄悦%杨瑞波%王桂琴
祁媛媛%趙少貞%黃悅%楊瑞波%王桂琴
기원원%조소정%황열%양서파%왕계금
干眼/诊断%眼表%非侵入性眼表综合分析仪
榦眼/診斷%眼錶%非侵入性眼錶綜閤分析儀
간안/진단%안표%비침입성안표종합분석의
Dry eye/diagnosis%Ocular surface%Noninvasive ocular surface analyzer
背景 干眼的发病率逐渐升高,但目前干眼的早期诊断尚有一定的困难,如何正确地诊断和治疗干眼是研究的热点.新型非侵入性眼表综合分析仪对干眼的分析研究具有重要的临床意义. 目的 探讨Keratograph 5M非侵入性眼表综合分析仪对干眼的临床诊疗价值. 方法 采用观察性研究方法,纳入2013年10-12月在天津医科大学眼科医院门诊就诊的拟行屈光手术的近视患者88例88眼,其中男32例,女56例;年龄18 ～51岁.对患者进行干眼相关检查,包括传统的泪膜破裂时间(TBUT)检测、角膜荧光素染色评分、Schirmer试验Ⅰ(SⅠ t);用Keratograph 5M非侵入性眼表综合分析仪对患眼进行非侵入性泪膜破裂时间(NITBUT)检测和结膜充血程度分级,采用Spearman秩相关分析评价干眼相关指标与Keratograph 5M非侵入性眼表综合分析仪检测结果间的关系. 结果 不同性别间的年龄差异无统计学意义(P=0.34).Keratograph 5M非侵入性眼表综合分析仪分析系统在88例受检者中检出正常者15例,可疑干眼44例,检出率为50.0％;检出干眼29例,检出率为33.0％,而采用《中国干眼临床诊疗专家共识》的标准检出正常者39例,干眼49例,干眼的检出率为55.7％.首次NITBUT (NITBUTf)所测的时间短于覆盖整个角膜的平均NITBUT(NITB UTav),差异有统计学意义(P=0.00),但二者间呈显著正相关(rs=0.62,P=0.00).干眼分级与NITBUTf及NITBUTav均呈显著负相关(rs=-0.60、-0.89,均P=0.00),与结膜充血程度分级呈正相关(rs=0.24,P=0.02).结膜充血程度分级与NITBUTav呈负相关(rs=-0.24,P=0.02),但与NITBUTf、TBUT、SⅠt值、角膜荧光素染色评分均无明显相关性(rs=-0.13,P=0.22;rs=0.16,P=0.14;rs=-0.16;P=0.13;rs=-0.08;P=0.44).TBUT与NITBUTf间差异无统计学意义(P=0.71),二者呈正相关性(rs=0.23,P=0.03);但TBUT与NITBUTav无明显相关(rs=0.18,P=0.09);S Ⅰ t结果与NITBUTf及NITBUTav均无明显相关性(rs =0.20,P=0.07;rs=0.05,P=0.66). 结论 Keratograph 5M非侵入性眼表综合分析仪测得的NITBUTav值对评估眼表情况意义更大,对球结膜充血的检测可作为临床判断眼表健康与否的参考指标之一.
揹景 榦眼的髮病率逐漸升高,但目前榦眼的早期診斷尚有一定的睏難,如何正確地診斷和治療榦眼是研究的熱點.新型非侵入性眼錶綜閤分析儀對榦眼的分析研究具有重要的臨床意義. 目的 探討Keratograph 5M非侵入性眼錶綜閤分析儀對榦眼的臨床診療價值. 方法 採用觀察性研究方法,納入2013年10-12月在天津醫科大學眼科醫院門診就診的擬行屈光手術的近視患者88例88眼,其中男32例,女56例;年齡18 ～51歲.對患者進行榦眼相關檢查,包括傳統的淚膜破裂時間(TBUT)檢測、角膜熒光素染色評分、Schirmer試驗Ⅰ(SⅠ t);用Keratograph 5M非侵入性眼錶綜閤分析儀對患眼進行非侵入性淚膜破裂時間(NITBUT)檢測和結膜充血程度分級,採用Spearman秩相關分析評價榦眼相關指標與Keratograph 5M非侵入性眼錶綜閤分析儀檢測結果間的關繫. 結果 不同性彆間的年齡差異無統計學意義(P=0.34).Keratograph 5M非侵入性眼錶綜閤分析儀分析繫統在88例受檢者中檢齣正常者15例,可疑榦眼44例,檢齣率為50.0％;檢齣榦眼29例,檢齣率為33.0％,而採用《中國榦眼臨床診療專傢共識》的標準檢齣正常者39例,榦眼49例,榦眼的檢齣率為55.7％.首次NITBUT (NITBUTf)所測的時間短于覆蓋整箇角膜的平均NITBUT(NITB UTav),差異有統計學意義(P=0.00),但二者間呈顯著正相關(rs=0.62,P=0.00).榦眼分級與NITBUTf及NITBUTav均呈顯著負相關(rs=-0.60、-0.89,均P=0.00),與結膜充血程度分級呈正相關(rs=0.24,P=0.02).結膜充血程度分級與NITBUTav呈負相關(rs=-0.24,P=0.02),但與NITBUTf、TBUT、SⅠt值、角膜熒光素染色評分均無明顯相關性(rs=-0.13,P=0.22;rs=0.16,P=0.14;rs=-0.16;P=0.13;rs=-0.08;P=0.44).TBUT與NITBUTf間差異無統計學意義(P=0.71),二者呈正相關性(rs=0.23,P=0.03);但TBUT與NITBUTav無明顯相關(rs=0.18,P=0.09);S Ⅰ t結果與NITBUTf及NITBUTav均無明顯相關性(rs =0.20,P=0.07;rs=0.05,P=0.66). 結論 Keratograph 5M非侵入性眼錶綜閤分析儀測得的NITBUTav值對評估眼錶情況意義更大,對毬結膜充血的檢測可作為臨床判斷眼錶健康與否的參攷指標之一.
배경 간안적발병솔축점승고,단목전간안적조기진단상유일정적곤난,여하정학지진단화치료간안시연구적열점.신형비침입성안표종합분석의대간안적분석연구구유중요적림상의의. 목적 탐토Keratograph 5M비침입성안표종합분석의대간안적림상진료개치. 방법 채용관찰성연구방법,납입2013년10-12월재천진의과대학안과의원문진취진적의행굴광수술적근시환자88례88안,기중남32례,녀56례;년령18 ～51세.대환자진행간안상관검사,포괄전통적루막파렬시간(TBUT)검측、각막형광소염색평분、Schirmer시험Ⅰ(SⅠ t);용Keratograph 5M비침입성안표종합분석의대환안진행비침입성루막파렬시간(NITBUT)검측화결막충혈정도분급,채용Spearman질상관분석평개간안상관지표여Keratograph 5M비침입성안표종합분석의검측결과간적관계. 결과 불동성별간적년령차이무통계학의의(P=0.34).Keratograph 5M비침입성안표종합분석의분석계통재88례수검자중검출정상자15례,가의간안44례,검출솔위50.0％;검출간안29례,검출솔위33.0％,이채용《중국간안림상진료전가공식》적표준검출정상자39례,간안49례,간안적검출솔위55.7％.수차NITBUT (NITBUTf)소측적시간단우복개정개각막적평균NITBUT(NITB UTav),차이유통계학의의(P=0.00),단이자간정현저정상관(rs=0.62,P=0.00).간안분급여NITBUTf급NITBUTav균정현저부상관(rs=-0.60、-0.89,균P=0.00),여결막충혈정도분급정정상관(rs=0.24,P=0.02).결막충혈정도분급여NITBUTav정부상관(rs=-0.24,P=0.02),단여NITBUTf、TBUT、SⅠt치、각막형광소염색평분균무명현상관성(rs=-0.13,P=0.22;rs=0.16,P=0.14;rs=-0.16;P=0.13;rs=-0.08;P=0.44).TBUT여NITBUTf간차이무통계학의의(P=0.71),이자정정상관성(rs=0.23,P=0.03);단TBUT여NITBUTav무명현상관(rs=0.18,P=0.09);S Ⅰ t결과여NITBUTf급NITBUTav균무명현상관성(rs =0.20,P=0.07;rs=0.05,P=0.66). 결론 Keratograph 5M비침입성안표종합분석의측득적NITBUTav치대평고안표정황의의경대,대구결막충혈적검측가작위림상판단안표건강여부적삼고지표지일.
Background The incidence of dry eye is growing.However,the early diagnosis of dry eye is still difficult up to now.Keratograph 5M analyzer,a novel noninvasive ocular surface analyzer for dry eye may offer important parameters.Objective This study was to evaluate the clinical value of Keratograph 5M analyzer for clinical diagnosis of dry eye.Methods An observational study was proceeded with 88 cases who accepted myopia diagnosis in Tianjin Medical University Eye Hospital from October to December 2013.A series of conventional dry eye-related examinations were performed on the patients,including tear film break-up time (TBUT),corneal fluorescein staining scoring,Schirmer Ⅰ test (S Ⅰ t),and then Keratograph 5M analyzer-related examinations were subsequently carried out,including noninvasive tear film break-up time (NITBUT) and conjunctival hyperemia scoring.The correlations between conventional dry eye-related examinations and Keratograph 5M analyzer-related examinations were assessed by using Spearman rank correlation analysis.Results A total of 88 patients were recruited with male 32 and female 56.No significant difference in age was found between different genders (P =O.34).In 88 patients,Keratograph 5M analyzer showed the non-dry eyes in 15 patients,suspicious 44 patients (50.0％) and dry eyes in 29 patients (33.0％).However,the non-dry eyes were checked out in 39 patients and dry eyes were in 49 (55.7％) based on China Dry Eye Clinical Diagnosis and Treatment Consensus.The first NITBUT (NITBUTf) was less than the average NITBUT (NITBUTav) (P =0.00),and a positive correlation was seen between them (rs =0.62,P =0.00).Dry eye grade was significantly correlated with NITBUTf or NITBUTav or conjunctival hyperemia scoring (rs =-0.60,P =0.00 ; r,=-0.89,P =0.00 ; rs =0.24,P =0.02).A negative correlation was found between the conjunctival hyperemia scoring and NITBUTav (rs =-0.24,P =0.02).However,no significant correlation was seen between conjunctival hyperemia scoring and NITBUTf,TBUT,S Ⅰ t or corneal fluorescein staining scoring (rs=-0.13,P=0.22;rs=0.16,P=0.14;rs =-0.16,P=0.13;rs=-0.08,P=0.44).No significant difference was found between TBUT and NITBUTf (P =0.71).And TBUT was correlated with NITBUTf (rs =0.23,P =0.03),but not NITBUTav (rs =0.18,P =0.09).In addition,no significant correlations were seen between S Ⅰ t and NITBUTf or NITBUTav (rs=0.20,P=0.07;rs=0.05,P=0.66).Conclusions NITBUTav has an important significance in assessing overall ocular surface conditions.The conjunctival hyperemia score is one of refrent indicators to judge ocular surface status.
