CAJ | 학술논문

目的评价眼表综合分析仪在干眼患者中的应用价值.方法横断面研究.选择70例(135眼)干眼患者作为研究对象.检查指标包括眼表疾病指数(OSDI)评分、泪液分泌试验(SⅠT)、睑板腺分泌物性质检查,以及利用眼表综合分析仪系统——Keratograph 5M进行泪河高度测量、泪膜破裂时间(BUT)测定以及睑板腺检查.Keratograph 5M与传统检查方法之间的相关性、干眼患者睑板腺状况评分与OSDI评分及BUT的相关性用Pearson相关及线性回归进行分析,Keratograph 5M分析眼表状况的重测信度用组内相关系数评价.结果 70例(135眼)患者OSDI评分为(15.8±3.4)分,SⅠT为(6.0±7.7)mm,泪河高度为(0.27±0.13)mm,BUT为(7.9±5.5)s.睑板腺分泌物评分为(3.3±1.4)分,睑板腺缺失面积评分为(3.4±1.6)分.测得的BUT时间越短,SⅠT越短(r=0.474,P＜0.01);泪河高度越低,SⅠT越短(r=0.432,P＜0.01).睑板腺分泌物评分、睑板腺照相评分与OSDI评分呈正相关(r=0.673、0.752,P＜0.05),与BUT呈负相关(r=-0.638、-0.603,P＜0.05).眼表综合分析仪的检查结果具有较好的重测信度(ICC值在0.84～0.89之间).结论眼表综合分析仪能够直观地评价干眼患者眼表状况,是一种非接触性、无创、可重复性强的快速检查手段,具有实际临床应用价值.
목적 평개안표종합분석의재간안환자중적응용개치.방법 횡단면연구.선택70례(135안)간안환자작위연구대상.검사지표포괄안표질병지수(OSDI)평분、루액분비시험(SⅠT)、검판선분비물성질검사,이급이용안표종합분석의계통——Keratograph 5M진행루하고도측량、루막파렬시간(BUT)측정이급검판선검사.Keratograph 5M여전통검사방법지간적상관성、간안환자검판선상황평분여OSDI평분급BUT적상관성용Pearson상관급선성회귀진행분석,Keratograph 5M분석안표상황적중측신도용조내상관계수평개.결과 70례(135안)환자OSDI평분위(15.8±3.4)분,SⅠT위(6.0±7.7)mm,루하고도위(0.27±0.13)mm,BUT위(7.9±5.5)s.검판선분비물평분위(3.3±1.4)분,검판선결실면적평분위(3.4±1.6)분.측득적BUT시간월단,SⅠT월단(r=0.474,P＜0.01);루하고도월저,SⅠT월단(r=0.432,P＜0.01).검판선분비물평분、검판선조상평분여OSDI평분정정상관(r=0.673、0.752,P＜0.05),여BUT정부상관(r=-0.638、-0.603,P＜0.05).안표종합분석의적검사결과구유교호적중측신도(ICC치재0.84～0.89지간).결론 안표종합분석의능구직관지평개간안환자안표상황,시일충비접촉성、무창、가중복성강적쾌속검사수단,구유실제림상응용개치.
Objective To assess the clinical application of the Keratograph 5M in dry eye patients.Methods In a noninterventional,cross-sectional study,135 eyes from 70 patients who were diagnosed with dry eye from October to November 2013 were recruited.The ocular surface disease index (OSDI),Schirmer Ⅰ test (S Ⅰ T) and meibomian secretion were measured.Tear meniscus height,tear film break-up time (BUT) and the meibomian glands were observed with the Keratograph 5M.A Pearson correlation and linear regression were used to study the correlation between the Keratograph 5M and traditional examinations,and the relationship between scores for the meibomian gland status compared to the ocular surface disease index and tear film break-up time.An interclass correlation coefficient was used to evaluate the repeatability of the Keratograph 5M.Results Scores for all subjects were OSDI,15.8±3.4; S Ⅰ T,6.0±7.7 mm; tear meniscus height,0.27±0.13 mm; BUT,7.9±5.5 s; the meibomian secretion score,3.3±1.4; and meiboscore 3.4±1.6.Both BUT and tear meniscus height were positively correlated with S Ⅰ T (r=0.474,0.432,P＜0.01).Both the meibomian secretion score and meiboscore had a positive correlation with OSDI (r=0.673,0.752,P＜0.05) and a negative correlation with BUT (r=-0.638,-0.603,P＜0.05).The Keratograph 5M showed fine test-retest reliability (ICC=0.84-0.89).Conclusion The Keratograph 5M can directly evaluate the ocular surface condition of dry eye patients.The Keratograph 5M is a non-contact,noninvasive and reliable examination with practical clinical application.