摘要
目的分析2型糖尿病患者眼表及泪液蛋白成分,并探讨其变化的原因。方法 收集2型糖尿病患者65例(72眼),拟行白内障手术患者40例(40眼)作为对照组。根据其眼底改变将糖尿病患者分为:糖尿病无眼底病变(non-diabetic retinopa-thy,NDR)组、非增生性糖尿病视网膜病变(nonproliferative diabetic retinopathy,NPDR)组和增生性糖尿病视网膜病变(prolifera-tive diabetic retinopathy,PDR)组。对所有患者进行干眼症状的问卷调查,观察指标包括角膜知觉、Schirmer I试验、泪膜破裂时间(break-up time,BUT)、角膜荧光素染色等,分别测定各组泪液总蛋白和泪液中乳铁蛋白、溶菌酶的含量等,并与正常对照组的各项指标进行对比。结果 糖尿病组干眼症阳性的患者为46例(70.77%)明显高于对照组11例(27.50%);Schirmer I试验显示:PDR组(9.76±2.76)mm远小于对照组(14.60±4.53)mm,BUT检查发现PDR组(7.00±2.24)s远少于对照组(11.32±2.95)s,角膜荧光染色评分PDR组(1.14±0.91)分高于对照组(0.44±0.65)分(均为P<0.05);NPDR组、PDR组角膜知觉[39.25±10.92)mm、(29.52±15.48)mm]及角膜神经纤维密度[(1053±142)μm/视野、(890±175)μm/视野]与对照组[(49.20±9.43)mm、(1248±151)μm/视野]比较均明显下降(均为P<0.05)。泪液总蛋白各组间比较差异无显著性,但NP-DR与PDR组中乳铁蛋白、溶菌酶含量较对照组均明显降低(均为P<0.05)。糖尿病患者的病程及血糖控制情况与眼表改变各参数均有明显的相关性。结论 糖尿病患者,特别是PDR患者易发生眼表异常,定期进行相关检查及早发现并治疗眼表疾病意义重大。
Objective To analyze the composition of the ocular surface and tear proteins of patients with type 2 diabetes mellitus,and discuss the causes of changes.Methods Sixty-five cases（72 eyes） with type 2 diabetes mellitus and forty cases（40 eyes） of non-diabetic controls were recruited.All patients received the questionnaire about the dry eye symptoms,including corneal fluorescein staining,corneal sensitivity measurement,SchirmerⅠtest,film break-up time（BUT）.Based on stage of the classification of diabetic retinopathy,the diabetic patients were divided into three sub-groups which included non-diabetic retinopathy（NDR）,non-proliferative diabetic retinopathy（NPDR） and proliferative diabetic retinopathy（PDR）.Total tear proteins,lysozyme and lactoferrin in tear were detected separately in these three groups,and compared with control group.Results The cases with positive dry eye symptoms in the diabetic group 70.77%（46 cases） were larger than that in the control group 27.50%（11 cases）,the results of SchirmerⅠtest in PDR group（9.76±2.76）mm was less than that in control group（14.60±4.53）mm;BUT in PDR group（7.00±2.24）seconds was less than that in control group（11.32±2.95）seconds,the results of corneal fluorescein staining in PDR group 1.14±0.91 was higher than that in control group 0.44±0.65,there were statistical differences（All P0.05）.The corneal sensitivity in NPDR group,PDR group and control group were（39.25±10.92）mm,（29.52±15.48）mm,（49.20±9.43）mm,the corneal nerve fibre density were（1 053±142）μm per visual field,（890±175）μm per visual field,（1 248±151）μm per visual field,there were significant decline in NPDR group,PDR group（All P0.05）.There was no significant difference in total tear proteins among these groups,but the concentrations of lactoferrin and lysozyme decreased significantly in NPDR and PDR groups compared with control group separately（All P0.05）.All parameters were related to the status of metabolic control and diabetic duration.Conclusion Diabetic patients present different degree of corneal damages,especially in the group with PDR.They should be examined regularly for early diagnose and treatment.
出处
《眼科新进展》
CAS
北大核心
2011年第3期267-270,共4页
Recent Advances in Ophthalmology
关键词
2型糖尿病
角膜知觉
泪液蛋白
type 2 diabetes mellitus
corneal sensitivity
tear film protein
