摘要
【目的】分析静止期轻度和中重度甲状腺相关眼病(GO)患者眼表损害的临床特征。【方法】回顾性收集2017年4月至2019年4月于中山大学孙逸仙纪念医院内分泌与眼科诊断为静止期轻度及中重度GO的初诊患者资料,共192例192眼。其中,轻度患者121例121眼;中重度患者71例71眼。将患者分为角膜损害组和无角膜损害组,对眼表刺激征和泪膜破裂时间(TFBUT)、上睑缘瞳孔反射距离1(MRD1)、下睑缘瞳孔反射距离2(MRD2)、基础泪液分泌实验(Schirmer′s test II)、眼球突出度等指标在两组之间的差异进行分析。【结果】本研究静止期轻度GO患者中角膜损害组表现异物感(21例,52.5%)和畏光(23例,57.5%)较无角膜损害组更常见(23例,28.4%;29例,35.8%)(P≤0.05);而静止期中重度GO两组之间没有差异。静止期轻度GO角膜损害组MRD15.1(S=1.9)mm,宽于无角膜损害组4.4(S=1.5)mm,(P≤0.05);静止期中重度GO角膜损害组TFBUT3.2(S=2.3)s,较无角膜损害组明显缩短6.2(S=3.2)s,(P≤0.05);同为角膜损害,轻度与中重度GO之间的症状和体征无明显差别。【结论】静止期轻度GO眼表损害患者更易出现异物感和畏光症状,眼表损害与MRD1增加相关;而中重度GO角膜损害患者症状与无角膜损害患者无差别,眼表损害与TFBUT缩短相关。
【Objective】To analyze characteristics of ocular surface damage in inactive mild and moderate-severe Graves′Orbitopathy(GO).【Methods】In this retrospective study,the clinical characteristics of GO patients at Sun Yatsen Memorial Hospital between April 2017 and April 2019 were reviewed.Data were collected from 192 eyes of 192 cases.There were 121 eyes of 121 cases with mild GO,and 71 eyes of 71 cases with moderate-severe GO.All patients were divid⁃ed into corneal-damage and non-corneal-damage groups.The ocular surface irritation,tear film breakup time(TFBUT),marginal reflex distance 1(MRD1),marginal reflex distance 2(MRD2),Schirmer′s testⅡ,and proptosis of the two groups were compared.【Results】Grittiness(21 cases,52.5%)and photophobia(23 cases,57.5%)were higher,in cornealdamage group of inactive mild GO patients,compared with non-corneal-damage group(23 cases,28.4%,29 cases,35.8%,respectively)(P≤0.05);but there was no statistical difference in symptoms between the two groups of moder⁃ate-severe GO patients.There was statistical difference in increased MRD1 between corneal-damage group[5.1(S=1.9)mm]and non-corneal-damagegroup[4.4(S=1.5)mm]of inactive mild GO patients(P≤0.05).Besides,decreased TFBUT in moderate-severe corneal-damage GO patients was 3.2(S=2.3)s,shorter than non-corneal-damage group[6.2(S=3.2)s,(P≤0.05)].In corneal-damage groups,there was no significant difference in symptoms and signs be⁃tween mild and moderate-severe GO.【Conclusions】Grittinessand photophobia are common symptoms in patients with mild GO ocular surface damage,and MRD1 is related with ocular surface damage.There is no difference in symptom be⁃tween corneal-damage group and non-corneal-damage group of moderate-severe GO patients,and TFBUT is related with ocular surface damage.
作者
余韵
王晓艺
欧阳正隆
范淑贤
胡玉新
徐明彤
王梅
YU Yun;WANG Xiao-yi;OUYANG Zheng-long;FAN Shu-xian;HU Yu-xin;XU Ming-tong;WANG Mei(Department of Ophthalmology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;Department of Endocrinology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou 510120,China;Department of Ophthalmology,The Seventh Affiliated Hospital,Sun Yat-sen University,Shenzhen 518107,China)
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2020年第6期937-943,共7页
Journal of Sun Yat-Sen University:Medical Sciences
基金
中华国际医学交流基金会中青年医生甲状腺研究项目(2017-N-14)
中山大学临床医学研究5010计划项目(2019004)
中山大学孙逸仙纪念医院逸仙临床培育项目(SYS-C-201904)。
关键词
甲状腺相关眼病
静止期
眼表损害
Graves′orbitopathy
inactive
ocular surface damage
