目的:研究糖尿病患者在自然状态下和持续睁眼状态下眼表面规则指数的变化。方法:分别对13例糖尿病患者连续病例及13例非糖尿病对照组患者(年龄、性别匹配)检测泪液分泌试验(SchirmerⅠtest,SⅠt),泪膜破裂时间(tear break-up time,BUT),角膜荧光素染色(fluorescein staining,FL)及干眼症症状问卷调查。角膜地形图检测自然眨眼状态下及持续睁眼10s后的角膜不规则系数(irregular index,Irreg),后者模拟日常无意识眨眼次数减少的凝视状态。结果:更多糖尿病患者(9/13,对照组6/13)主诉每周至少一次出现一种以上干眼症症状。与对照组相比,糖尿病组SⅠt试验(11.4±2.5vs14.9±3.3mm/5min,P<0.01)及BUT(10.9±4.7vs13.6±3.4s,P=0.02)均明显降低。两组FL差异无显著性意义(0.59±0.65vs0.29±0.54,P=0.06)。自然状态下糖尿病组Irreg较对照组高,但差异无统计学意义(分别为1.36±0.46,1.11±0.45,P=0.06)。然而,持续睁眼10s后,糖尿病组Irreg明显增高至4.23±1.32,而对照组保持在2.08±0.60(P<0.01)。结论:糖尿病患者反射性泪液分泌及泪膜稳定性下降。持续睁眼时糖尿病患者角膜规则性指数(SRI)增加。

AIM:To investigate the variance of the irregular index of diabetics under ordinary circumstances and after sustained eye opening. ·METHODS:In 13 consecutive diabetics and 13 cases of non-diabetic controls (age and sex matched),we performed the Schirmer Ⅰ test (SⅠt),tear break-up time (BUT),fluorescein staining (FL) and symptom of dry eye questionnaires. Irregular index of corneal topography was also measured under routine circumstances and after sustained eye opening for 10 seconds,as a simulation of daily acts of gazing,which is defined as looking at an object with involuntary blink suppression. ·RESULTS:More diabetics (9/13 vs the control group 6/13) complained the presence of one or more symptoms of dry eye once a weak. When compared with the control group diabetics showed significantly decreased SⅠt (11.4±2.5 vs 14.9±3.3mm/5min,P<0.01 ) and BUT (10.9±4.7 vs 13.6±3.4s,P=0.02).None of values differed between FL of two groups (0.59±0.65 vs 0.29±0.54,P=0.06). The ordinary irregular index was higher in diabetics although the differences were not significant (1.36±0.46,1.11±0.45,P=0.06). However,after 10 seconds of sustained eye opening,the irregular index increased significantly to 4.23±1.32 in the diabetic group,whereas it remained at 2.08±0.60 in controls (P<0.01). ·CONCLUSION:In diabetics,reflex tearing and the tear film stability are demonstrated to be decreased. The SRI of diabetics increases when the eyes are kept open.

R587.1

中国宁夏自然科学基金资助项目(No.NZ08133)~~