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[摘要]
目的：研究不同发病年龄组及不同病程组的原发干燥综合征(Sjö；gren's syndrome，SS)眼部表现的差异，以探讨SS患者的泪液功能和角结膜状况及其影响因素。
方法：回顾性分析SS患者80例160眼，根据病程将其分为3组：A组患者病程≤1a，B组患者病程1～2a，C组患者病程>2a，同时根据年龄将其分4个组：A组14～30岁，B组31～45岁，C组46～60岁，D组61～75岁，对比分析各组角膜荧光素染色(cornea fluorescein，CF)、泪膜破裂时间(break-up time，BUT)及Schirmer试验(Schirmer Ⅰ test，SⅠt)检查以及干眼症出现情况。
结果：SS患者干眼症患病率为38%，明显高于普通人群，干眼症患病率随发病年龄的增大(χ2=10.66，P=0.014)及病程的延长(χ2=20.127，P=0.000)而增加。SⅠt随发病年龄的增大(H=2.575，P=0.462)及病程的延长(H=7.356，P=0.025)而减少，BUT随发病年龄的增大(H=11.932，P=0.008)及病程的延长(H=12.969，P=0.002)而缩短，CF随发病年龄的增大(H=14.068，P=0.003)及病程的延长(H=16.060，P=0.000)而加重。
结论：SS患者易继发干眼症。SS患者的眼表改变表现为泪液的质和量的失调，泪膜稳定性下降，泪液分泌量下降，角膜荧光素着色，上述变化与发病年龄和病程成正相关。BUT、SⅠt、CF检查有必要作为SS患者的眼科常规检查。
[Key word]
[Abstract]
AIM: To analyze the difference of ocular manifestations in Sjögren's syndrome(SS)of different age groups and different disease courses. And investigate whether SS is correlated with tear dysfunction and ocular surface disorder.
METHODS: Retrospective analysis of 80 patients(160 eyes)with SS. The cases were divided into three groups according to the course. Group A: course of disease ≤1a. Group B: course of disease from 1 to 2a; Group C: course of disease >2a. At the same time, cases were divided into four groups according to the age, group A: 15-30 years old; Group B: 31-45 years old; Group C: 46-60 years old; Group D: 61-75 years old. The data including the staining of cornea fluorescein(CF), the tear break-up time(BUT), Schirmer Ⅰ test(SⅠt)and the occurrence of dry eye were collected and compared.
RESULTS: Prevalence of dry eye with SS was 36%, significantly higher than the general population. The prevalence of dry eye increased with increasing age(χ2=10.66, P=0.014)and extension of course(χ2=20.127, P=0.000), the secretion of tear decreased with increasing age(H=2.575, P=0.462)and extension of course(H=7.356, P=0.025)and the tear film break-up time become shorter with increasing age(H=11.932, P=0.008)and extension of course(H=12.969, P=0.002), the degree of staining with fluorescin on the cornea increased with increasing age(H=14.068, P=0.003)and extension of course(H=16.060, P=0.000).
CONCLUSION: Patients with SS are susceptible persons of the dry eye. The ocular surface disease in SS is characterized by a disorder of tear quantity and quality, decreased tear film stability, decreased secretion of the tear, staining with fluorescin on the cornea. The correlation of these changes and age and course is positive. BUT, SⅠt and CF should become routine tests of ophthalmology in SS.
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