目的：评估干眼患者泪液结晶图中外层透明带的临床意义，探索评估泪液脂质层的新方法。

方法：随机选取2018-05/2019-07于在我院就诊的干眼患者47例47眼(均取右眼数据进行分析)，所有入组患者均行眼表疾病指数(OSDI)问卷评分，采用DR-1泪膜干涉成像仪行脂质层分级检测，眼表综合分析仪行非侵入式泪膜破裂时间(NIBUT)和泪河高度检查，采集泪液行泪液结晶试验，拍摄泪液结晶图全貌，使用Digimizer软件测量结晶图，计算结晶图外层透明带的面积占比，并分析其与OSDI评分、脂质层分级、泪河高度、NIBUT的相关性。

结果：本研究纳入患者泪液结晶图透明带面积占比与OSDI评分呈负相关(r=-0.764，P<0.05)，与DR-1成像仪脂质层分级呈负相关(r=-0.838，<0.05)，与NIBUT呈正相关(r=0.575，P<0.05)，与泪河高度无明显相关(r=-0.237，P=0.112)。

结论：检测泪液结晶图外层透明带可有效评估泪液脂质层情况，透明带面积占比越大，脂质层越厚。该检测方法具有结果可量化、重复性较好、设备要求低等优点。

METHODS:Forty-seven patients were randomly selected from the outpatient department of ophthalmology, He Eye hospital, Shenyang from May 2018 to July 2019. The right eye was selected as the study object. All patients were investigated by the ocular surface disease index(OSDI)questionnaire and performed lipid layer classification by DR-1 tear interferometry, NIBUT and tear meniscus height examination by OCULUS Keratograph. Then tears were collected and tear ferning tests was performed. The whole tear crystallization images were observed and photographed by microscopy, then measured by Digimizer software and the area ratios of outer transparent belt were calculated. Pearson correlation analysis were performed between area ratios of outer transparent belt and OSDI scores, lipid layer levels, tear meniscus height values, NIBUT values.

RESULTS: The area ratios of outer transparent belt were negatively correlated with OSDI scores(r=-0.764, P<0.05), negatively correlated with lipid layer levels(r=-0.838, P<0.05), positively correlated with NIBUT values(r=0.575, P<0.05)and the correlation between tear meniscus height values was not significantly(r=-0.237, P=0.112).

CONCLUSION: The outer transparent belt in tear crystallization image can be used to evaluate the lipid layer of tear film; the larger area ratios of outer transparent belt, the thicker the lipid layer. This method has the advantages of quantified results, good repeatability, low requirement on equipment, and is worth popularizing.