目的：评价阿奇霉素雾化熏蒸联合睑板腺按摩治疗睑板腺功能障碍(MGD)的有效性及安全性。

方法：前瞻性研究。选择2019-01/06在本院的47例中、重度MGD患者进行阿奇霉素雾化熏蒸联合睑板腺按摩治疗。在基线、治疗1、3mo时分别记录患者眼表疾病指数问卷(OSDI)、非侵入式泪膜破裂时间(NI-BUT)、泪河高度以及睑板腺萎缩率。

结果：治疗1mo的OSDI为21.43±13.14分、首次NI-BUT为9.03±6.09s、平均NI-BUT为9.72±4.05s、泪河高度为0.24±0.09mm，与基线相比有差异(均P<0.05)； 治疗3mo的OSDI为23.02±11.41分、首次NI-BUT为7.80±4.82s、平均NI-BUT为10.25±4.78s、泪河高度为0.24± 0.09mm，与基线相比有差异(均P<0.05)； 治疗1mo与3mo OSDI、首次NI-BUT、平均NI-BUT和泪河高度均无差异(均P>0.05)。治疗前后的睑板腺萎缩率无差异(均P>0.05)。

结论：阿奇霉素雾化熏蒸联合睑板腺按摩可有效改善中、重度MGD患者的临床症状，并且增加首次NI-BUT、平均NI-BUT和泪河高度。

METHODS: In this prospective study, 47 patients with moderate to severe MGD were treated with azithromycin aerosol fumigation combined with meibomian gland massage. The ocular surface disease index(OSDI)questionnaire, noninvasive tear breakup time(NI-BUT), tear meniscus height and atrophic rate of meibomian glands were recorded at baseline, at 1mo after treatment, and at 3mo after treatment.

RESULTS: The OSDI was 21.43±13.14, the first NI-BUT was 9.03±6.09s, the average NI-BUT was 9.72±4.05s, and the tear meniscus height was 0.24±0.09mm after 1mo of treatment. The OSDI was 23.02±11.41, the first NI-BUT was 7.80±4.82s, the average NI-BUT was 10.25±4.78s, and the tear meniscus height was 0.24±0.09mm after 3mo of treatment. Compared with the baseline, the difference was statistically significant(all P<0.05); There was no significant difference in OSDI, first NI-BUT, average NI-BUT and tear meniscus height between 1mo after treatment and 3mo after treatment(all P>0.05). Compared with baseline, there was no significant improvement in atrophic rate of meibomian glands after 1mo of treatment and 3mo after treatment(all P>0.05). In addition, azithromycin aerosol fumigation administration was well tolerated and no adverse reactions were observed during follow-up(all P>0.05).

CONCLUSION: Azithromycin aerosol fumigation combined with meibomian gland massage can effectively improve the clinical symptoms and increase first NI-BUT, average NI-BUT, tear meniscus height of patients with moderate to severe MGD.