目的：观察P2Y₂受体激动剂地夸磷索钠(DQS)滴眼液治疗糖尿病相关干眼的临床疗效。

方法：选取2022-01/03就诊于我院的糖尿病相关干眼患者80例160眼作为研究对象，随机分为研究组(40例80眼，使用3% DQS滴眼液治疗)和对照组(40例80眼，使用0.3%玻璃酸钠滴眼液治疗)。分别在基线、治疗后1wk，1、3mo进行眼表疾病指数(OSDI)评分、非接触式泪河高度(NITMH)、首次非侵入式泪膜破裂时间(NIBUTf)、平均非侵入式泪膜破裂时间(NIBUTav)、睑板腺缺失评分、脂质层厚度分级、眼红分析(包括结膜等级、睫状等级)等检查，采用眼表染色评分(OSS)法进行角结膜染色评分，并分别在基线、治疗后3mo行结膜印迹细胞学和共聚焦显微镜检查。

结果：治疗前后，两组患者OSDI评分、睑板腺缺失评分、结膜等级和睫状等级评分均无组间差异(P>0.05)。治疗后1、3mo，研究组OSS评分均低于对照组，NITMH、NIBUTf、NIBUTav均高于对照组(P<0.05)。治疗后3mo，研究组结膜杯状细胞密度较基线增多、角膜树突状细胞较基线减少(均P<0.05)，对照组较基线无明显变化(均P>0.05)。

结论：3% DQS滴眼液治疗糖尿病相关干眼效果显著，且无严重的并发症出现。

METHODS: A total of 80 patients(160 eyes)with diabetic dry eye who admitted to our hospital from January 2022 to March 2022 were selected. They were randomly divided into study group and control group. A total of 40 patients(80 eyes)in the study group were treated with 3% DQS eye drops and 40 patients(80 eyes)in the control group were treated with 0.3% sodium hyaluronate eye drops. The ocular surface disease index(OSDI)score, non-invasive tear meniscus height(NITMH), first non-invasive tear film break-up time(NIBUTf), average non-invasive tear film break-up time(NIBUTav), tarsal gland loss score, lipid layer thickness grade and bulbar redness analysis(including conjunctival grade and ciliary grade), were examined before treatment and at 1wk, 1 and 3mo after treatment, respectively. Furthermore, corneal fluorescence staining and conjunctival lissamine green staining were analyzed based on the ocular surface staining score(OSS), and the conjunctival impression cytology and confocal microscopy were evaluated before and 3mo after treatment, respectively.

RESULTS: There were no differences in OSDI score, tarsal gland loss score, conjunctival grade score and ciliary grade score between the two groups before and after treatment(P>0.05). OSS scores in the study group were lower than those in the control group, while NITMH, NIBUTf and NIBUTav were higher than those in the control group at 1 and 3mo after treatment(P<0.05). After 3mo of treatment, the density of conjunctival goblet cells increased and corneal dendritic cells decreased in the study group compared with the baseline(all P<0.05), while there were no significant changes in the control group compared with the baseline(all P>0.05).

CONCLUSION: 3% DQS eye drops were effective in treating diabetic dry eye without serious complications.