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目的研究干眼患者症状与泪膜脂质层厚度(LLT)的相关关系。设计回顾性病例系列。研究对象随机选取2015年7-10月就诊于北京同仁医院眼科门诊的干眼患者139例,其中男性58例,女性81例,年龄18~77岁,平均(37.75±12.86)岁。方法所有入组患者均进行眼表疾病指数(OSDI)问卷(共包括12项症状)调查以及用Lipi View~眼表面光干涉仪测量LLT。根据干眼症状(OSDI问卷评分)分为三组:轻度症状组35例(0~20分),中度症状组61例(21~45分),重度症状组43例(46~100分)。分析干眼症状与LLT的相关性以及不同程度干眼症状与LLT的关系。主要指标OSDI问卷评分、泪膜脂质层厚度。结果 139例干眼患者OSDI评分与LLT呈显著相关且为负相关(r=-0.256,P=0.002),随着OSDI得分增加(症状的加重)脂质层厚度变薄。OSDI问卷中异物感、眼酸痛、看电视、看电脑眼部不适与LLT有明显相关性(r=-0.206、-0.232、-0.190、-0.179,P均<0.05),其他8项症状与LLT无相关性。严重程度不同的三个组别之间LLT存在差异,尤其是轻度症状组(64.89±16.40 nm)与重度症状组(54.65±14.48 nm)之间差异更明显(F=10.092,P=0.027);轻度症状组中LLT≤60 nm者14例(40%),而重度组中LLT≤60 nm者30例(70%)(χ~2=6.953,P=0.008)。结论干眼症状与泪膜脂质层厚度呈明显负相关。干眼症状中的异物感、眼酸痛、看电视或电脑眼部不适等症状与泪膜脂质层厚度相关性较显著。泪膜脂质层厚度低于60 nm者干眼症状严重。
Objective To study the relationship between the symptoms of patients with dry eye and the thickness of lamellar lipid layer (LLT). Design retrospective case series. Subjects were randomly selected from January to October 2015 in Beijing Tongren Hospital Eye Hospital 139 cases of dry eye patients, including 58 males and 81 females, aged 18 to 77 years (mean, 37.75 ± 12.86 years). Methods All patients were enrolled in the OSDI questionnaire (12 included) and the LLT was measured using the Lipi View ~ eye surface optical interferometer. According to the symptom of dry eye (OSDI questionnaire score), the patients were divided into three groups: 35 cases (0-20) in mild symptom group, 61 cases (21-45 points) in moderate symptom group and 43 cases (46-100 cases) in severe symptom group ). The correlation between dry eye symptoms and LLT and the relationship between dry eye symptoms and LLT were analyzed. OSDI questionnaire score, tear film thickness of the lipid layer. Results The OSDI score of 139 patients with dry eye was significantly and negatively correlated with LLT (r = -0.256, P = 0.002). The thickness of the lipid layer became thinner with the increase of OSDI score (aggravation of symptoms). OSDI questionnaire, foreign body sensation, eye pain, watching TV, computer eye discomfort and LLT were significantly correlated (r = -0.206, -0.232, -0.190, -0.179, P all <0.05), the other eight symptoms and LLT No correlation. There were differences in LLT among the three groups with different severity, especially between mild group (64.89 ± 16.40 nm) and severe group (54.65 ± 14.48 nm) (F = 10.092, P = 0.027) 14 cases (40%) had LLT≤60 nm in mild symptom group, and 30 cases (70%) had LLT≤60 nm in severe group (χ ~ 2 = 6.953, P = 0.008). Conclusion Dry eye symptoms and tear film thickness of the lipid layer was significantly negatively correlated. Dry eye symptoms of foreign body sensation, eye pain, watching TV or computer eye discomfort and other symptoms and tear film thickness of the lipid layer more significant correlation. Tear film thickness less than 60 nm dry eye symptoms are serious.