2型糖尿病病情及干眼症相关性探究.doc

2型糖尿病病情及干眼症相关性探究 　【摘要】 ［目的］探讨2型糖尿病患者干眼症相关客观指标变化与糖尿病病程、血糖控制情况及糖尿病视网膜病变程度之间的相关性［方法］测定51例(102眼)2型糖尿病患者及20例(40眼)正常人泪膜破裂时间，并行泪液分泌试验及角膜荧光素染色试验，观察糖尿病病程、血糖控制情况及糖尿病性视网膜病变程度［结果］与正常对照组比较，糖尿病组患者泪膜破裂时间显著缩短，角膜荧光素染色阳性率显著增高，基础泪液分泌值显著减少.糖尿病患者的泪膜破裂时间、角膜荧光素染色阳性率及基础泪液分泌值与血糖控制情况呈显著相关性，而与糖尿病病程及糖尿病性视网膜病变程度无明显相关性［结论］2型糖尿病患者是干眼症的易患人群，较好地控制2型糖尿病患者血糖可预防干眼症的发生，缓解或消除干眼症症状. 【关键词】 糖尿病 2型 干眼病 糖尿病视网膜病变 ABSTRACT:OBJECTIVETo investigate the correlation of the duration, severity and grade of diabetic retinopathy (DR) with the changes of ocular surface in type 2 diabetes mellitus(T2DM)METHODSIt was examined in 102 eyes of 51 cases of non insulin dependent T2DM and 40 eyes of 20 healthy subjects that the tear film break up time(BUT) and Schirmer I test, fluorescein vital staining(FL). The grades of DR in patients were also evaluated with fluorescein angiographyRESULTSThe mean BUT and SchirmerI test in the diabetic patients was significantly lower than that in the control subjects. The average score of FL were significantly higher in diabetic patients than that of control subjects. The BUT value, SchirmerI test value, the score of FL were significantly related to the control condition of diabetes, and no significant correlation with duration of T2DM and the grade of DRCONCLUSIONT2DM would damage ocular surface, including tear film function and keratoconjunctival epithelium, and the extent of damage is closely related to the control condition of diabetes. Non insulin dependent diabetics are susceptible persons of the dry eye. Key words:diabetes mellitus, type 2;xerophthalmia;diabetic retinopathy 糖尿病可通过一系列病理过程影响眼表微环境而引起眼表的角膜、结膜及泪液发生变化.本研究给糖尿病患者行泪膜破裂时间（breakup time，BUT）测定、基础泪液分泌试验及角膜荧光素染色（fluorescein vital， FL），同时观察糖尿病病程、血糖控制情况以及糖尿病性视网膜病变程度，探讨了2型糖尿病患者并发干眼症的情况以及干眼症客观指标与糖尿病病程、血糖控制情况、糖尿病性视网膜病变程度之间的相关关系. 1 对象和方法 1.1 对象 糖尿病组与正常对照组选择标准：无明确诊断的角结膜病史（细菌性、病毒性及真菌性），无软、硬性角膜接触镜佩戴史，近4周内无眼部局部用药史，无糖尿病视网膜病变以及糖尿病性白内障之外的眼科疾病，无眼部外伤及眼部手术史.2型糖尿病组为2005年11月—2006年4月间经延边大学医院内分泌科确诊的51例，均符合WHO 1999年糖尿病诊断标准［1］，年龄为36～76岁；男性为27例