睑板腺功能障碍相关干眼的临床观察及影响因素分析
Clinical observation of meibomian gland dysfunction-related dry eye and its influencing factors
目的:分析睑板腺功能障碍(MGD)相关干眼的临床表现及影响因素。方法:横断面研究。纳入郑州大学第一附属医院2023年10月至2024年2月确诊为MGD相关干眼患者403例(806只眼)为研究对象。所有患者行眼表综合分析,记录患者年龄、泪河高度、非接触泪膜破裂时间、泪膜脂质层厚度、睑板腺缺失面积评分、睑板腺开口评分及睑缘形态异常评分等,并行影响因素Spearman相关性分析。结果:年龄与睑缘形态异常评分、睑板腺缺失面积评分、睑板腺开口评分之间存在正相关( r=0.72、0.64、0.64,均 P<0.001),睑板腺缺失面积评分与睑缘形态异常评分及睑板腺开口评分均呈正相关( r=0.63、0.55,均 P<0.001);睑缘形态异常评分与睑板腺开口评分存在正相关( r=0.81,均 P<0.001)。非接触首次泪膜破裂时间与泪膜脂质层厚度呈负相关( r=-0.28, P<0.001)。非接触平均泪膜破裂时间与泪膜脂质层厚度呈负相关( r=-0.16, P<0.001)。 结论:患者年龄越大,睑板腺缺失面积越多,睑缘形态越异常,睑板腺开口堵塞越严重。睑板腺缺失面积越大、睑板腺开口堵塞越严重、睑缘形态越异常。泪膜脂质层厚度越厚,泪膜的稳定性可能越差。
更多Objective:To analyze the clinical manifestation and influencing factors of meibomian gland dysfunction (MGD) related dry eye.Methods:This was a cross-sectional study. A total of 403 cases (806 eyes) with MGD-related dry eye in the Dry Eye Center of the First Affiliated Hospital of Zhengzhou University from Oct. 2023 to Feb. 2024 were included in the study. Statistics with comprehensive ocular surface analysis examination were recorded on the age of the patients, tear meniscus height, non-invasive tear film break-up time, lipid layer thickness, meibomian gland loss score, meibomian gland opening score, and eyelid margin morphological score in each eye of the patients, and Spearman′s correlation analysis was performed.Results:There was a positive correlation among age and eyelid margin morphology abnormality score, meibomian gland loss area score and meibomian gland opening score ( r=0.72, 0.64, 0.64; all P<0.001). There was a positive correlation between eyelid margin morphology abnormality score and meibomian gland loss area score, between meibomian gland loss area score and meibomian gland opening score, and between eyelid margin morphology abnormality score and meibomian gland opening score ( r=0.63, 0.55, 0.81; all P<0.001).There was a negative correlation between first non-invasive tear film break-up time and lipid layer thickness ( r=-0.28, P<0.001).There was a negative correlation between average non-invasive tear film break-up time and lipid layer thickness ( r=-0.16, P<0.001). Conclusion:The older the age, the more area of meibomian gland loss, the more morphological of the eyelid margin, and the worse the obstruction of meibomian gland opening; the more area of meibomian gland loss, the more morphological of the eyelid margin, and the worse the obstruction of meibomian gland opening. The thicker the lipid layer of the tear film, the less stable the tear film may be.
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