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干眼检查中泪膜破裂时间测定对泪河高度影响.doc

花匠小妙招
2025-09-06 09:28

干眼检查中泪膜破裂时间测定对泪河高度影响

干眼检查中泪膜破裂时间测定对泪河高度影响　　[摘要] 目的研究在进行泪河高度（TMH）测量时非侵入性泪膜破裂时间测定（NIK-BUT）对其的影响。方法整群选取2015年3月―2015年6月在厦门市中医院眼科就诊的63例干眼患者及63名常规体检的健康人，所有入选者都用Keratograph 5M眼表综合分析仪（OCULUS，德国）拍摄泪河的图片，记录基础泪河高度（△TMH），并在非侵入性泪膜破裂时间检查前后分别测量泪河高度。泪膜破裂时间检查要求受检者尽量保持不眨眼，并在下一次眨眼后停止检查。结果健康人群及干眼患者的基础TMH（△TMH）分别为（0.24±0.06） mm和（0.14±0.04） mm。干眼患者基础TMH值显著低于健康人群TMH（P0.001）。在行NIK-BUT检查后TMH值显著增加，健康人群TMH增加（0.12±0.08）mm，干眼患者TMH增加（0.06±0.09）mm（P 0.001，P=0.026）。结论在用眼表综合分析仪检测干眼患者时，泪河高度测量应该在泪膜破裂时间检查等强制性眨眼动作前完成。　　[关键词] 干眼；泪河高度测量；非侵入性泪膜破裂时间　　[中图分类号] R777 [文献标识码] A [文章编号] 1674-0742（2016）06（b）-0051-03 　　[Abstract] Objective To study the effect of non-invasive break-up time （NIK-BUT） measurement on tear meniscus height（TMH） assessment. Methods Group selection 63 patients with dry eye and 63 normal subjects who treated in Xiamen Hospital of TCM from March 2015 to June 2015 were enrolled.Lower tear meniscus images were captured， the baseline TMH（△TMH） was measured，and then recorded TMH values before and after NIK-BUT measurements in each subject with Keratograph 5M（OCULUS，Germany）. NIK-BUT measurements need all subjects to keep their eyes open as long as possible until the next blink. Results The △TMH values of the normal and dry eye groups were （0.24±0.06）mm and （0.14±0.04）mm. The △TMH values of dry eye patients were significantly lower than normal subjects （P0.001）. Significant increases in TMH values were observed in both normal subjects （0.12±0.08）mm and dry eye patients（0.06±0.09）mm after NIK-BUT measurement （P0.001， P=0.026）. Conclusion On the diagnosis of dry eye with Keratograph 5M，TMH should be assessed before tests that require forced eye opening such as NIK-BUT. 　　[Key words] Dry eye； Tear meniscus height（TMH）； Measurement，Non-invasive break-up time （NIK-BUT）　　干眼指的是因泪液的量或质或流体动力学异常继发泪膜不稳定和（或）眼表损害而致眼部不适及视功能障碍的一类疾病[1]，目前其全球内的发病率约为5.5%～33.7%。对于干眼的分类及诊断，目前国际上尚无明确的统一标准。我国将干眼分为粘蛋白缺乏型、水液缺乏型、蒸发过强型、泪液动力学异常型以及混合型五大类型，尤以混合型干眼最为常见。在诊断上，荧光素染色、泪膜破裂时间（BUT）及泪液分泌测定（Schirmer’s试验）是传统的诊断干眼的客观检测方法[2]。但是，随着科技的进步，非侵入性的