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樊旭.老年糖尿病干眼的患病率及其诱发因素分析[J].中国医药科学,2023,(1):192-196        基金项目:
老年糖尿病干眼的患病率及其诱发因素分析
Analysis on the prevalence of diabetic dry eye in the elderly and the predisposing factors
  
DOI:
中文关键词:  糖尿病;老年;干眼;糖尿病视网膜病变;糖尿病周围神经病变
英文关键词:Diabetes mellitus; The elderly; Dry eye; Diabetic retinopathy; Diabetic peripheral neuropathy
作者单位
樊旭 北京市健宫医院眼科,北京 100054 
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中文摘要:
      [摘要] 目的 了解老年糖尿病干眼的患病率及其可能的诱发因素。 方法 选取2020年12月至2022年4月于北京市健宫医院眼科就诊的≥60岁的80例2型糖尿病患者为糖尿病组,同期志愿加入本研究的年龄及性别与糖尿病组匹配的50名健康者为对照组。将糖尿病组患者分别依据血糖控制情况、病程、糖尿病视网膜病变(DR)、糖尿病周围神经病变(DPN)进一步分组。所有研究对象均接受Salisbury眼睛评价问卷调查以及泪膜破裂时间、角膜荧光素染色和基础泪液分泌量检查。 结果 糖尿病组干眼患病率为60.0%,高于对照组的30.0%,差异有统计学意义(P=0.001)。对照组、糖尿病组血糖控制良好亚组和糖尿病组血糖控制不佳亚组的干眼患病率、泪膜破裂时间、基础泪液分泌量、角膜荧光素染色阳性率、干眼症状发生率比较,差异有统计学意义(P < 0.05)。对照组、糖尿病组病程<10年亚组和糖尿病组病程≥10年亚组的干眼患病率、泪膜破裂时间、基础泪液分泌量、角膜荧光素染色阳性率、干眼症状发生率比较,差异有统计学意义(P < 0.05)。对照组、糖尿病组无DR亚组和糖尿病组并发DR亚组的干眼患病率、泪膜破裂时间、基础泪液分泌量、角膜荧光素染色阳性率、干眼症状发生率比较,差异有统计学意义(P < 0.05)。对照组、糖尿病组无DPN亚组和糖尿病组并发DPN亚组的干眼患病率、泪膜破裂时间、基础泪液分泌量、角膜荧光素染色阳性率、干眼症状发生率比较,差异有统计学意义(P < 0.05)。进一步两两比较发现,随着血糖控制变差、病程变长、并发DR、并发DPN,泪膜破裂时间缩短、基础泪液分泌量减少、角膜荧光素染色阳性率和干眼症状发生率均增加。 结论 老年糖尿病患者干眼的患病率较普通人群显著升高,血糖控制不佳、病程长、并发DR或DPN可能在其中起一定的诱发作用。
英文摘要:
      the Department of Ophthalmology in Beijing Jiangong Hospital from December 2020 to April 2022 were included in the diabetic group, and 50 healthy volunteers with age and gender matching those patients in the diabetic group at the same period were included in the control group. Patients in the diabetic group were further grouped according to the status of glycemic control, disease duration of diabetes mellitus, diabetic retinopathy (DR), and diabetic peripheral neuropathy (DPN). All study subjects were subject to a survey by the Salisbury eye evaluation questionnaire, and to examinations of tear film rupture time, corneal fluorescein staining, and basal tear secretion. Results The prevalence of dry eye in the diabetic group was 60.0%, higher than 30.0% in the control group, with statistically significant difference (P=0.001). There were statistically significant differences in the prevalence of dry eye, tear film rupture time, basal tear secretion, positive rate of corneal fluorescein staining, and incidence of dry eye symptoms among the control group, the subgroup with good glycemic control, and the subgroup with poor glycemic control (P < 0.05). There were statistically significant differences in the prevalence of dry eye, tear film rupture time, basal tear secretion, positive rate of corneal fluorescein staining, and incidence of dry eye symptoms among the control group, the subgroup with < 10 years of diabetes mellitus, and the subgroup with ≥ 10 years of diabetes mellitus (P < 0.05). There were statistically significant differences in the prevalence of dry eye, tear film rupture time, basal tear secretion, positive rate of corneal fluorescein staining, and incidence of dry eye symptoms among the control group, the subgroup with no DR, and the subgroup with DR (P < 0.05). There were statistically significant differences in the prevalence of dry eye, tear film rupture time, basal tear secretion, positive rate of corneal fluorescein staining, and incidence of dry eye symptoms among the control group, the subgroup with no DPN, and the subgroup with DPN (P < 0.05). Further two-by-two comparisons revealed that with poorer glycemic control, longer disease duration of diabetes mellitus, and the presence of concurrent DR and DPN, shorter tear film rupture time, decreased basal tear secretion, and increased positive rate for corneal fluorescein staining and incidence of dry eye symptoms. Conclusion The prevalence of dry eye in the elderly with diabetes mellitus is significantly higher than that in other populations, and poor glycemic control, long disease duration of diabetes mellitus, and the presence of concomitant DR or DPN are possible predisposing factors.
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