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青少年原发性干燥综合征患者角膜神经纤维变化与干眼的相关性研究

Correlation between corneal nerve fiber changes and dry eye in adolescents with primary dry syndrome
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摘要 目的 应用角膜共焦激光显微镜分析青少年原发性干燥综合征患者的角膜神经纤维的变化,探讨其与干眼之间的相关性。方法 选取2020年1月—2022年5月宁波市眼科医院收治的青少年原发性干燥综合征患者的78只左眼为观察组,再选择同期体检的78只健康者左眼作为对照组,入选人员均进行了眼表疾病指数(OSDI)、泪膜破裂试验、泪液分泌试验等指标的检查(均一致),排除了其他原因导致干眼的可能性,比较2组活体共焦光纤显微镜相关指数和OSDI评分。采用Pearson检验分析原发性干燥综合征患者角膜神经纤维变化与干眼的相关性。结果 观察组的神经纤维直径为(2.12±0.58)μm,低于对照组的(3.21±0.45)μm,观察组的神经纤维珠数量、朗格汉斯细胞密度、OSDI评分分别为(7.25±2.15)个/100μm、(636.05±38.15)个/100μm、(45.23±5.21)分,均高于对照组的(2.85±1.36)个/100μm、(13.85±4.02)个/100μm、(11.23±3.21)分(P<0.05)。Pearson相关性分析显示,原发性干燥综合征患者OSDI评分与神经纤维直径呈负相关关系(r=-0.432,P<0.05),与神经纤维珠数量、朗格汉斯细胞密度呈正相关关系(r=0.562、0.515,P<0.05)。结论 青少年原发性干燥综合征患者干眼与神经纤维直径、神经纤维珠数量、朗格汉斯细胞密度具有相关性,以上指标可作为临床诊断治疗原发性干燥综合征的提示因素。 Objective Corneal confocal laser microscopy was applied to analyze changes in corneal nerve fibers in adolescent patients with primary dry syndrome and to discuss their correlation with dry eye.Methods Seventy-eight left eyes of adolescent patients with primary dry eye syndrome admitted to Ningbo Eye Hospital between January 2020 and May 2022 were selected as the observation group,and then 78 left eyes of healthy people with physical examination during the same period were selected as the control group,and the enrolled patients were examined for ocular surface disease index(OSDI) values,tear film break-up test,tear secretion test and other indices(all were consistent),and other causes of dry eye were excluded,and the in vivo confocal fibre-optic microscopy related indices and OSDI scores were compared between the two groups.Pearson's test was used to analyse the correlation between corneal nerve fibre changes and dry eye in patients with primary dry syndrome.Results The diameter of the nerve fibres in the observation group was(2.12±0.58)μm,which was smaller than that in the control group [(3.21±0.45)μm].The number of nerve fibre bundles,Langerhans cell density and OSDI scores of the observation group were(7.25±2.15)/100 μm,(636.05±38.15)/100 μm and(45.23±5.21) points,respectively,which were higher than that in the control group [(2.85±1.36)/100 μm,(13.85±4.02)/100 μm,(11.23±3.21) points,P<0.05].Pearson correlation test showed a negative correlation between OSDI score and nerve fibre diameter in patients with primary dry syndrome(r=-0.432,P<0.05);and a positive correlation with nerve fibre count and Langerhans cell density(r=0.562,0.515,P<0.05).Conclusion There is a correlation between dry eye and nerve fibre diameter,number of nerve fibre bundles and Langerhans cell density in juvenile patients with primary dry syndrome,and the above indicators can be used as suggestive factors for clinical diagnosis and treatment of primary dry syndrome.
作者 金霞 王莹 吴晓兰 郭晓红 桂孟芳 张晓瑾 JIN Xia;WANG Ying;WU Xiaolan;GUO Xiaohong;GUI Mengfang;ZHANG Xiaojin(Department of Optometry Clinic,Ningbo Eye Hospital,Ningbo,Zhejiang 315040,China)
出处 《中华全科医学》 2024年第3期437-439,共3页 Chinese Journal of General Practice
基金 浙江省医药卫生科技计划项目(2019KY631)。
关键词 原发性干燥综合征 角膜神经纤维变化 干眼 相关性 Primary dry syndrome Corneal nerve fiber changes Dry eye Correlation
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