干眼患者非接触泪膜破裂时间测定结果的临床分析

摘要

Objective This survey was to evaluate noninvasive first break-up time (NIKf-BUT)and average break-up time (NIKav-BUT)using noninvasive Keratograph 5 in dry eye patients. Methods NIKf-BUT and NIKav-BUT were examined by using noninvasive Keratograph 5 in 31 patients. Patients also submitted Ocular Surface Disease Index (OSDI)questionnaire and were examined with conventional tear film break-up time (TBUT)and Schirmer I test. Results NIKf-BUT was significantly shorter than TBUT (2. 83 ± 1. 10 sec vs. 4. 10 ± 1. 43 sec,P < 0. 01),but there was no difference between NIKav-BUT and TBUT (4. 44 ± 1. 25 sec vs. 4. 10 ± 1. 43 sec,P = 0. 32). There were positive correla-tions between TUBT and NIKf-BUT (r = 0. 768,P < 0. 01)and between TBUT and NIKav-BUT (r = 0. 811,P <0. 01). There were negative correlations between NIKf-BUT and OSDI score (r = - 0. 734,P < 0. 01)and between NIKf-BUT and OSDI score (r = - 0. 689,P < 0. 01). No correlation was found between NIKf-BUT and Schirmer I test (r =- 0. 265,P = 0. 149)or between NIKav-BUT and Schirmer’s test (r = 0. 144,P = 0. 438). Conclusion NIKf-BUT and NIKf-BUT,which is obtained by using noninvasive Keratograph 5,can be used as a new method to asses dry eye pa-tients’tear film break-up time.%目的分析利用Oculus Keratograph 5测定的干眼患者非接触泪膜破裂时间的临床价值。方法利用Oculus Keratograph 5测定31例干眼患者右眼的非接触首发泪膜破裂时间（NIKf-BUT）及非接触平均泪膜破裂时间（NIKav-BUT），然后比较其与眼表疾病指数（OSDI）问卷评分，传统荧光素法泪膜破裂时间（TBUT）及泪液分泌试验I（Schirmer I）的相关性。结果31例入组者的平均NIKf-BUT （2．83±1．10）s，平均NIKav-BUT （4．44±1．25）s，平均TBUT为（4．10±1．43）s，平均OSDI调查问卷评分（44．09±20．37）分，，平均Schirmer I时间为（3．90±3．31） mm． NIKf-BUT明显短于TBUT（P ＜0．01），但NIKav-BUT与TBUT之间的差异无统计学意义（P ＝0．32）。Pearson相关分析发现，NIKf-BUT和NIKav-BUT均与TBUT之间存在正相关（r ＝0．768，P ＜0．01；r ＝0．811，P ＜0．01）。NIKf-BUT和NIKav-BUT与OSDI调查问卷评分存在负相关（r ＝－0．734，P ＜0．01；r ＝－0．689，P ＜0．01），但NIKf-BUT和NIKav-BUT与平均Schirmer I时间无相关性（r ＝－0．265，P ＝0．149；r ＝－0．144，P ＝0．438）。结论应用Oculus Keratograph 5测定非接触泪膜破裂时间（NITBUT）与传统荧光素法泪膜破裂时间一样，都可以作为干眼诊断的重要指标，其操作的非接触性及可重复性应使其被更广泛的应用。