蠕形螨睑缘炎眼表改变的研究
|
摘要
目的:探讨蠕形螨睑缘炎的眼表改变,了解蠕形螨睑缘炎患者眼表的细胞学改变。方法:收集2013年9月-2015年9月在我院眼科门诊确诊为蠕形螨睑缘炎的患者60例作为实验组;对照组为体检中心眼科检查无眼部蠕形螨感染的体检人群40例。对每位患者进行蠕形螨镜检和眼表疾病指标问卷(OSDI)调查,记录实验组蠕形螨感染的数量和OSDI得分等参数;同时进行角膜荧光素钠染色(FL)、泪膜破裂时间测定(BUT)和泪液分泌试验(SIT)检查。运用结膜印迹细胞学联合苏木素-糖原(PAS)染色方法,分析实验对象结膜上皮鳞状化生程度。鳞状化生程度比较采用χ2检验。结果:(1)本研究60例蠕形螨睑缘炎患者(120只眼)中,31(25.83%)只眼为重度蠕形螨感染;48(40.00%)只眼为中度感染;41(34.17%)只眼为轻度感染;对照组40例(80眼),均无眼部蠕形螨感染。实验组BUT及SIT较对照组均降低,差异有统计学意义(P<0.05);OSDI问卷的得分比较,实验组较对照组明显升高,差异有统计学意义(P<0.05)。(2)结膜印迹细胞学检查中发现实验组结膜鳞状化生程度显著高于对照组,差异有统计学意义(P<0.05)。结论:(1)蠕形螨睑缘炎导致泪膜不稳定及泪液分泌减少同时伴发炎症。(2)蠕形螨睑缘炎引起结膜细胞学改变,导致患者结膜上皮鳞状化生级别升高。
Objective:To study the ocular surface changes,the cytological changes.Methods:Sixty outpatients diagnosed to have demodex blepharitis were chosen as experimental group while 40 healthy individual without demodex blepharitis were collected as the control group in our hospital during September 2013 and September 2015.Personal information and past medical history were recorded.Ocular surface disease index questionnaire(OSDI)were recorded and calculated.Demodex count in the lashes,slit lamp examination,tear film breakup time and Schirmer I Test examination were done to each individual.The difference of these parameters were compared between two groups.Results:(1)In 60 cases(120 eyes)of demodex blepharitis patients,31(25.83%)eyes were diagnosed to have severe demodex infection;48(40.00%)eyes were diagnosed to have moderate demodex infection while 41(34.17%)eyes had mild demodex infection.Compared with the 40 cases(80 eyes)in control group,nobody had demodex infection.Tear film breakup time and Schirmer I Test were lower in experimental group compared with control group(P<0.05),however OSDI questionnaire scores was higher in experimental group(P<0.05).(2)The degree of squamous metaplasia in experimental group was higher compared with control group by the conjunctival impression cytology(P<0.05).Conclusion:(1)Blepharitis caused by demodex infection lead to instability in tear film and decrease of tear secretion and often accompanied with inflammation.(2)The degree of conjunctival squamous metaplasia in demodex blepharitis patients was higher than that in control group.
Objective:To study the ocular surface changes,the cytological changes.Methods:Sixty outpatients diagnosed to have demodex blepharitis were chosen as experimental group while 40 healthy individual without demodex blepharitis were collected as the control group in our hospital during September 2013 and September 2015.Personal information and past medical history were recorded.Ocular surface disease index questionnaire(OSDI)were recorded and calculated.Demodex count in the lashes,slit lamp examination,tear film breakup time and Schirmer I Test examination were done to each individual.The difference of these parameters were compared between two groups.Results:(1)In 60 cases(120 eyes)of demodex blepharitis patients,31(25.83%)eyes were diagnosed to have severe demodex infection;48(40.00%)eyes were diagnosed to have moderate demodex infection while 41(34.17%)eyes had mild demodex infection.Compared with the 40 cases(80 eyes)in control group,nobody had demodex infection.Tear film breakup time and Schirmer I Test were lower in experimental group compared with control group(P<0.05),however OSDI questionnaire scores was higher in experimental group(P<0.05).(2)The degree of squamous metaplasia in experimental group was higher compared with control group by the conjunctival impression cytology(P<0.05).Conclusion:(1)Blepharitis caused by demodex infection lead to instability in tear film and decrease of tear secretion and often accompanied with inflammation.(2)The degree of conjunctival squamous metaplasia in demodex blepharitis patients was higher than that in control group.
引文
[1]孙旭光,张晓玉.重视蠕形螨感染与睑缘炎[J].中华实验眼科杂志,2016,34(6):481-483.
[2]姚卫兰,许福荣,黄碧文,等.蠕形螨睑缘炎临床特征研究[J].中国实用眼科杂志,2017,35(2):151-154.
[3]张晓玉,孙旭光.蠕形螨睑缘炎的研究进展[J].中华眼科杂志,2016,52(4):315-320.
[4]赵汝娟,杨雪荣,赵影,等.芜湖市医学生蠕形螨感染情况调查及影响因素分析[J].中国血吸虫病防治杂志,2017,29(3):358-362.
[5]Czepita D,Ku nagrygiel W,Czepita M,et al.Demodex folliculorum and Demodex brevis as a cause of chronic marginal blepharitis[J].Ann Acad Med Stetin,2007,53(1):63-67.
[6]宁晓玲,马骎.40例蠕形螨睑缘炎患者临床特点分析[J].中国寄生虫学与寄生虫病杂志,2016,34(2):182.
[7]张晓玉,王智群,张阳,等.睫毛毛囊蠕形螨感染与睑板腺功能障碍的关系[J].眼科,2016,25(6):387-390.
[8]林宝涛,郭萍,邹仲良,等.顽固性睑缘炎患者眼睑蠕形螨感染调查与分析[J].中国实用眼科杂志,2015,33(8):918-920.
[2]姚卫兰,许福荣,黄碧文,等.蠕形螨睑缘炎临床特征研究[J].中国实用眼科杂志,2017,35(2):151-154.
[3]张晓玉,孙旭光.蠕形螨睑缘炎的研究进展[J].中华眼科杂志,2016,52(4):315-320.
[4]赵汝娟,杨雪荣,赵影,等.芜湖市医学生蠕形螨感染情况调查及影响因素分析[J].中国血吸虫病防治杂志,2017,29(3):358-362.
[5]Czepita D,Ku nagrygiel W,Czepita M,et al.Demodex folliculorum and Demodex brevis as a cause of chronic marginal blepharitis[J].Ann Acad Med Stetin,2007,53(1):63-67.
[6]宁晓玲,马骎.40例蠕形螨睑缘炎患者临床特点分析[J].中国寄生虫学与寄生虫病杂志,2016,34(2):182.
[7]张晓玉,王智群,张阳,等.睫毛毛囊蠕形螨感染与睑板腺功能障碍的关系[J].眼科,2016,25(6):387-390.
[8]林宝涛,郭萍,邹仲良,等.顽固性睑缘炎患者眼睑蠕形螨感染调查与分析[J].中国实用眼科杂志,2015,33(8):918-920.