睑板腺挤压辅助治疗原发性干燥综合征相关干眼的临床价值OA
Clinical value of meibomian gland compression-assisted treatment for dry eye associated with primary Sjögren's syndrome
目的 探究睑板腺挤压辅助治疗原发性干燥综合征(pSS)相关干眼的有效性及安全性.方法 采用前瞻性随机对照研究方法,选择2021年2月至2024年12月该院确诊中、重度干眼症的pSS患者33例为研究对象,随机分为治疗组及对照组,均接受相同的全身用药及眼液治疗,治疗组患者同时接受睑板腺挤压治疗.观察两组患者治疗前及治疗后1、3个月的标准干眼症状评估(SPEED)问卷评分、眼表疾病指数(OSDI)问卷评分、泪液分泌试验、脂质层厚度、泪河高度、泪膜破裂时间(TBUT)、最佳矫正视力(BCVA)、角膜染色指数(OSS)评分.结果 两组患者治疗后SPEED及 OSDI问卷评分均明显下降(P<0.05),两组间比较差异无统计学意义(P>0.05),两组变化趋势也无统计学意义(P>0.05).两组内脂质层厚度及 TBUT随时间均明显改善(P<0.05),治疗组在治疗后1个月脂质层厚度及 TBUT改善更为明显.两组泪液分泌量比较差异有统计学意义(P<0.05),治疗组在治疗后泪液分泌量均明显高于对照组,尤其在治疗后1个月增加更为明显(P<0.05).两组泪河高度随时间变化差异均有统计学意义(P<0.05),泪河高度明显增加,但两组间差异及变化趋势无统计学意义(P>0.05).两组BCVA变化及差异无统计学意义(P>0.05).两组角膜 OSS评分比较差异有统计学意义(P<0.05),治疗组在治疗后角膜 OSS评分明显低于对照组,两组内角膜 OSS评分随时间均明显下降(P<0.05).结论 常规治疗能有效改善pSS患者的干眼症状及体征,联合睑板腺挤压辅助治疗能更明显地提高泪液分泌量、降低角膜 OSS评分,有效性及安全性良好.
Objective To explore the effectiveness and safety of meibomian gland compression-assisted treatment for dry eye associated with primary Sjögren's syndrome(pSS).Methods A prospective randomized controlled study was conducted.From February 2021 to December 2024,33 patients with pSS who were diag-nosed with moderate to severe dry eye disease in this hospital were selected as the research subjects.They were randomly divided into the treatment group and the control group.Both groups received the same system-ic medication and eye drops treatment.Patients in the treatment group also received meibomian gland com-pression therapy.The standard dry eye symptom assessment(SPEED)questionnaire scores,ocular surface disease index(OSDI)questionnaire scores,tear secretion test,lipid layer thickness,tear meniscus height,tear film break-up time(TBUT),best corrected visual acuity(BCVA),and corneal staining index(OSS)scores of the two groups were observed before treatment and at 1 and 3 months after treatment.Results After treat-ment,the scores of the SPEED and OSDI questionnaires in both groups significantly decreased(P<0.05),but there was no statistically significant difference between the two groups(P>0.05),and there was also no sta-tistically significant difference in the trend of change between the two groups(P>0.05).The thickness of the lipid layer and TBUT in both groups significantly improved over time(P<0.05),and the lipid layer thickness and TBUT in the treatment group improved more significantly at 1 month after treatment(P<0.05).There was a statistically significant difference in the comparison of tear secretion volume between the two groups(P<0.05),and the tear secretion volume in the treatment group was significantly higher than that in the con-trol group after treatment,especially at 1 month.The change in tear meniscus height within both groups was statistically significant over time(P<0.05),and the tear meniscus height significantly increased,but there was no statistically significant difference or trend between the two groups(P>0.05).There was no statisti-cally significant difference in the change of BCVA between the two groups(P>0.05).There was a statistical-ly significant difference in the comparison of corneal OSS scores between the two groups(P<0.05),and the corneal OSS score in the treatment group was significantly lower than that in the control group after treat-ment,and the corneal OSS score in both groups decreased significantly over time(P<0.05).Conclusion Conven-tional treatment can effectively alleviate the dry eye symptoms and signs of patients with pSS.Combined with meibomian gland compression-assisted therapy,it can significantly increase the tear secretion volume and re-duce the corneal OSS score,with good efficacy and safety.
周青青;熊洁;陈蒙蒙;罗启惠
陆军军医大学第一附属医院眼科,重庆 400038陆军军医大学第一附属医院眼科,重庆 400038陆军军医大学第一附属医院眼科,重庆 400038陆军军医大学第一附属医院眼科,重庆 400038
医药卫生
原发性干燥综合征干眼症睑板腺挤压OSS评分泪液分泌试验脂质层厚度
primary Sjögren's syndromedry eye diseasemeibomian gland expressionocular surface staining scoreSchirmer's Testlipid layer thickness
《重庆医学》 2026 (5)
1044-1049,6
重庆市科卫联合医学科研面上项目(2020MSXM046).
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