摘要
目的 探究妊娠期高脂血症患者的睑板腺形态功能以及对泪膜的影响.方法 回顾性病例研究.选取2020年1月至2022年1月来我院眼科就诊的妊娠期妇女60例(120只眼),根据血脂情况分为高脂血症组(30例60只眼)和正常妊娠期(30例60只眼).两组受试者接受眼表疾病指数量表(OSDI)、睑板腺功能检查、泪液相关检查和血脂指标检测.比较两组受试者的睑板腺各项评分、角膜荧光素染色评分、泪液分泌试验(SIt)、泪膜破裂时间(BUT)的差异.分析BUT与血脂之间的相关性.结果 妊娠期高脂血症组的OSDI、睑板腺分泌物性状评分、睑板腺分泌功能评分显著高于对照组(均P<0.05),BUT显著低于对照组.两组的SIt、睑板腺缺失评分和睑缘评分差异没有统计学意义.BUT与血脂中的总胆固醇(TC)、三酰甘油(TG)和低密度蛋白胆固醇(LDL-C)呈负相关性.结论 妊娠期高脂血症患者容易出现睑板腺分泌能力下降,引起泪膜稳定性下降,但是对泪液分泌量没有明显改变.这种改变与血脂中的TC、TG和 LDL-C高度相关.
Abstract
Objective To investigate the changes of morphology and function of meibomian glands in pregnant women with hyperlipidaemia and their influence on the tear film.Methods A retrospective case series study.A total of 60 pregnant women(120 eyes)admitted to the ophthalmology department of our hospital from January 2020 to January 2022 were selected,and divided into hyperlipidemia group(60 eyes,30 cases)and control group(60 eyes,30 cases)according to whether they were combined with hyperlipidemia.Both groups received ocular surface disease index(OSDI)、meibomian gland function examination,ocular surface examination and blood lipid examination.The differences between the two groups were compared with the morphology and the scores of the function of lid edge and meibomian glands,the scores of fluores-cence staining of cornea,breakup time(BUT)of tear film,Schirmer I test(SIt).The correlation between the scores of BUT and blood lipid level in the hyperlipidemia group was analyzed.Results The scores of OSDI,meibomian gland secretion ability and meibomian gland secretion traits in the hyperlipidemia group were significantly higher than those in the control group(P<0.05).The BUT in the hyperlipidemia group was significantly lower than that in the control group.There were no significant differences in the values of SIt,the scores of eyelid margin change and meibomian gland loss scores between the two groups(P>0.05).Spearman correlation analysis showed that the severity of BUT in the hyperlipidemia group was posi-tively correlated with total cholesterol(TC)、triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)levels(P<0.05).Conclusions Pregnant women with hyperlipidaemia were prone to cause the dysfunction of the meibomian gland se-cretion,which was easy to shorten the stability of the tear film.There was no significant change in tear secretion.The change of BUT was highly correlated with the level of TC,TG and LDL-C in blood lipids.
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