摘要
目的 分析无干眼相关症状儿童睑板腺形态异常的患病率及其与泪膜稳定性指标的相关性.方法 横断面研究.纳入 2023 年 6 月至 2023 年 10 月就诊于郑州大学第一附属医院眼科门诊的4～17 岁儿童326 例(326 只眼),通过非侵入式眼表综合分析仪进行睑板腺图像采集.所有患儿进行非侵入性泪河高度(NTMH)、非侵入性首次泪膜破裂时间(f-NIBUT)、非侵入性平均泪膜破裂时间(av-NIBUT)、最小脂质层厚度(LLT-min)、最大脂质层厚度(LLT-max)及平均脂质层厚度(LLT-av)检查.根据睑板腺图像对睑板腺缺失度及睑板腺扭曲度进行评分,并根据睑板腺腺管走形形态将睑板腺分为 5 种不同类型(垂直、弯曲、重叠、钩状、U型).利用Pearson/Spearman相关性分析方法分析睑板腺缺失度评分及扭曲度评分与年龄、性别、睑板腺扭曲类型及NTMH、f-NIBUT、av-NIBUT、LLT-min、LLT-max、LLT-av等的相关性.结果 326 例儿童中,睑板腺形态异常者 302 例(92.64%),其中睑板腺缺失者 274 例(84.05%).睑板腺缺失评分为 0 分者占 15.95%(52/326),1 分者占79.75%(260/326),2 分者占 4.30%(14/326).睑板腺扭曲者 287 例(88.04%,287/326).睑板腺扭曲度评分为 0 分者占 11.96%(39/326),1 分者占 35.89%(117/326),2 分者占 52.15%(170/326).Spearman相关性分析结果显示,睑板腺缺失度评分与LLT-min、LLT-max、LLT-av、f-NIBUT、av-NIBUT及NTMH均呈负相关(r=-0.14、-0.14、-0.13、-0.12、-0.11、-0.17,均P<0.05).睑板腺扭曲度评分与LLT-min、LLT-max、LLT-av及f-NIBUT均呈负相关(r=-0.17、-0.17、-0.16、-0.14,均P<0.05).结论 无干眼相关症状儿童常见睑板腺形态异常,且睑板腺形态异常与泪膜破裂时间及脂质层厚度等多个泪膜稳定性指标相关.
Abstract
Objective To analyze the prevalence of abnormal meibomian gland morphology in children without dry eye and its correlation with tear film stability indicators.Methods This was a cross-sectional study.A total of 326 eyes of 326 children aged 4 to 17 years old in the First Affiliated Hospital of Zhengzhou University from Jun.2023 to Oct.2023 were included.The images of the meibomian gland were collected by non-invasive ocular surface analyzer.All children received non-invasive tear meniscus height(NTMH),non-invasive first tear film break-up time(f-NIBUT),non-invasive average tear film break-up time(av-NIBUT),minimum lipid layer thickness(LLT-min),maximum lipid layer thickness(LLT-max),and average lipid layer thickness(LLT-av)examinations.The meibomian gland deficiency degree and meibomian gland distortion degree were scored according to the image of meibomian gland.And the meibomian glands were divided into 5 types based on the shape of meibomian gland ducts,which were vertical,curved,overlapping,hook-shaped and U-shaped.The correlation of meibomian gland deficiency score and distortion score with age,gender,meibomian gland distortion type and NTMH,f-NIBUT,av-NIBUT,LLT-min,LLT-max,LLT-av were analyzed by Pearson or Spearman correlation analysis methods.Results Among the 326 children,302 cases(92.64%)had abnormal meibomian gland morphology and 274 cases(84.05%)had meibomian gland deficiency.The meibomian gland deficiency score was 0 score in 52 cases(15.95%,52/326),1 score in 260 cases(79.75%,260/326)and 2 scores in 14 eyes(4.30%,14/326).The rate of meibomian gland distortion was 88.04%(287/326).The meibomian gland distortion score was 0 score in 39 eyes(11.96%,39/326),1 score in 117 eyes(35.89%,117/326)and 2 scores in 170 eyes(52.15%,170/326).The results of Spearman correlation analysis showed that the meibomian gland deficiency was negatively correlated with LLT-min,LLT-max,LLT-av,f-NIBUT,av-NIBUT or NTMH(r=-0.14,-0.14,-0.13,-0.12,-0.11,-0.17;all P<0.05).The meibomian gland distortion was negatively correlated with LLT-min,LLT-max,LLT-av or f-NIBUT(r=-0.17,-0.17,-0.16,-0.14;all P<0.05).Conclusion Morphosis of meibomian gland is common in children without dry eye,and it is correlated with tear film stability indicators such as tear film rupture time and lipid layer thickness.
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