|本期目录/Table of Contents|

[1]钟敏,赵少贞.糖尿病病程与合并周围神经病变患者眼表的关系[J].天津医科大学学报,2020,26(06):549-552,556.
　ZHONG Min,ZHAO Shao-zhen.The relationship between the course of diabetes mellitus and ocular surface in patients with peripheral neuropathy[J].Journal of Tianjin Medical University,2020,26(06):549-552,556.
点击复制

糖尿病病程与合并周围神经病变患者眼表的关系(PDF)
分享到：

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
26卷
期数:
2020年06期
页码:
549-552,556
栏目:
临床医学
出版日期:
2020-11-20

文章信息/Info

Title:
The relationship between the course of diabetes mellitus and ocular surface in patients with peripheral neuropathy
作者:
钟敏1; 2; 赵少贞3
1.天津医科大学研究生院，天津300070；2.天津市静海区医院眼科，天津301600；3.天津医科大学眼科医院屈光与角膜病科，天津 300384
Author(s):
ZHONG Min1; 2;  ZHAO Shao-zhen3
1．Graduate School，Tianjin Medical University，Tianjin 300070，China；2．Department of Ophthalmology, Jinghai District Hospital，Tianjin 301600，China；3．Department of Refraction and Corneal Disease，Tianjin Medical University Eye Hospital，Tianjin 300384，China
关键词:
糖尿病病程; 糖尿病周围神经病变; 眼表; 干眼
Keywords:
scourse of diabetes;  diabetic peripheral neuropathy;  ocular surface;  dry eye
分类号:
R587.1+R774.6
DOI:
-
文献标志码:
A
摘要:
目的：探讨糖尿病病程与合并糖尿病周围神经病变（DPN）患者眼表的关系。方法：收集2型糖尿病合并周围神经病变患者79例。按糖尿病病程分为A组（＜10年）及B组（≥10年）。比较两组HbA1c、眼表疾病指数（OSDI）量表、角膜知觉、泪膜破裂时间（BUT）、角膜荧光素染色（FL）评分、基础泪液分泌（SIt）、足部震动感觉阈值（VPT）检查。分析糖尿病病程与眼表指标及VPT的关系。结果：不同糖尿病病程患者的年龄、HbA1c、OSDI、BUT、SIt以及角膜染色评分差异均无统计学意义（均P＞0.05），而干眼发生率（χ2=33.785，P=0.000）、角膜知觉（t=3.457，P=0.001）及VPT（Z=-2.221，P=0.026）差异有统计学意义。糖尿病病程与角膜知觉（r=-0.440，P＜0.05）呈负相关，与OSDI（r=0.246，P＜0.05）以及VPT（r=0.372，P＜0.05）呈正相关。结论：合并DPN的糖尿病患者干眼发生率高，且随着糖尿病病程的延长，角膜知觉明显减退，VPT及OSDI评分升高。
Abstract:
Objective: To explore the relationship between the course of diabetes mellitus and ocular surface in patients with diabetic peripheral neuropathy (DPN).Methods: A total of 79 patients with type 2 diabetes mellitus complicated with peripheral neuropathy in our hospital were collected. According to the course of diabetes, they were divided into group A(< 10 years) and group B(≥10 years). HbA1c, ocular surface disease index(OSDI), corneal sensitivity，tear break up time(BUT), corneal fluorescein(FL),schirmer I test(SIt), foot vibration perception thresholds(VPT) in two groups were compared. The relationship between the course of diabetes mellitus and ocular surface index and VPT was analyzed. Results: There were not statistically significant in age, HbA1c,OSDI,BUT,SIt and corneal staining score among patients with different course of diabetes(all P＞0.05), while the incidence of dry eye（χ2=33.785, P=0.000）, corneal perception（t=3.457, P=0.001） and VPT（Z=-2.221, P=0.026） were statistically significant. The course of diabetes was negatively correlated with corneal perception（r=-0.440, P＜0.05） and positively correlated with OSDI（r=0.246, P＜0.05） and VPT（r=0.372, P＜0.05）.Conclusion: The incidence of dry eye is high in diabetic patients with DPN, and with the extension of diabetes, corneal perception decreases significantly, and VPT and OSDI scores increase.

参考文献/References:

[1] 刘祖国，张晓博． 解读国际泪膜与眼表协会2017年干眼专家共识中的干眼定义与分类[J]．中华眼科杂志， 2018，54（4）：246
[2] Shi Z． Prevalence of diabetes among men and women in China[J]． N Engl J Med，2010，362（25）： 2425
[3] 中华医学会糖尿病学分会. 中国 2 型糖尿病防治指南（2017 年版）[J]. 中华糖尿病杂志， 2018， 10 （1）:4
[4] Pop-Busui R，Boulton A J，Feldman E L，et al. Diabetic neuropathy: a position statement by the American Diabetes Association[J]. Diabetes Care，2017，40（1）:136
[5] Kr?覿mer H H，Rolke R，Bickel A，et al. Thermal thresholds predict painfulness of diabetic neuropathies[J]. Diabetes Care，2004，27:2386
[6] 中华医学会眼科学分会角膜病学组．干眼临床诊疗专家共识 （2013年）[J]．中华眼科杂志，2013，49 （1）:73
[7] Schiffman R M，Christianson M D，Jacobsen G，et al. Reliability and validity of the ocular surface disease index[J]. Arch Ophthalmol，2000，118（5）：615
[8] Michael A L，Christophe B，Jules B，et al. The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop（2007） [J]. Ocul Surf，2007，5（2）:75
[9] 刘祖国，王华． 关注干眼慢性疾病管理体系的建设[J]．中华眼科杂志，2018，54（2）：81
[10] Zhang X， Zhao L，Deng S，et al. Dry eye syndrome in patients with diabetes mellitus：prevalence， etiology，and clinical characteristics[J]. J Ophthalmol， 2016，2016：8201053
[11] 李琰，杨炜. 2型糖尿病患者的干眼患病情况及其相关影响指标[J]. 国际眼科杂志， 2016，16（3）：508
[12] Shy M E，Frohman E M，So Y T，et a1．Quantitative sensory testing：report of the therapeutics and technology asaesament subcommittee of the american academy of neurology[J]．Neurology，2003，60（6）: 898
[13] Rathur H M， Boulton A J. The diabetic foot[J]. Clin Dermatol， 2007，25（1）:109
[14] 杨小玲，林婷，陈霞霞. 数字震动感觉阈值检查早期诊断老年2型糖尿病患者周围神经病变的意义[J]. 糖尿病新 世界，2017，20（16）:173
[15] Saito J，Enoki M，Hara M，et al. Correlation of corneal sensation， but not of basal or reflex tear secretion，with the stage of diabetic retinopathy[J]. Cornea，2003，22（1）:15
[16] Tavakoli M，Kallinikos P，Iqbal A，et al. Corneal confocal microscopy detects improvement in corneal nerve morphology with an improvement in risk factors for diabetic neuropathy[J]. Diabet Med， 2011，28（10）：1261
[17] Tavakoli M， Kallinikos P， Iqbal A， et al. Corneal confocal microscopy detects improvement in corneal nerve morphology with an improvement in risk factors for diabetic neuropathy[J]. Diabet Med， 2011，28（10）:1261
[18] Sitompul R. Corneal sensitivity as apotential marker of diabetic neuropathy[J]. Acta Med Indones， 2017，49（2）:166
[19] Najafi L， Malek M， Valojerdi A E， et al. Dry eye and its correlation to diabetes microvascular complications in people with type 2 diabetes mellitus[J]. J Diabetes Complications， 2013，27（5）:459
[20] Ahmed M A， Kishore G， Khader H A， et al. Risk factors and management of diabetic nephropathy [J]. Saudi J Kidney Dis Transpl， 2013，24（6）:1242
[21] Musa H G，Ahmed M E. Associated risk factors and management of chronic diabetic foot ulcers exceeding 6 months′ duration[J]. Diabet Foot Ankle，2012，3:18980
[22] Ozdemir M，Buyukbese M A，Cetinkaya A，et al. Risk factors for ocular surface disorders in patients with diabetes mellitus[J]. Diabetes Res Clin Pract， 2003，59（3）:195
[23] Yu L，Chen X，Qin G，et al. Tear film function in type 2 diabetic patients with retinopathy[J]. Ophthalmologica， 2008，222（4）:284
[24] Manaviat M R，Rashidi M，Afkhami-Ardekani M，et al. Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients[J]. BMC Ophthalmol， 2008，8:10
[25] Kojima T， Ishida R， Dogru M， et al. A new noninvasive tear stability analysis system for the assessment of dry eyes[J]. Invest Ophthalmol Vis Sci， 2004，45（5）:1369
[26] 王睿，马挺，龙潭. 糖尿病病程对合并糖尿病的白内障患者眼表的影响[J]. 国际眼科杂志，2018，18 （12）:2228
[27] 张佳楠，李海丽，晏晓明. 两种干眼症状问卷评分与干眼临床检查的关联性研究[J]. 中华实验眼科杂志， 2012 ，30（4）:362
[28] 杜瑞兵. 420例2型糖尿病患者震动感觉阈值测定及分析[J]. 中国保健营养，2012，22（18）:3674

相似文献/References:

备注/Memo

备注/Memo:
文章编号 1006-8147（2020）06-0549-04
作者简介 钟敏（1974-），女，主任医师，硕士在读，研究方向：眼科学；通信作者：赵少贞，E-mail：zhaosz1997@sina.com。
更新日期/Last Update: 2020-11-20