原发性干燥综合征患者干眼临床特点分析

The Clinical Analysis of Dry Eye in Patients with Primary Sj?gren’s Syndrome

摘要: 目的：以普通干眼患者为对照，分析原发性干燥综合征(primary Sjögren’s syndrome, pSS)患者干眼的临床特点。方法：2013年12月至2014年7月，由我院风湿内科诊断为pSS的患者30例，对患者进行病史询问并行角膜荧光素染色、BUT、Schimer I test (SIT)检查。同时随机选择此时间段内就诊的年龄、性别与之相匹配的普通干眼患者，行角膜荧光素染色、BUT检查并对结果进行分析。结果：30例pSS患者中，女性患者27例(90%)。患者右眼BUT (1.53 ± 0.63) s，左眼BUT(0.77 ± 0.43) s，双眼BUT结果有统计学差异(P = 0.000)。30例普通干眼患者右眼BUT (2.87 ± 0.94) s，左眼BUT(3.30 ± 0.95) s，双眼BUT结果无统计学差异(P = 0.081)。pSS患者与普通干眼患者相比，双眼BUT结果均存在统计学差异(P = 0.000)。pSS患者中，SIT结果 ≤ 5 mm/5min的有49眼(81.7%)。双眼SIT结果差异有统计学意义(P = 0.019),双眼的BUT与SIT结果没有相关性(右眼P = 0.848，左眼P = 0.063)。结论：pSS患者女性多于男性，患者眼部症状与普通干眼患者无明显差异，主要为眼干、异物感，但pSS患者中近一半患者合并口干。与普通干眼患者不同，pSS患者双眼的干眼程度有差异，且双眼的BUT与SIT均无相关性。相同年龄段内，pSS患者的BUT较普通干眼患者更短。

Abstract: Objective: To analyze the clinical characteristics of dry eyes in patients with primary Sjögren’s Syndrome (pSS). Methods: 30 cases of pSS patients which were diagnosed by the Department of Rheumatology from December 2013 to July 2014 were included in this study. The medical history and symptoms were recorded. The break-up time (BUT) and Schirmer I test (SIT) were operated by one doctor and the results were collected. At the same time, 30 age and sex-matched common dry eye patients were selected, and the BUT and SIT were operated by the same doctor. Results: 27 (90%) of the 30 pSS patients were female. The average BUT of the right eye was (1.53 ± 0.63) s and the left eye was (0.77 ± 0.43) s. There was a statistical difference between the results of BUT results of the binoculus (P = 0.000). For the 30 patients with ordinary dry eyes, the mean BUT of the right eye was (2.87 ± 0.94) s and the left was (3.30 ± 0.95) s. There is no statistically significant difference between the binoculus (P = 0.081). Statistical differences were found for both eyes among patients with pSS and ordinary dry eyes (P = 0.000). 49 eyes (81.7%) of the pSS patients had SIT results ≤ 5 mm/5min. There was a statistical difference between SIT results of both eyes (P = 0.019). No significant correlations were found between the results of SIT and BUT in both eyes (P = 0.848 in right eyes and P = 0.063 in left eyes). Conclusions: There were more female pSS patients than male pSS patients, and their symptoms of the eyes were not significantly different from those of ordinary dry eye patients. Dry eyes and foreign body sensation were the common symptoms of these patients. However, nearly half of pSS patients had dry mouth. Different from the ordinary dry eye patients, dry eyes differ in severity in both eyes for pSS patients. And there were no significant correlations between the results of SIT and BUT in both eyes. pSS patients had shorter BUT than ordinary dry eye patients in the same age group.