目的：探讨眼表面干涉仪在睑板腺功能障碍(MGD)辅助诊断中的意义。

方法：前瞻性病例对照研究。选取2017-10/11在北京大学第三医院就诊的62例MGD患者和38例健康志愿者作为研究对象。所有入组人员均按规定顺序，进行眼表疾病指数(OSDI)问卷调查、裂隙灯眼前节检查、眼表面干涉仪检查及泪膜破裂时间(BUT)检测。用独立样本t检验和卡方检验分别比较两组受试者检查结果，并用Spearman相关分析法观察MGD组指标间的相关性。

结果：两组受试者中均有眼睑缘形态改变者，且病变形态各异。MGD组OSDI评分、睑板腺排出能力评分、睑板腺缺失评分均明显升高(P<0.05)，平均泪膜脂质层厚度明显降低(P<0.05)。两组间BUT、不完全瞬目时间比例、睑板腺开口评分和睑板腺分泌物性质评分差异均无统计学意义(P>0.05)。MGD患者平均泪膜脂质层厚度与OSDI评分、睑板腺开口评分及睑板腺缺失评分均呈负相关(r_s=-0.730，P<0.01； r_s=-0.639，P<0.01； r_s=-4.15，P=0.001)，与BUT呈正比，与睑板腺排出能力和分泌物性质的评分均呈反比，但均无明显相关性。OSDI评分与睑板腺缺失评分呈正相关(r_s=0.790，P<0.01)。

结论：MGD症状和体征与眼表面干涉仪检测的泪膜脂质层厚度、睑板腺缺失显著相关，眼表面干涉仪可快速、无创、客观地诊断MGD并评估病情发展的阶段。

METHODS: Prospective case-control studies. Totally 62 patients with MGD and 38 healthy volunteers were selected in Peking University Third Hospital from October to November in 2017. All subjects of both groups were examined respectively for Ocular Surface Disease Index Questionnaire(OSDI), slit-lamp anterior segment check, the eye surface interferometer inspection, and break up time. Independent sample t-test and chi-square test were used for comparison between the two groups. Spearman correlation analysis was used in the group of patients with MGD.

RESULTS: In both groups, there were changes on the morphology of the eyelid, and the lesions were different. The score of OSDI, the discharge ability and the loss score of the MGD group were significantly higher than those in the control group(P<0.05). However, the lipid layer thickness(LLT)was significantly lower than that in the control group(P<0.05). There was no significant difference in BUT, the proportion of incomplete blink time, the score of Meibomian gland orifice and the quality score of the Meibomian gland discharge ability between the two groups(P>0.05). The Spearman correlation analysis indicated that the negative correlation between LLT and the OSDI questionnaire score(r_s=-0.730, P<0.01), LLT and the Meibomian gland orifice(r_s=-0.639, P<0.01), LLT and the loss of Meibomian gland(r_s=-4.15, P=0.001); however, the positive correlation was shown between the loss of Meibomian gland and the OSDI questionnaire score(r_s=0.790, P<0.01).

CONCLUSION: Meibomian gland dysfunction symptoms and signs significantly correlates with LLT, loss of Meibomian gland detected by ocular surface interferometer, so ocular surface interferometer can be used for rapid, noninvasive and objective diagnosis of Meibomian gland dysfunction and assess the stage of disease progression.