中老年睫毛蠕形螨感染与睑板腺功能障碍的相关性分析

Correlation between infection with demodex folliculorum of eyelash and Meibomian gland dysfunction in elderly patients

摘要:

目的：调查中老年睑板腺功能障碍(MGD)患者睫毛蠕形螨的感染情况，以分析睫毛蠕形螨感染与MGD的相关性。

方法：将2017-09/2018-03于福建省老年医院眼科门诊就诊的中老年患者(年龄≥40岁)，分为MGD组患者137例137眼和非MGD组患者96例96眼，进行裂隙灯下检查睑缘情况、睑板腺脂质分泌性状、角膜荧光染色及泪膜破裂时间等相关检查。同时取受检者眼部睫毛，在显微镜下查找蠕形螨并计算其数量。比较两组患者蠕形螨检出阳性率，并分析蠕形螨感染数量与睑缘评分、睑板腺脂质分泌性状评分、角膜荧光染色评分、泪膜破裂时间的相关性。

结果：MGD组患者蠕形螨检出阳性率为89.1%，高于非MGD组患者(74.0%，P<0.05)。蠕形螨感染数量与睑缘评分(r=0.89，P<0.05)、睑板腺脂质分泌性状评分(r=0.67，P<0.05)、角膜荧光染色评分(r=0.35，P<0.05)均呈正相关，与泪膜破裂时间呈负相关(r=-0.37，P<0.05)。非MGD组蠕形螨感染阳性患者中轻度感染率为60.6%，显著高于MGD组(37.7%，P<0.05)。

结论：中度及重度以上的眼部蠕形螨感染和MGD的发生密切相关，可能是中老年MGD患者的致病因素。

Abstract:

AIM:To investigate the prevalence of demodex folliculorum in eyelashes of elderly patients with Meibomian gland dysfunction(MGD)and to find the correlation between the presence of demodex folliculorum and MGD.

METHODS: The study involved elderly patients(age≥40)who visited Department of Ophthalmology in Fujian Provincial Hospital for the Elderly between September 2017 and March 2018. Patients were divided into MGD group(137 patients 137 eyes)and non-MGD group(96 patients 96 eyes). The patients underwent eyelid examinations by slit lamp, lipid secretion of the Meibomian gland, fluorescein corneal staining(FL), tear film breakup time(BUT). At the same time underwent epilation of eyelashes, and the number of Demodex was counted. The positive rate of demodex was compared between the two groups, the relation of number of demodex with eyelid margin score, lipid secretion of the meibomian gland, FL score and BUT were evaluated.

RESULTS: The positive rate of demodex in MGD group was 89.1%, significantly higher than that of group non-MGD 74.0%(P<0.05). The number of demodex showed significant positive correlations with the eyelid margin(r=0.89, P<0.05), lipid secretion of the meibomian gland(r=0.67, P<0.05), FL(r=0.35, P<0.05)and BUT(r=-0.37, P<0.05). The mild infection rate of demodex mites in non-MGD(60.6%)was higher than MGD(37.7%, P<0.05).

CONCLUSION: There is a strong correlation between ocular moderate or severe demodex mites infection and MGD, suggesting that demodex folliculorum may play a pathogenic role in elderly patients with MGD.