目的：分析蠕形螨相关性睑板腺功能障碍(MGD)患者的临床情况及综合治疗对蠕形螨感染状态的影响。

方法：前瞻性病例对照研究。选取2016-01/2017-06在沈阳何氏眼科医院门诊就诊的MGD患者132例264眼(试验组)及基本资料相匹配的健康志愿者96例192眼(对照组)。试验组患者进行综合治疗。两组受检者均进行睫毛采样镜检蠕形螨感染情况，并进行泪膜破裂时间(BUT)、Schirmer Ⅰ试验(SⅠt)、角膜荧光染色(FL)评分检查； 试验组患者同时进行主观症状评分检查。

结果：治疗前，试验组和对照组受检者蠕形螨感染数量分别为7(6，9)、2(1，3)个/眼，差异有统计学意义(Z=5.264，P<0.01)； 蠕形螨阳性率分别为100.0%和28.1%，差异有统计学意义(χ²=35.957，P<0.01)； BUT分别为4.06±1.38、12.00±2.82s，FL评分分别为3.06±1.57、0.46±0.63分，SⅠt分别为6.93±2.08、11.13±2.38mm/5min，差异均有统计学意义(t=-9.825、5.978、-4.776，均P<0.01)。治疗前和治疗后4wk，试验组患者主观症状评分分别为6.57±2.93、3.27±1.89分，差异有统计学意义(t=5.443，P<0.01)。治疗后4wk，试验组患者蠕形螨阳性率为57.6%； 蠕形螨数量平均为3(0，5)个/眼，较治疗前明显减少(Z=3.937，P<0.01)； BUT、FL评分分别为6.53±3.27s、1.67±0.54分，均较治疗前好转，差异有统计学意义(t=5.152、4.328，均P<0.01)，而SⅠt(8.37±5.34mm/5min)较治疗前无明显改变，差异无统计学意义(t=-0.285，P=0.748)。

结论：蠕形螨感染可引起MGD，产生相应的临床症状。综合治疗能降低眼部蠕形螨寄生数量，有效缓解蠕形螨相关性MGD的临床症状。

METHODS: This study was a prospective analysis.The MGD patients(experimental group, 264 eyes in 132 patients)and normal subjects(control group, 192 eyes in 96 patients)were collected from the He Eye Hospital from January 2016 to July 2017. Comprehensive treatment of patients in the experimental group. Eyelash sampling, demodex counting, tear film break up time(BUT), cornea fluorescein staining(FL)and Schirmer Ⅰ test(SⅠt)were measured for both groups. The symptom score of MGD patients was recorded.

RESULTS: For the experimental and control groups, the number of demodex before the treatment was 7(6, 9)and 2(1, 3), respectively(Z=5.264, P<0.01). The percentage of demodex infestation was 100% and 28.1%,respectively(χ²=35.957, P<0.01). The BUT was 4.06±1.38 and 12.00±2.82s. The FL was 3.06±1.57 and 0.46±0.63. The SⅠt was 6.93±2.08mm and 11.13±2.38mm/5min, respectively(t=-9.825, t=5.978, t=-4.776; all P<0.01). The symptom score of the MGD group before and after treatment was 6.57±2.93 and 3.27±1.89, respectively(t=5.443, P<0.01). After the treatment, the percentage of demodex infestation of the experimental group were 57.6%, the number of demodex were 3(0-5), had significant difference with the data before the treatment(Z=3.937, P<0.01). The BUT and FL were 6.53±3.27s and 1.67±0.54, and all had significant difference with the data before the treatment(t=5.152, 4.328; all P<0.01). The SⅠt of the experimental group after the treatment was 8.37±5.34mm/5min, with no significant difference with the data before the treatment(t=-0.285, P=0.748).

CONCLUSION: Demodex infection can cause Meibomian gland dysfunction and produce corresponding clinical symptoms. The comprehensive treatment can greatly diminishes the number of demodex mites and effectively relieve the symptoms of Meibomian gland dysfunction which is associated with demodex infestation.