目的：应用活体共焦显微镜观察干燥综合征患者角膜潜基质神经纤维的形态学变化，分析其与临床症状的关系。

方法：收集22例44眼干燥综合征患者(观察组)和22例44眼同龄健康人(对照组)进行角膜中央神经纤维直径、念珠状结构数目、弯曲度的观察，记录泪膜破裂时间、泪液分泌试验、泪河高度、树突状细胞密度，并对结果进行统计分析。

结果：在活体共焦显微镜观察下，观察组角膜潜基质神经纤维直径较对照组小，念珠状结构数目和神经纤维弯曲度均增加(P<0.05)。Pearson相关分析：观察组的角膜潜基质神经纤维直径与泪膜破裂时间(r=0.472，P<0.01)、泪液分泌(r=0.562，P<0.01)、泪河高度(r=0.246，P=0.02)和树突状细胞密度(r=-0.636，P<0.01)呈相关性，角膜潜基质神经纤维念珠状结构数目与泪膜破裂时间(r=-0.621，P<0.01)、泪液分泌(r=-0.688，P<0.01)、泪河高度(r=-0.438，P<0.01)和树突状细胞密度(r=0.528，P<0.01)呈相关性，神经纤维弯曲度与泪膜破裂时间(r=-0.634，P<0.01)、泪液分泌(r=-0.713，P<0.01)、泪河高度(r=-0.384，P<0.01)和树突状细胞密度(r=0.604，P<0.01)呈相关性。

结论：活体共焦显微镜能有效观察角膜潜基质神经纤维的形态，干燥综合征患者角膜潜基质神经纤维直径变小，念珠状结构数目增多，神经纤维弯曲度增加，神经纤维损伤程度与干眼症的严重程度呈相关性。

METHODS: We collected 22 cases(44 eyes)patients with Sjogren's syndrome(observation group)and 22 cases(44 eyes)healthy people with the same age(control group)for observation of central corneal SBN fibers diameter, number of beads, and tortuosity, and recorded tear film break up time(BUT), Schirmer's Ⅰ test(SⅠt), tear meniscus height(TMH), dendritic cell(DC)density, the results were applied to perform statistical analysis.

RESULTS: Under IVCM observation, the diameter of corneal SBN fibers in the observation group became thinner, the number of beads and the degree of nerve fiber tortuosity were increased compared with the control group(P<0.05). Pearson correlation analysis: the diameter of corneal SBN fibers in the observation group was significantly correlated with BUT(r=0.472, P<0.01), SⅠt(r=0.562, P<0.01), TMH(r=0.246, P=0.02)and DC density(r=-0.636, P<0.01). The number of nerve fiber beads was correlated with BUT(r=-0.621, P<0.01), SⅠt(r=-0.688, P<0.01), TMH(r=-0.438, P<0.01)and DC density(r=0.528, P<0.01). There was a significant correlation between nerve fiber tortuosity and BUT(r=-0.634, P<0.01), SⅠt(r=-0.713, P<0.01), TMH(r=-0.384, P< 0.01)and DC density(r=0.604, P<0.01).

CONCLUSION: IVCM can effectively observe the morphology of corneal nerve plexus. In SS patients, the diameter of corneal SBN fibers becomes thinner, the number of beads increases, and the tortuosity of nerve fiber increases. Moreover, the degree of nerve fiber lesions is correlated with the severity of dry eye clinical symptoms.