目的：探究蠕形螨感染程度与睑缘炎相关性角结膜病变(BKC)患者角膜细胞密度变化、眼表功能的相关性。

方法：选取2019-07/2020-07于本院眼科就诊的BKC患者94例为研究对象(BKC组)，另外同期选择相匹配的健康志愿者80例为对照组。根据BKC患者是否感染蠕形螨，分为感染组45例和未感染组49例。根据睫毛检出蠕形螨数量分为可疑感染17例、中度感染18例、重度感染10例。对所有研究对象使用激光共聚焦显微镜检查，计算中央角膜和周边角膜各层组织的细胞密度。检查BKC患者眼表功能[泪液分泌试验、眼表疾病指数(OSDI指数)、睑缘异常评分、角膜荧光素染色检查及泪膜破裂时间(TF-BUT)检查]，分析BKC患者蠕形螨感染与角膜细胞密度、眼表功能的相关性。

结果：与对照组相比，BKC组在中央和周边角膜浅基质层细胞密度较低(P<0.05)，OSDI指数、睑缘异常评分、角膜荧光素染色评分较高(P<0.05)； BKC未感染组、蠕形螨可疑感染、蠕形螨中度感染、蠕形螨重度感染患者中央和周边角膜浅基质层细胞密度依次降低(P<0.05)，OSDI指数、睑缘异常评分、角膜荧光素染色评分依次显著增加(P<0.05)； 蠕形螨感染程度与BKC患者中央和周边角膜浅基质层细胞密度负相关(P<0.05)，与OSDI指数、睑缘异常评分、角膜荧光素染色评分正相关(P<0.05)。

结论：蠕形螨感染严重程度与BKC患者角膜中央和周边角膜浅基质层细胞密度具有显著负相关，与眼表功能障碍具有显著正相关。

METHODS: Ninety-four patients with BKC(BKC group)at Department of Ophthalmology of our hospital from July 2019 to July 2020 were selected as the research objects, in addition, 80 matched healthy volunteers were selected as control group. The BKC patients were divided into infected group(45 cases)and uninfected group(49 cases)according to whether they were infected with demodex. According to the number of demodex detected in eyelashes, there were 17 cases of suspicious infection, 18 cases of moderate infection and 10 cases of severe infection. All subjects were examined by laser confocal microscopy, and the cell density in the superficial stromal layer of the central cornea and peripheral cornea was calculated. The ocular surface function \〖Schirmer test, Ocular Surface Disease Index(OSDI)\〗, eyelid margin abnormality score, corneal fluorescence stain and tear film break-up time(TF-BUT)of patients with BKC were examined, and the correlation between demodex infection with corneal cell density and ocular surface function in patients with BKC was analyzed.

RESULTS: Compared with those in the control group, the cell density in the superficial stromal layer of the central cornea and peripheral cornea was lower in the BKC group(P<0.05), and the OSDI, eyelid margin abnormality score and corneal fluorescence stain score were higher(P<0.05); the cell density in the superficial stromal layer of the central cornea and peripheral cornea of patients in uninfected group, patients with suspicious demodex infection, moderate demodex infection and severe demodex infection decreased in turn(P<0.05), and the OSDI, eyelid margin abnormality score and corneal fluorescence stain score increased significantly in turn(P<0.05); the degree of demodex infection was negatively correlated with the cell density in the superficial stromal layer of the central cornea and peripheral cornea in patients with BKC(P<0.05), and was positively correlated with OSDI, eyelid margin abnormality score and corneal fluorescence stain score(P<0.05).

CONCLUSION: The severity of demodex infection has a significant negative correlation with the cell density in the superficial stromal layer of the central cornea and peripheral cornea in patients with BKC, has a significant positive correlation in patients with ocular surface dysfunction.