三种泪液评估方法在干眼诊断中相关性及一致性研究

Correlation and consistency of three methods for tear evaluation in the diagnosis of dry eye

摘要:

目的：研究SchirmerⅠ试验(SⅠt)、泪河高度(TMH)、新一代泪液检测技术泪河试纸(SMTube)三种泪液评估方法在干眼诊断中的相关性及其评价泪液量的一致性。方法：采用诊断试验研究方法，选择2021-05/06期间按照就诊顺序，随机纳入就诊于河南省立眼科医院干眼门诊的干眼患者183例183眼(均纳入右眼)。均行SⅠt、TMH和SMTube检查，对测量结果的相关性和一致性进行分析。 结果：纳入患者 OSDI问卷得分为43.75(31.25，58.33)分，NIBUT为7.26(4.97，9.37)s，SⅠt测量结果为6(2，12)mm/5min，TMH测量结果为0.18(0.14，0.22)mm，SMTube测量结果为5(3，8)mm/5s； 相关性分析结果：TMH与SMTube呈正相关(rs=0.751，P<0.001)，SⅠt与TMH(rs=0.139，P=0.060)和SMTube(rs=0.019，P=0.799)无相关性。一致性分析结果：TMH与SMTube评价泪液量的一致性好(Kappa=0.794，P=0.044)，SⅠt与TMH(Kappa=0.271，P=0.074)和SMTube(Kappa=0.193，P=0.070)评价泪液量的一致性差。结论：SMTube是一种新型、简单、快捷评价泪液量的工具，与TMH测量结果的相关性和一致性好，在临床应用中可替代TMH测量但不能替代SⅠt。

Abstract:

AIM:To explore the correlation and consistency of three tear assessment methods in the diagnosis of dry eye, which include the Schirmer Ⅰ test(SⅠt), tear meniscus height(TMH)measurement and a new generation of tear detection technology-Strip meniscometry tube(SMTube).METHODS: A diagnostic test study. A total of 183 dry eye outpatients(183 right eyes)in the Dry Eye Center of Henan Eye Hospital were enrolled from May to June 2021. The SⅠt, TMH and SMTube were performed on all patients, and the correlation and consistency of the measurement results were analyzed.RESULTS:The ocular surface disease index(OSDI)of all included patients was 43.75(31.25, 58.33), noninvasive breakup time(NIBUT)was 7.26(4.97, 9.37)s, and the results of SⅠt, TMH and SMTube were 6(2, 12)mm/5min, 0.18(0.14, 0.22)mm and 5(3,8)mm/5s, respectively; The results of correlation analysis: TMH was positively correlated with SMTube(rs=0.751, P<0.001), however, SⅠt had no correlation with TMH(rs=0.139, P=0.060)and SMTube(rs=0.019, P=0.799). The results of consistency analysis: TMH showed good consistency with SMTube(Kappa=0.794, P=0.044), however, SⅠt showed poor consistency with TMH(Kappa=0.271, P=0.074)and SMTube(Kappa=0.193, P=0.070)respectively.CONCLUSION:SMTube is a new, simple and convenient tool for evaluating tear volume. It has a good correlation and consistency with TMH measurement results. Therefore, it can replace TMH measurement, but cannot replace SⅠt in clinical application.