芳香化酶抑制剂对眼表微环境影响的分析

Effects of aromatase inhibitors on the ocular surface microenvironment

摘要:

目的：分析芳香化酶抑制剂(AIs)对服用者眼表微环境的影响。

方法：横断面观察性研究。研究对象为2022-11/2023-05我院乳腺科就诊的接受AIs治疗的药物绝经后的女性，根据AIs的种类分为甾体组和非甾体组。对照组为年龄相匹配的职业健康体检女性。所有参与者都进行了眼表疾病指数(OSDI)问卷评分，详细的眼科检查包括：最佳矫正视力、眼压、眼轴、角膜曲率、泪河弯曲面的曲率半径、泪液渗透压、泪膜破裂时间、角膜荧光素钠染色评分、泪液分泌试验(SchirmerⅠ试验)、睑板腺红外线评分。

结果：对照组与甾体组、非甾体组的年龄、最佳矫正视力、眼压、眼轴、角膜曲率比较均无差异(P>0.05)； 甾体组和非甾体组的药物服药时长比较无差异(P>0.05)。对照组与甾体组、非甾体组的OSDI评分、泪河弯曲面的曲率半径、泪液渗透压、泪膜破裂时间、角膜荧光素钠染色评分、SchirmerⅠ试验、睑板腺红外线评分比较均有差异(P<0.05)； 甾体组和非甾体组SchirmerⅠ试验结果比较有差异(P<0.05)，其余数据之间均无差异(P>0.05)。

结论：接受AIs治疗的药物绝经后女性患者，眼表微环境改变明显，干眼的发生既有泪液分泌不足，也存在泪液蒸发过强。特别是接受非甾体类AIs者主泪腺分泌减少更明显。

Abstract:

AIM: To analyze the effects of aromatase inhibitors(AIs)on the ocular surface microenvironment of the users.

METHODS: A cross-sectional observational study was conducted. The study included postmenopausal women who received AIs treatment at galactophore department of our hospital from November 2022 to May 2023. Participants were divided into two groups based on the mechanism of AIs: the steroidal group and the non-steroidal group. The control group consisted of age-matched women who underwent occupational health examinations. All participants completed the ocular surface disease index(OSDI)questionnaire and underwent detailed ophthalmic examinations, including best-corrected visual acuity, intraocular pressure, axial length, corneal curvature, radius of curvature of curved lacrimal river surface, tear osmolarity, tear film break-up time, corneal fluorescein staining score, Schirmer Ⅰ test, and meibomian gland infrared score.

RESULTS: There were no statistically significant differences in age, best-corrected visual acuity, intraocular pressure, axial length, and corneal curvature between control group and steroidal and non-steroidal group(P>0.05). The duration of drug treatment between the steroidal group and the non-steroidal group also showed no statistically significant difference(P>0.05). However, statistically significant differences were observed between the control group and the steroidal and non-steroidal group in OSDI scores, radius of curvature of curved lacrimal river surface, tear osmolarity, tear film break-up time, corneal fluorescein staining score, Schirmer Ⅰ test, and meibomian gland infrared score(P<0.05). The Schirmer Ⅰ test also showed statistically significant differences between the steroidal group and the non-steroidal group(P<0.05), while other data showed no statistically significant differences(P>0.05).

CONCLUSION: Postmenopausal patients receiving AIs treatment experienced significant changes in the ocular microenvironment, with both decreased tear secretion and excessive tear evaporation contributing to the occurrence of dry eye. Notably, patients receiving non-steroidal AIs treatment showed a more significant reduction in main lacrimal gland secretion.