Ⅱ型糖尿病病情及眼表疾病相关性探究.docVIP

Ⅱ型糖尿病病情及眼表疾病相关性探究 　【摘要】 探讨Ⅱ型糖尿病患者角膜上皮损伤、结膜杯状细胞及上皮细胞病理改变与糖尿病病程、血糖控制情况及糖尿病性视网膜病变间的相关关系.［方法］给51例(102眼)Ⅱ型糖尿病患者和20名（40眼）正常人进行结膜印迹细胞学检查和角膜荧光素染色试验，观察结膜上皮细胞鳞状化程度、结膜杯状细胞形状、密度及角膜损伤程度，并与糖尿病病程、血糖控制情况、糖尿病性视网膜病分别进行一元线性相关及回归分析.［结果］与正常对照组比较，糖尿病组患者角膜上皮损伤严重，杯状细胞密度显著降低，结膜上皮细胞的鳞状化级别显著增加，相比较均有显著性差异.杯状细胞密度和结膜上皮细胞鳞状化程度与糖尿病患者血糖控制情况呈显著性相关.［结论］Ⅱ型糖尿病患者是干眼症的易感人群，控制好Ⅱ型糖尿病患者的血糖，可改善角膜上皮、结膜上皮细胞及杯状细胞的病理变化. 【关键词】 结膜疾病 眼表疾病 糖尿病 Ⅱ型 ABSTRACT:OBJECTIVETo study the correlation of the duration, severity and grade of diabetic retinopathy (DR) with the disorders of ocular surface in type 2 diabetic patients.METHODS102 eyes of 51 patients with non insulindependent diabetes mellitus(DM) and 40 eyes of 20 healthy subjects underwent examinations with fluorescein vital staining (FL) and conjunctival impression cytologic analysis (CIC) to observe the degree of conjunctival epithelium squamatization, conjunctival goblet cell shape and density as well as the degree of cormea injury.RESULTSThe average grade of squamous metaplasia and the average score of FL were significantly higher and the mean goblet cell density was significantly lower in diabetic patients than in control subjects. The grade of conjunctival squamous metaplasia, the conjunctival goblet cell density and the score of FL were significantly related to the control condition of DM.CONCLUSIONThe patients of type 2 DM is susceptible population of xeroma, and the blood glucose is controlled well in patients of type 2 DM to be improvement the pathological changes of corneal epithelium, conjunctival epithelium and goblet cells. Key words:conjunctival diseases;corneal diseases;diabetes mellitus, type2 糖尿病常并发全身多器官并发症，在眼部主要表现为视网膜病理变化及糖尿病性白内障等.多数糖尿病患者常主诉有眼部异物感、烧灼感及畏光等干眼症状，有学者认为糖尿病可通过影响眼表微环境，引起眼表的角膜、结膜及泪液发生变化.本研究观察了糖尿病患者角膜上皮、结膜杯状细胞及上皮细胞病理变化，探讨了与血糖控制情况、糖尿病病程、糖尿病性视网膜病理变化程度的相关性. 1 对象和方法 1.1 对象 51例Ⅱ型糖尿病均在2005年11月至2006年4月间经延边大学医院内分泌科确诊的患者，均符合WHO 1999年的糖尿病诊断标准［1］；年龄为36～76岁；男性为27例，女性为24例.根据糖尿病血糖控制目标和糖尿病性视网膜病变国际分级法［1，2］，将血糖控制情况分为理想、尚可及差3个级别，本组患者中分别为11、19、21例.将糖尿病性