摘要
目的:探讨类风湿性关节炎(RA)与干眼的相关临床特点。方法:对46例RA患者进行问卷调查同时通过眼表检查确诊干眼患者42例(84眼),然后对其相关因素进行统计分析。结果:干眼与RA患者的病程、年龄有相关性。RA继发性干眼泪液分泌时间(SIT)、眼部症状评分在抗SSA抗体阳性和抗SSA抗体阴性患者中存在显著差异(P<0.05);抗SSB抗体阳性患者SIT较抗SSB抗体阴性患者低,眼部症状评分高,差异有统计学意义(P<0.05);角膜荧光素染色(FL)评分类分湿因子(RF)阳性患者较RF阴性患者高,差异有统计学意义(P<0.05);C反应蛋白(CRP)阳性患者泪膜破裂时间(BUT)较CRP阴性患者长,差异有统计学意义(P<0.05);FL、BUT、SIT及眼部症状评分血沉(ESR)阳性与ESR阴性患者比较差异无统计学意义(P>0.05);RA继发干眼中医辨证分型高发前3位中肝肾亏虚证占总例数的40.5%、痰瘀痹阻证占19.0%、湿热痹阻占16.7%,风湿痹阻证患者SIT时间最长,肝肾亏虚证患者眼部主观症状最明显。结论:RA患者应常规做干眼检查,应给予早期干预,并结合相关指标及辨证分型给予治疗和控制。
Objective:To discuss clinical features of the correlation of rheumatoid arthritis(RA)with xeroma.Methods:All42patients(84eyes)were diagnosed with xeroma by questionnaire of RA patients and ocular surface examination,and the related factors were statistically analyzed.Results:Xeroma was related to the gender and the course of RA patients.The significant difference existed in the comparisons of Schirmer I test(SIT)of RA patients with secondary xeroma and the scores of eye symptoms between the patients with positive and negative anti-SSA antibody(P<0.05);positive anti-SSB antibody patients was lower than negative anti-SSB antibody patients in SIT,while higher than negative antibody patients in the scores of eye symptoms,and the difference had statistical meaning(P<0.05);corneal fluorescein staining(FL)scales of positive rheumatoid factor(RF)patients were higher than these of negative RF patients,and the difference showed statistical meaning(P<0.05);tear break-up time(BUT)of positive C-reactive protein(CRP)patients was longer than that of the negativeCRPones,andthe difference was statisticallysignificant(P<0.05);while the difference had no statistical meaning in the comparisons of FL,BUT,SIT and the scores of eye symptoms between the patients with positive and negative ESR(P>0.05).The first three patterns of secondary xeroma of RA patients:liver kidney deficiency pattern secondary xeroma of RA patients occupied40.5%of total case number,phlegm-stagnation obstruction pattern held19.0%,damp-heat obstruction held16.7%,SIT of the patients of wind-damp obstruction pattern was the longest,eye subjective symptoms of the patients of liver kidney deficiency pattern was the most obvious.Conclusion:Dry eye examination should be performed for RA patients as a matter of routine,early intervention,the treatment and control should be given based on the related indexes and syndrome differentiation and patterns.
作者
丁宁
高卫萍
DING Ning;GAO Weiping(Nanjing University of Chinese Medicine, Nanjing 210046, China)
出处
《西部中医药》
2018年第3期1-5,共5页
Western Journal of Traditional Chinese Medicine
基金
江苏省中医药局科研专项课题(编号ZX2016C1)
关键词
类风湿性关节炎
干眼
辨证分型
实验室检查
性别
病程
rheumatoid arthritis
xeroma
syndrome differentiation and patterns
lab tests
the gender
duration
