中文摘要：

目的研究干眼患者症状与泪膜脂质层厚度（LLT）的相关关系。设计回顾性病例系列。研究对象随机选取2015年7-10月就诊于北京同仁医院眼科门诊的干眼患者139例,其中男性58例,女性81例,年龄18-77岁,平均（37.75±12.86）岁。方法所有入组患者均进行眼表疾病指数（OSDI）问卷（共包括12项症状）调查以及用Lipi View-眼表面光干涉仪测量LLT。根据干眼症状（OSDI问卷评分）分为三组：轻度症状组35例（0-20分）,中度症状组61例（21-45分）,重度症状组43例（46-100分）。分析干眼症状与LLT的相关性以及不同程度干眼症状与LLT的关系。主要指标OSDI问卷评分、泪膜脂质层厚度。结果 139例干眼患者OSDI评分与LLT呈显著相关且为负相关（r=-0.256,P=0.002）,随着OSDI得分增加（症状的加重）脂质层厚度变薄。OSDI问卷中异物感、眼酸痛、看电视、看电脑眼部不适与LLT有明显相关性（r=-0.206、-0.232、-0.190、-0.179,P均〈0.05）,其他8项症状与LLT无相关性。严重程度不同的三个组别之间LLT存在差异,尤其是轻度症状组（64.89±16.40 nm）与重度症状组（54.65±14.48 nm）之间差异更明显（F=10.092,P=0.027）;轻度症状组中LLT≤60 nm者14例（40%）,而重度组中LLT≤60 nm者30例（70%）（χ^2=6.953,P=0.008）。结论干眼症状与泪膜脂质层厚度呈明显负相关。干眼症状中的异物感、眼酸痛、看电视或电脑眼部不适等症状与泪膜脂质层厚度相关性较显著。泪膜脂质层厚度低于60 nm者干眼症状严重。

英文摘要：

Objective To study the relationship between dry eye symptoms and lipid layer thickness（LLT） in dry eye patients. Design Retrospective case series. Participants 139 dry eye patients were selected from ophthalmology department Tongren Hospital from July 2015 to October （81 of females and 58 males, age range=18-77 years, mean age= 37.75 ±12.86 years）. Methods All patients were required to complete the Ocular Surface Disease Index （OSDI） questionnaire after which their LLTs were evaluated using a new interferometer （LipiView, TearScience Inc, Morrisville, NC）. Based on the OSDI questionnaire scores, 139 patients were divided into three groups： mild symptom group （0~20 scores）, moderate symptom group （21~45 scores） and severe symptom group（46~100 scores）. The relationship between the OSDI score and LLT, as well as the relationship between different degree symptoms and LLT were analyzed. Main Outcome Measures OSDI score and LLT. Results OSDI score was negatively correlated with LLT（r=-0.256, P=0.002）, i.e. with the increase of OSDI score, lipid layer thickness decreased. OSDI questionnaire including 12 items, only foreign body sensation, painful or sore, watching TV or computer causing discomfort were correlated with LLT（r=-0.206, -0.232, -0.190, -0.179 respectively,all P〈0.05）, the other 8 items had no relevance with LLT. Among three different severe groups, LLT was significantly different by analysis of variance, especially between the mild symptom group （64.89±16.403 nm） and the severe symptom group （54.65±14.481 nm）（F=10.092, P=0.027）. There were 40% of （14 people） patients with LLT≤60 nm in mild symptom group, while 70% of （30 people） patients in severe symptom group; the proportion of the patients with LLT≤60 nm in severe symptom group was significantly greater than mild symptom group（χ^2=6.953, P=0.008）. Conclusion Dry eye symptoms have negative correlation with the lipid layer thickness of dry eye patients, especially foreign body sensatio