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中华眼科医学杂志(电子版) ›› 2024, Vol. 14 ›› Issue (04) : 212 -216. doi: 10.3877/cma.j.issn.2095-2007.2024.04.004

论著

干眼的症状、体征与焦虑及抑郁相关性的临床研究
汪毅仁1, 江晓丹2, 李佳曦1, 赵天瑶3, 李学民2,()   
  1. 1.100191 北京大学第三医院2017级八年制研究生
    2.100191 北京大学第三医院眼科中心 眼部神经损伤的重建保护与康复北京市重点实验室
    3.100191 北京大学第三医院2021级博士研究生
  • 收稿日期:2024-06-01 出版日期:2024-08-28
  • 通信作者: 李学民
  • 基金资助:
    首都卫生发展科研专项项目(首发2024-2-40913)

The correlation of dry eye symptoms and signs with anxiety and depression

Yiren Wang1, Xiaodan Jiang2, Jiaxi Li1, Tianyao Zhao3, Xuemin Li2,()   

  1. 1.Eight-year Postgraduate degree 2017,Peking University Third Hospital,Beijing 100191,China
    2.Department of Ophthalmology,Peking University Third Hospital,Beijing Key Laboratory of Reconstruction,Protection and Rehabilitation of Eye Nerve Injury,Beijing 100191,China
    3.Doctoral degree2021,Peking University Third Hospital,Beijing 100191,China
  • Received:2024-06-01 Published:2024-08-28
  • Corresponding author: Xuemin Li
引用本文:

汪毅仁, 江晓丹, 李佳曦, 赵天瑶, 李学民. 干眼的症状、体征与焦虑及抑郁相关性的临床研究[J/OL]. 中华眼科医学杂志(电子版), 2024, 14(04): 212-216.

Yiren Wang, Xiaodan Jiang, Jiaxi Li, Tianyao Zhao, Xuemin Li. The correlation of dry eye symptoms and signs with anxiety and depression[J/OL]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2024, 14(04): 212-216.

目的

探讨干眼症状、体征与焦虑及抑郁之间的相关性。

方法

收集2021年6月至2021年12月就诊于北京大学第三医院眼科中心患者83例(166只眼)进行研究。其中,男性9例(18只眼),女性42例(84只眼)。年龄24~83岁,平均年龄为(51.0±16.1)岁。根据干眼诊断标准分为干眼组和对照组。应用眼表疾病指数问卷(OSDI)评估受试者干眼症状,应用医院用焦虑抑郁评分量表(HADS)测量患者焦虑评分和抑郁评分,分别应用Oculus Keratograph 5M眼表分析仪和角膜共聚焦激光扫描显微镜收集患者睑板腺红外成像照片及角膜神经图片,并应用ImageJ软件测量睑板腺面积指数和角膜神经密度。经检验,患者OSDI评分、HADS焦虑分数、HADS抑郁分数、睑板腺指数及角膜神经密度符合正态分布,以表示。干眼组和对照组患者各项指标的差异性采用独立样本t检验,干眼组患者的干眼症状、体征指标与HADS评分之间的相关性采用Pearson分析,干眼症状、体征对HADS评分的预测模型采用二元Logistics回归分析。

结果

干眼组和对照组患者OSDI评分分别为(22.7±18.0)分和(28.8±16.4)分,其差异具有统计学意义(t=1.54,P<0.05)。干眼组和对照组患者睑板腺指数分别为(0.19±0.06)和(0.22±0.07),其差异具有统计学意义(t=-2.20,P<0.05)。干眼组和对照组患者角膜神经密度分别为(2346.7±783.0)μm/mm2和(2419.8±386.5)μm/mm2,其差异具有统计学意义(t=0.56,P<0.05)。干眼组和对照组患者HADS焦虑分数分别为(7.5±4.4)分和(1.9±1.8)分,其差异具有统计学意义(t=9.49,P<0.05)。干眼组和对照组患者HADS抑郁分数分别为(7.5±3.1)分和(3.5±2.6)分,其差异具有统计学意义(t=6.08,P<0.05)。干眼组患者HADS焦虑分数与OSDI评分有弱相关性且呈正相关,与角膜神经密度有弱相关性且呈负相关,与睑板腺指数有中等相关性且呈负相关,其相关性均具有统计学意义(r=0.37,-0.35,-0.43;P<0.05)。干眼组患者HADS抑郁分数与OSDI评分有中等相关性且呈正相关,与睑板腺指数有中等相关性且呈负相关,其相关性具有统计学意义(r=0.45,-0.52;P<0.05)。多因素二元Logistics回归分析发现OSDI评分、角膜神经密度及睑板腺指数对HADS焦虑分数评分的影响具有统计学意义(OR=1.10,95%CI:1.04~1.16;P<0.05)、(OR=0.90,95%CI:0.81~0.98;P<0.05)及(OR=0.87,95%CI:0.78~0.95;P<0.05)。其中,OSDI评分对于HADS焦虑评分是危险因素,角膜神经密度和睑板腺指数对于HADS焦虑评分是保护因素。OSDI评分及睑板腺指数对HADS抑郁分数评分的影响具有统计学意义(OR=1.07,95%CI:1.02~1.13;P<0.05)及(OR=0.90,95%CI:0.82~0.97;P<0.05)。其中,OSDI评分对于HADS焦虑评分是危险因素,睑板腺指数对于HADS焦虑评分是保护因素。

结论

干眼患者比健康人更容易产生焦虑及抑郁情绪,干眼OSDI评分、角膜神经密度及睑板腺指数与焦虑、抑郁HADS评分有显著相关性。

Objective

To explore the correlation between dry eye symptoms,signs and anxiety and depression.

Methods

A total of 83 patients(166 eyes)in the Department of Ophthalmology of Peking University Third Hospital from June 2021 to December 2021 were collected.There were 9 males(18 eyes) and 42 females(84 eyes)with the average age of(51.0±16.1)years(ranged from 24 to 83 years).According to the diagnostic criteria of dry eye,the patients were divided into dry eye group and control group.The dry eye symptoms of the subjects were evaluated by the ocular surface disease index questionnaire(OSDI).The anxiety and depression scores of the patients were measured by the hospital anxiety and depression rating scale(HADS).The infrared images of meibomian gland and corneal nerve images were collected by Oculus Keratograph 5M eye surface analyzer and corneal confocal laser scanning microscope,respectively.The meibomian gland area index and corneal nerve density were measured by ImageJ software.After examination,the OSDI score,HADS anxiety score,HADS depression score,meibomian gland index and corneal nerve density of the patients conformed to the normal distribution,and were expressed as.The difference of each index between the dry eye group and the control group was tested by independent sample t test.The correlation between the dry eye symptoms,signs and HADSscore in the dry eye group was analyzed by Pearson.The prediction model of dry eye symptoms and signs on hads score was analyzed by binary Logistics regression.

Results

The OSDI scores of patients in the dry eye group and the control group were(22.7±18.0)and(28.8±16.4)points,respectively,with a statistically significant difference(t=1.54,P<0.05).The meibomian gland index of patients in the dry eye group and the control group was(0.19±0.06)and(0.22±0.07),respectively,with a statistically significant difference(t=-2.20,P<0.05).The corneal nerve density of patients in the dry eye group and the control group was(2346.7±783.0)μm/mm2 and(2419.8±386.5)μm/mm2,respectively,with a statistically significant difference(t=0.56,P<0.05).The HADSanxiety scores of patients in the dry eye group and the control group were(7.5±4.4)and(1.9±1.8)points,respectively,with a statistically significant difference(t=9.49,P<0.05).The HADSdepression scores of patients in the dry eye group and the control group were(7.5±3.1)and(3.5±2.6)points,respectively,with a statistically significant difference(t=6.08,P<0.05).The HADS anxiety score in patients with dry eye syndrome showed a weak positive correlation with OSDI score,a weak negative correlation with corneal nerve density,and a moderate negative correlation with meibomian gland index.All these correlations were statistically significant(r=0.37,-0.35,-0.43;P<0.05).The HADS depression score of patients in the dry eye group showed a moderate positive correlation with the OSDI score,and a moderate negative correlation with the meibomian gland index.The correlation was statistically significant(r=0.45,-0.52;P<0.05).Multivariate binary Logistics regression analysis revealed that the OSDI score,corneal nerve density,and meibomian gland index had statistically significant effects on the HADSanxiety score(OR=1.10,95%CI:1.04 to 1.16;P<0.05),(OR=0.90,95%CI:0.81 to 0.98;P<0.05),and(OR=0.87,95%CI:0.78 to0.95;P<0.05).Among them,the OSDI score was a risk factor for HADS anxiety score,while corneal nerve density and meibomian gland index were protective factors for HADS anxiety score.The impact of OSDI score and meibomian gland index on HADSdepression score was statistically significant(OR=1.07,95%CI:1.02 to 1.13;P<0.05)and(OR=0.90,95%CI:0.82 to0.97;P<0.05).Specifically,OSDIscore was a risk factor for HADSanxiety score,while meibomian gland index was a protective factor for HADSanxiety score.

Conclusions

Dry eye patients are more likely to suffer from anxiety and depression than healthy individuals.OSDI score,corneal nerve density,and meibomian gland area index are significantly correlated with HADSscores.

图1 干眼组与对照组医院用焦虑抑郁评分量表评分的比较
图2 医院用焦虑抑郁评分量表焦虑评分及抑郁评分的受试者工作特征曲线
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