摘要目的 探讨睑缘炎相关角结膜病变(BKC)的临床特征及其治疗效果. 方法 回顾性分析2012年1月至2014年12月北京同仁医院眼科门诊临床诊断为BKC患者172例,对其一般情况、睑缘病变及角结膜病变的临床表现与程度及疗效进行统计分析.主要指标包括:睑缘情况、角结膜病变范围与程度及治疗有效率.计数资料比较采用x2检验.结果 共收集临床诊断为BKC患者172例,年龄范围为2～78岁,平均(27±18)岁,其中男性49例(28.5％),女性123例(71.5％);105例患者有睑缘及角结膜病变照片记录,其中,28例(26.7％)为单眼发病,68例(64.8％)双眼BKC程度相近,9例(8.6％)双眼程度不一,轻度BKC 39例(40.6％),中度BKC 24例(25.0％),重度BKC33例(34.4％);不同性别之间BKC程度差异无统计学意义(x2=1.022,P=0.600).同期临床诊断睑缘炎患者1 875例,并发BKC的172例(9.2％).其中,女性患者更易发生BKC (x2=8.355,P＜0.05).儿童睑缘炎患者,BKC发生率显著高于其他年龄各组(x2=224.566,P＜0.05),但不同年龄组之间,BKC程度差异无统计学意义(x2=10.967,P=0.089).96例(164只眼)BKC患者中,表现为角膜上皮点状混浊30例(55只眼,33.5％),角膜上皮下混浊15例(25只眼,15.2％),角膜基质浸润24例(38只眼,23.2％),角膜溃疡9例(15只眼,9.1％),角膜云翳3例(5只眼,3.1％),角膜血管翳15例(26只眼,15.9％).患者随访时间1～80个月,平均7个月,根据BKC的不同程度进行治疗.治疗1个月后,69例(71.9％)患者达到临床痊愈,其余患者均有明显好转,随访期内复发9例(15只眼),复发率9.2％.结论 BKC在睑缘炎患者并不少见,且临床表现多样;女性及儿童睑缘炎患者更易发生BKC,需要引起临床重视,进行睑缘炎及BKC的规范诊治对提高疗效十分重要.

abstractsObjective To summarize the clinical characteristics,diagnosis,and treatment of blepharokeratoconjunctivitis (BKC).Methods Retrospective analysis.One hundred and seventy-two patients were diagnosed as BKC between January 2012 and December 2014 at Beijing Tongren Hospital.The clinical characteristics,the degrees of blepharitis and BKC,and the therapeutic effect were evaluated.Results The patients were aged from 2 to 78 years (mean,27±18 years).Forty-nine patients (28.5％) were males,and 123 patients (71.5％) were females.One hundred and five patients had photograph records of lid margin,cornea,and conjunctiva.BKC was unilateral in 28 (26.7％) of them,and bilateral in 68 (64.8％) with similar degrees and in 9 (8.6％) with different degrees.The disease was mild in 39 patients (40.6％),moderate in 24 patients (25.0％),and severe in 33 patients (34.4％).There was no significant difference in the degree of BKC between males and females (x2=1.022,P=0.600).A total of 1 875 patients were diagnosed as blepharitis during the same period,and 172 patients (9.2％) were complicated by BKC.Female patients with blepharitis were more susceptible to BKC (x2=8.355,P＜0.05).Among the children patients with blepharitis,the incidence of BKC was significantly higher than that in the other groups (x2=224.566,P＜ 0.05),but in the degree of BKC,there was no significant difference among groups.Typical clinical findings consisted of punctuate epithelial and subepithelial haze,stromal infiltrates,corneal ulcer,corneal scar,and corneal pannus.The patients were followed up for 1 to 80 months (mean,7 months).According to the different degrees of BKC,the patients were given treatment for 1 month.Sixty-nine patients (71.9％) had clinical recovery,and the other cases were improved obviously.Nine patients (15 eyes) had recurred BKC during the follow-up period,and the recurrence rate was 9.2％.Conclusions BKC is not uncommon in patients suffering blepharitis,with a variety of clinical characteristics.Female and children patients with blepharitis are more susceptible to BKC.It is vital to perform standardized diagnosis and treatment for improvement of therapeutic effect.