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目的:比较在诊断干眼方法中酚红棉线,Schirmer’s I试验及泪膜破裂时间测量泪膜的一致性。方法:110只白内障术眼术前分别用酚红棉线试验,Schirmer’s I试验测量泪液分泌量,两种方法间隔5min,然后均行泪膜破裂时间测定(break up time,BUT),所有资料均采用Kappa统计学方法,分析其一致性。结果:酚红棉线测量泪液分泌试验,棉线湿长<10mm的患者,占总眼数的36.4%,湿长<20mm者,占总眼数的89.1%;Schirmer’s I试验滤纸湿长<5mm者,占总眼数的10.9%,湿长<10mm者,占总眼数的40.0%。BUT<5s者占总眼数的23.6%,<10s者占总眼数的65.5%。酚红棉线试验与Schirmer’s I试验,BUT的一致性Kappa值分别为从0.03到0.29,从-0.028到0.13,酚红棉线试验与Schirmer’s I试验及BUT的一致性较差。同样Schirmer’s I试验与BUT的一致性Kappa值从0.12到0.31,两者的一致性较差。结论:酚红棉线试验与Schirmer’s I试验,BUT试验在测试泪液量方面的一致性较差,而且Schirmer’s I试验与BUT试验相比较一致性也较差,因此诊断干眼患者需要联合多种检查方法。
OBJECTIVE: To compare tear film consistency in the determination of phenol red cotton thread, Schirmer’s I test, and tear film breakup time in a diagnostic dry eye method. Methods: One hundred and ten cataract patients were treated with phenol red cotton thread test before operation, Schirmer’s I test was used to measure the amount of lacrimal fluid secretion. The interval between the two methods was 5 minutes, then the break up time (BUT) was measured. All the data were taken Kappa statistical methods, analysis of its consistency. Results: The tear secretion test of phenol red cotton thread, 36.4% of the total number of eyes with wet length less than 10mm, 89.1% of the total number of eyes with wet length less than 20mm, Schirmer’s I test, 10.9% of the total number of eyes, wet length <10mm, accounting for 40.0% of the total number of eyes. BUT <5s accounted for 23.6% of the total number of eyes, <10s accounted for 65.5% of the total number of eyes. The consistent Kappa values for phenol red cotton and Schirmer’s I and BUT were from 0.03 to 0.29, respectively, from -0.028 to 0.13. The phenol-cotton thread test was less consistent with the Schirmer’s I test and the BUT. Similarly, the consistent Kappa values for Schirmer’s I trial and BUT range from 0.12 to 0.31, with poor agreement. CONCLUSIONS: The differences between the phenolphthalein cotton thread test and the Schirmer’s I test and the BUT test in testing the tear volume were poor and the consistency between the Schirmer’s I test and the BUT test was poor. Therefore, patients with dry eye need to combine multiple screening methods .