目的：应用传统干眼症检查方法与光学相干断层扫描(OCT)对狼疮性肾炎患者进行干眼症检查，分析狼疮性肾炎与干眼症患病关系，并探讨传统检查方法与OCT在干眼症诊断方面的作用。

方法：选取2014-01/2015-01在我院肾脏病科住院的狼疮性肾炎患者组和患者家属(无免疫系统疾病史)作为正常对照组各27例54眼，分别进行干眼症症状询问、行泪液分泌试验(Schirmer Ⅰ test，SⅠt)、泪膜破裂时间(break-up time，BUT)、角膜荧光素染色(fluorescein staining，FL)、光学相干断层扫描(OCT)测量泪河高度(tear meniscus height，TMH)及面积(tear meniscus area，TMA)检查。

结果：狼疮性肾炎组干眼症主观症状发生率(59%)高于对照组(35%)，SⅠt低于对照组，差异有统计学意义(P<0.01)，BUT短于对照组，差异有统计学意义(P<0.01)，角膜荧光素染色阳性率(63%)高于对照组(30%)，光学相干断层扫描测TMH低于对照组，差异有统计学意义(P=0.002)，TMA小于对照组，差异有统计学意义(P=0.028)。OCT测量TMH与SⅠt(P=0.012)、BUT(P=0.002)检查呈正相关； OCT测量TMA与SⅠt(P=0.023)、BUT(P=0.004)检查呈正相关。

结论：狼疮性肾炎患者干眼症患病率高， OCT作为一种操作简便、高效、准确的干眼症检查方法，在干眼症的诊断中具有价值。

AIM: To observe the application of traditional examinations and optical coherence tomography analysis in diagnosis of dry eye who are suffered from lupus nephritis. The correlation between traditional examinations and optical coherence tomography were analyzed.

METHODS: We included 27 cases(54 eyes)with lupus nephritis and the same number of normal subjects as control group. Subjective symptom scores, Schirmer Ⅰ test, break-up time(BUT), fluorescein staining, optical coherence tomography(OCT)measurement of tear meniscus height and tear meniscus area were carried out for both groups.

RESULTS: Compared with the normal control group(35%), the lupus nephritis group(59%)shows a higher prevalence of subjective symptom, less lacrimal secretion(P<0.01), shorter BUT(P<0.01), a higher positive rate of FL staining(LN 63%, control group 30%), lower tear meniscus heigt(P=0.002)and smaller tear meniscus area(P=0.028). The incidence of dry eye is significantly higher in lupus nephritis group. The value of tear meniscus height had positive correlation with SⅠt(P=0.012)or BUT(P=0.002)results. The value of tear meniscus area had positive correlation with SⅠt(P=0.023)or BUT(P=0.004)results.

CONCLUSION: The prevalence of dry eye is higher in lupus nephritis than normal people. We should examining and giving treatment in time in order to relive eye discomfort. As a simplicity of operator, high-efficiency, accurate examination method, OCT will be of value to diagnosis of dry eye.

南京军区总院院管课题(No.2012040)