目的：研究甲状腺相关眼病(TAO)患者干眼症患病率与泪膜功能及角膜状况。

方法：选取2014-09/2016-08在本院接受治疗并确诊为TAO的患者218例436眼，依据TAO的临床活动度评分(CAS)把患者分成两组：评分≥4分为活动期患者，共72例144眼； 评分<4分为非活动期患者，共146例292眼； 依据患者病程情况分成三组，低于1a为短病程组，共133例266眼； 病程1～2a为中病程组，共40例80眼，大于2a为长病程组，共45例90眼； 对比患者进行角膜荧光素染色(FS)、泪膜破裂时间(BUT)和泪液分泌试验(S I t)检测情况。

结果：患者218例中共有138例276眼诊断是干眼症； 其中活动期患者患病率高于非活动期患者，差异有统计学意义(P<0.05)，短病程组患者患病率高于中病程组和长病程组，和长病程组对比差异有统计学意义(P<0.05)； 三组不同病程患者在BUT与S I t检测方面比较，差异无统计学意义(P>0.05)，在FL检测方面对比差异有统计学意义(P<0.05)； 非活动期患者和活动期患者在FS、BUT和S I t检测方面对比差异均有统计学意义(P<0.05)。

结论：多数TAO患者泪液分泌不充分、泪膜不够稳定，近1/3 TAO患者的角膜上皮出现损坏，患干眼病几率比正常人显著增加。

METHODS: Totally 218 patients(436 eyes)with TAO admitted to our hospital from September 2014 to August 2016 were selected and divided into two groups according to TAO's clinical activity score(CAS): score≥ 4 divided into active patients, 72 cases of 144 eyes; score <4 points were inactive patients, a total of 146 cases of 292 eyes; according to the patient's course of the situation was divided into three groups, less than 1a for the short course of disease, a total of 133 cases of 266 eyes; course of disease in the 1-2a in the medium course group, there were 40 eyes of 80 eyes and 45 eyes of 90 eyes in more than 2a, as long course group. Contrast patients were examined by corneal fluorescein staining(FL), tear film break-up time(BUT)and tear secretion test(SⅠt)Happening.

RESULTS: In 218 patients, 138 cases of 276 eyes were diagnosed as dry eye. The prevalence rate of active period patients was higher than that of inactive patients, and the difference was statistically significant(P<0.05). The prevalence rate in the short course group was higher than that of the middle course group and the long course group, and the difference was statistically significant compared with that in long course group(P<0.05). There was no significant difference between any two of the three groups in BUT and SⅠt detection(P>0.05), and the differences was statistically significant in the detection of FL(P<0.05). The differences of FL, BUT and SⅠt between the inactive patients and the active patients were statistically significant(P<0.05).

CONCLUSION: Most patients with TAO have inadequate tear secretion and tear film instability. The corneal epithelium of 1/3 TAO patients is damaged and the incidence of dry eye disease is significantly higher than that of normal subjects.