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【关键词】调查问卷;准分子激光原位角膜磨镶术;近视;干眼;诊断
【中图分类号】R779.63 【文献标识码】B 【文章编号】1002-8714（2019）12-0074-02
【Abstract】 Objective： To evaluate the McMonnies questionnaire （MQ） and Ocular Surface Disease Index（OSDI）questionnaire in diagnosis for dry eye before LASIK. Method： 60 myopic patients before LASIK were enrolled. Scores of MQ and OSDI were obtained. Ophthalmic examinations including Schirmer I， BUT and corneal fluorescein staining were performed. Dry eye were diagnosed according to dry eye diagnostic standard. Reliability， validity， accuracy wee assessed. Result： Dry eyes were detected in 21patients. The Cronbach α of MQ was 0.56， and the average correlation coefficient of each item was 0.37. The overall alpha reliability coefficient of OSDI was 0.80， and the alpha reliability coefficients of eye symptoms， visual function， and environmental triggering factors were 0.65， 0.68， and 0.82， respectively. The intraclass correlation coefficient of MQ and OSDI were 0.89 and 0.92， respectively. MQ and OSDI each identified 4 main common factors， and the cumulative contribution rates were 60.5% and 68.2% respectively. The areas under the ROC curves of MQ and OSDI were 0.85±0.14 and 0.92±0.26， respectively. Conclusion： Both questionnaires have good internal repeatability. But OSDI have better reliability， internal consistency， construct validity and accuracy. Then， the OSDI questionnaire is more fitful for diagnosis of dry eye before LASIK.
【key word】 questionnaire; LASIK; myopia; dry eye; diagnosis
干眼是由于泪液质或量的异常或泪膜稳定性造成眼部不适或组织损伤的一类疾病。造成干眼的因素很多，近视是一个重要原因[1]。准分子激光原位角膜磨镶术（laser insitu keratomileusis，LASIK）是迄今施行最多的角膜屈光手术，但手术可能会引起或加重干眼并严重影响生活质量。因此，术前对患者干眼的筛查十分重要。本文旨在以探討不同调查问卷在干眼筛查中的诊断价值，现将结果报告如下。
1.1 一般资料：选择2016年6月～2017年11月于我院进行LASIK手术的患者60例。年龄23～43岁，平均27.6±10.8岁，其中男性40例，女性20例。所有患者均为初次接受手术，既往无眼部手术及外伤史，能认真正确填充问卷调查并配合相应检查。本研究患者均签署知情同意书。
1.2 方法：研究对象首先填写McMonnies（MQ）和Ocular Surface Disease Index（OSDI）问卷，随后先后进行泪膜破裂时间（breaking up time，BUT）、角结膜荧光素染色（fluoresceinstaining，FL）和泪液分泌试验I（Schirmer’s I test，SIt），每两项检查间隔2-10min。根据荧光素染色进行评分[2]。所有询问及检查均在上午10：00～下午4：00，室温18℃±2℃、湿度65%±2%环境下由同一医师完成。受试者3周后再次填写调查问卷。干眼诊断标准依据中华医学会眼科学分会角膜病学组2013年干眼临床诊疗专家共识。
1.3 统计学处理：数据采用SPSS13.0软件进行统计学分析，P
【中图分类号】R779.63 【文献标识码】B 【文章编号】1002-8714（2019）12-0074-02
【Abstract】 Objective： To evaluate the McMonnies questionnaire （MQ） and Ocular Surface Disease Index（OSDI）questionnaire in diagnosis for dry eye before LASIK. Method： 60 myopic patients before LASIK were enrolled. Scores of MQ and OSDI were obtained. Ophthalmic examinations including Schirmer I， BUT and corneal fluorescein staining were performed. Dry eye were diagnosed according to dry eye diagnostic standard. Reliability， validity， accuracy wee assessed. Result： Dry eyes were detected in 21patients. The Cronbach α of MQ was 0.56， and the average correlation coefficient of each item was 0.37. The overall alpha reliability coefficient of OSDI was 0.80， and the alpha reliability coefficients of eye symptoms， visual function， and environmental triggering factors were 0.65， 0.68， and 0.82， respectively. The intraclass correlation coefficient of MQ and OSDI were 0.89 and 0.92， respectively. MQ and OSDI each identified 4 main common factors， and the cumulative contribution rates were 60.5% and 68.2% respectively. The areas under the ROC curves of MQ and OSDI were 0.85±0.14 and 0.92±0.26， respectively. Conclusion： Both questionnaires have good internal repeatability. But OSDI have better reliability， internal consistency， construct validity and accuracy. Then， the OSDI questionnaire is more fitful for diagnosis of dry eye before LASIK.
【key word】 questionnaire; LASIK; myopia; dry eye; diagnosis
干眼是由于泪液质或量的异常或泪膜稳定性造成眼部不适或组织损伤的一类疾病。造成干眼的因素很多，近视是一个重要原因[1]。准分子激光原位角膜磨镶术（laser insitu keratomileusis，LASIK）是迄今施行最多的角膜屈光手术，但手术可能会引起或加重干眼并严重影响生活质量。因此，术前对患者干眼的筛查十分重要。本文旨在以探討不同调查问卷在干眼筛查中的诊断价值，现将结果报告如下。
1 资料与方法
1.1 一般资料：选择2016年6月～2017年11月于我院进行LASIK手术的患者60例。年龄23～43岁，平均27.6±10.8岁，其中男性40例，女性20例。所有患者均为初次接受手术，既往无眼部手术及外伤史，能认真正确填充问卷调查并配合相应检查。本研究患者均签署知情同意书。
1.2 方法：研究对象首先填写McMonnies（MQ）和Ocular Surface Disease Index（OSDI）问卷，随后先后进行泪膜破裂时间（breaking up time，BUT）、角结膜荧光素染色（fluoresceinstaining，FL）和泪液分泌试验I（Schirmer’s I test，SIt），每两项检查间隔2-10min。根据荧光素染色进行评分[2]。所有询问及检查均在上午10：00～下午4：00，室温18℃±2℃、湿度65%±2%环境下由同一医师完成。受试者3周后再次填写调查问卷。干眼诊断标准依据中华医学会眼科学分会角膜病学组2013年干眼临床诊疗专家共识。
1.3 统计学处理：数据采用SPSS13.0软件进行统计学分析，P