혈액투석 중인 만성신부전 환자에서 눈물막 및 안구표면의 변화에 관한 연구 = Tear Film and Ocular Surface Changes in Chronic Renal Failure Patients Undergoing Hemodialysis

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the changes of tear film and ocular surface in patients with chronic renal failure (CRF) undergoing
hemodialysis.
Methods: In 50 eyes of 25 CRF patients undergoing hemodialysis and 30 eyes of 15 control subjects, tear break-up time (BUT),
basal tear secretion (BST), corneal sensation, tear clearance rate (TCR), keratoepitheliopathy and impression cytology findings
were compared. Correlation between the above parameters and local or systemic factors was analyzed.
Results: Tear BUT, BST, TCR, conjunctival squamous metaplasia and conjunctival goblet cell density in the patient and control
groups were 7.7±3.8 and 11.1±2.9 sec, 7.0±3.1 and 14.0±6.2 mm, 3.5±1.2 and 4.5±0.7, 1.5±0.6 and 0.3±0.5, 6.5±1.7 and
24.3±21.4 cells/mm2. Osmolarity in serum and tears of the patient group was higher than that of the control group. Serum and
tear osmolarity correlated with BST, corneal sensation and conjunctival goblet cell density, and serum creatine level correlated
with conjunctival goblet cell density (p<0.05).
Conclusions: Patients with CRF undergoing hemodialysis have an increased risk of dry eye and thus, serum and tear osmolarity
in dry eye patients should be closely monitored.

국문 초록 (Abstract)

목적: 혈액투석을 시행받는 만성신부전 환자의 눈물지표의 변화에 대해 알아보고자 하였다.
대상과 방법: 만성신부전으로 혈액투석 중인 환자 25명과 정상대조군 15명을 대상으로 눈물막파괴시간, 기본눈물분비량, 각막지각, 눈물
청소율, 각막상피병증, 결막압흔검사 소견을 비교하였으며, 국소적, 전신적 인자와 눈물지표와의 관계에 대해 조사하였다.
결과: 환자군과 정상인에서 눈물막파괴시간, 기본눈물분비량, 눈물청소율, 결막의 편평상피화 정도 및 결막술잔세포의 밀도는 각각
7.7±3.8과 11.1±2.9 sec, 7.0±3.1과 14.0±6.2 mm, 3.5±1.2와 4.5±0.7, 1.5±0.6과 0.3±0.5, 6.5±1.7과 24.3±21.4 cells/mm2였고,
환자군에서 혈청과 눈물의 오스몰 농도는 정상군보다 높았다. 혈청 및 눈물 오스몰 농도는 기본눈물분비량, 각막지각, 술잔세포밀도와
관계가 있었으며, 혈청 크레아틴 농도가 증가할수록 술잔세포의 밀도는 감소하였다(p<0.05).
결론: 혈액투석을 받는 만성신부전 환자에서 건성안이 발생할 수 있으므로 오스몰 농도가 높은 경우 건성안에 대한 주의깊은 관찰이
필요하다.

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