不完全而非完全鼻泪管阻塞与绝经后PANDO妇女的睑板腺功能障碍密切相关：一项横断面研究
Incomplete rather than complete nasolacrimal duct obstruction Is strongly associated with meibomian gland dysfunction in postmenopausal women with PANDO: a cross-sectional study.
摘要(中文译文)
尽管患有原发性获得性鼻泪管阻塞（PANDO）的绝经后女性常合并睑板腺功能障碍（MGD），且已知PANDO可导致眼表炎症，但驱动这些患者发生MGD的具体因素仍不明确。本研究旨在识别和评估与MGD相关的关键人口学、临床及激素因素。本前瞻性研究纳入272名绝经后女性（180例PANDO患者，92例对照）。所有受试者均接受标准化评估：睑板腺成像（Keratograph 5M）评估腺体丢失、裂隙灯睑板腺评估及眼表疾病指数（OSDI）问卷。多变量回归分析确定了MGD的独立危险因素，并校正了年龄、绝经年限、阻塞完全性、病程及泪囊炎。另进行了探索性泪液细胞因子（n=71）和血清激素（n=98）分析。校正后，不完全阻塞与重度上睑睑板腺丢失表现出最强的独立相关性（95% CI：2.48-8.82，P<0.001），且下睑睑酯质量较差的比值增加2.02倍（95% CI：1.13-3.63，P=0.019）。PANDO病程较长与睑酯排出功能受损的比值降低相关（OR=0.96/年，P=0.027）。较高的非侵入性泪河高度预示较长的泪膜破裂时间（β=2.85，P<0.001）。若干单因素显著的因素在多变量模型中失去独立性。在此横断面分析中，不完全性PANDO是绝经后女性重度且常无症状MGD的主要相关因素。临床评估应超越溢泪范畴。建议常规行睑板腺成像以检测沉默性腺体萎缩并指导眼表保护策略。
Abstract
Although postmenopausal women with primary acquired nasolacrimal duct obstruction (PANDO) frequently present with concurrent meibomian gland dysfunction (MGD), and PANDO is known to contribute to ocular surface inflammation, the specific factors driving MGD in these patients remain unclear. This study aimed to identify and assess key demographic, clinical, and hormonal factors associated with MGD. This prospective study included 272 postmenopausal women (180 with PANDO, 92 controls). All underwent standardized assessments: meibography (Keratograph 5 M) for gland loss, slit-lamp MG evaluation, and the Ocular Surface Disease Index (OSDI) questionnaire. Multivariable regression identified independent MGD risk factors, adjusting for age, menopause duration, obstruction completeness, disease duration, and dacryocystitis. Exploratory tear cytokine ( = 71) and serum hormone ( = 98) analyses were performed. After adjustment, incomplete obstruction showed the strongest independent association with severe upper eyelid MG loss (95% CI: 2.48-8.82, < 0.001) and a 2.02-fold increased odds of worse lower eyelid meibum quality (95% CI: 1.13-3.63, = 0.019). A longer duration of PANDO was associated with reduced odds of expressibility impairment (OR = 0.96 per year, = 0.027). Higher non-invasive tear meniscus height predicted longer tear breakup time ( = 2.85, < 0.001). Several univariately significant factors lost independence in multivariable models. Incomplete PANDO is the principal factor associated with severe, often asymptomatic MGD in postmenopausal women in this cross-sectional analysis. Clinical evaluation should extend beyond epiphora. Routine meibography is recommended to detect silent gland atrophy and guide ocular surface preservation strategies.
如何引用
AMA
Haili Jin, Yin Liu, Xianjie Chen. Incomplete rather than complete nasolacrimal duct obstruction Is strongly associated with meibomian gland dysfunction in postmenopausal women with PANDO: a cross-sectional study.. Frontiers in medicine. 2026; doi:10.3389/fmed.2026.1831157.
APA
Haili Jin, Yin Liu, Xianjie Chen (2026). Incomplete rather than complete nasolacrimal duct obstruction Is strongly associated with meibomian gland dysfunction in postmenopausal women with PANDO: a cross-sectional study.. Frontiers in medicine. https://doi.org/10.3389/fmed.2026.1831157
GB/T 7714
Haili Jin, Yin Liu, Xianjie Chen. Incomplete rather than complete nasolacrimal duct obstruction Is strongly associated with meibomian gland dysfunction in postmenopausal women with PANDO: a cross-sectional study.[J]. Frontiers in medicine, 2026 doi:10.3389/fmed.2026.1831157.
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