[Analysis of structure and function of meibomian glands in healthy population at different ages].

Objective: To observe the structure and function of meibomian glands in normal population at different ages. Methods: From October 2011 to August 2012, meibomian gland information was collected in healthy volunteers without any symptoms of ocular discomfort, aged more than 5 years. The people were grouped by every 10 years of age. The meibomian gland opening, secretion state and characteristics and Max's line were observed by slit lamp microscopic examination, and the meibomian gland dropouts were examined by noncontact infrared meibomian gland microscopy. The changes of meibomian glands were scored from 0 to 3, 0 for a normal state, 1 for mild abnormality, 2 for moderate abnormality and 3 for severe abnormality. The Mann-Whitney U test was used to compare the meibomian scores between male and female, and between left and right eyes. The correlation of these scores and the age of volunteers was analyzed by the Spearman test. Results: Among all the 100 volunteers, there were 47 males and 53 females, aged from 5 to 83 years (mean, 40.9±22.9). The meibomian gland dropouts were gradually increasing with age, significantly faster after 40 years old (scores for each age group were 2(1), 2(1), 2(1), 2(1), 3(2), 3.5(1.75), 4(3), 6(2). Meibomian gland opening, secretion traits and secretor status gradually became poorer with age, and changes were dramatically fast in the group of 40-49 years of age [scores of this group were 3(1.5), 3(3) and 2(2)], but slowed down after age of 50 years. Moreover, the Max's line position moved to the front gradually with age, with a marked change in the group of 40-49 years of age [scores for each age group were 0(1), 1(1), 2(2), 2(2), 3(2), 2(2), 3(2)], 4 gland changes showed a significantly positive relation to age(r=0.729, 0.635, 0.669, 0.639, 0.470. P<0.01), but not to gender and eye dominance (P>0.05). Conclusions: Meibomian gland opening and meibomian gland secretion become worse with age. The age of 50 years old is the key period for the meibomian gland changes. (Chin J Ophthalmol, 2017, 53: 528-533).目的： 探讨健康人群睑板腺结构和功能状态与年龄的关系。 方法： 横断面研究。于2011年10月至2012年8月筛选来源于本院医护人员家属的无眼表临床症状健康志愿者100名作为研究对象。其中男性47名，女性53名，年龄5~83岁，平均年龄为（40.9±22.9）。100名志愿者按年龄段分组，每10岁为一个年龄段，分别为5~9岁、10~19岁、20~29岁、30~39岁、40~49岁、50~59岁、60~69岁及70岁以上共8个年龄段。所有受试者双眼均进行检查，以右眼作为评判年龄相关性的统计眼。通过裂隙灯显微镜检查睑板腺开口、睑板腺分泌状态和分泌物的性状、Max线的位置，睑板腺红外线扫描仪检查睑板腺的缺失情况。上述所有的检测指标均根据睑板腺的变化程度均分为0~3分，0分为正常状态，1分为轻度异常；2分为中度异常；3分为重度异常。采用两独立样本非参数Mann-Whitney U检验分析左、右眼及不同性别之间是否存在睑板腺功能评分结果的差异，采用Spearman秩检验对各项睑板腺功能评分与年龄的相关性进行分析。 结果： 随着年龄的增长睑板腺缺失的程度逐渐加重，呈逐步上升的趋势，40岁以后睑板腺缺失的进程明显加快[各年龄段评分分别为：2（1），2（1），2（1），2（1），3（2），3.5（1.75），4（3），6（2）]；睑板腺的开口、睑板腺分泌物的性状和分泌状态呈现逐渐变差的趋势，在40~49年龄段有明显的变化[评分分别为3（1.5），3（3），2（2）]，呈跳跃式的增加，50岁以后变化趋于缓慢；Max线的位置随着年龄的增长呈现逐渐前移的趋势、在40~49年龄段也是有明显加重的表现，以后随着年龄的增长进一步恶化[各年龄段评分分别为：0（1），1（1），2（2），2（2），3（2），2（2），3（2），4（2）]。睑板腺缺失情况、Max线位置、睑板腺开口情况、睑板腺分泌物性状及睑板腺分泌状态评分均与年龄相关（r=0.729，0.635，0.669，0.639，0.470；P<0.01），且不存在左右眼及性别差异（P>0.05）。 结论： 随着年龄的增长，健康人群睑板腺的开口情况、睑板腺的分泌状态和分泌物的性状均会变差，50岁左右是变化的关键时期。（中华眼科杂志，2017，53：528-533）.