原发性青光眼患者角膜内皮形态研究  

Morphological study of corneal endothelium in patients with primary glaucoma

作　　者：肖诗艺[1] 朱格非[1] 胡燕华[2] 李鹏程[2] 

机构地区：[1]暨南大学医学院第二附属医院深圳市人民医院眼科,广东省深圳市518020 [2]华中科技大学同济医学院附属协和医院眼科,湖北省武汉市430022

出　　处：《眼科新进展》2005年第3期251-253,共3页Recent Advances in Ophthalmology

摘　　要：目的研究角膜内皮细胞在各种原发性青光眼患者中的形态改变及临床意义。方法选择住院青光眼患者34例52眼及同期住院患者中的正常眼32眼作为对照,采用非接触型角膜内皮显微镜测量角膜内皮细胞密度和细胞面积等各项指标,用Goldman压平式眼压计测量眼压并用超声角膜测厚仪测量角膜中央厚度;分析比较不同类型青光眼患者角膜内皮细胞各项测量指标及角膜中央厚度的差异。结果急性闭角型青光眼有急性发作史者角膜内皮细胞密度为(2060±314)个·mm-2,显著低于正常人的(2876±341)个·mm-2,并且细胞面积增大(P<0.05);慢性闭角型青光眼平均角膜内皮细胞密度为(2806±253)个·mm-2,原发性开角型青光眼组角膜内皮细胞密度为(2704±430)个·mm-2,二者均与正常人的内皮细胞平均密度之间差异无统计学意义(P>005)。急性闭角型青光眼急性发作后角膜中央厚度平均为569.7μm,明显大于正常人的536.0μm;而慢性闭角型青光眼组角膜中央厚度平均为541.0μm,原发性开角型青光眼组为540.7μm,二者均与正常对照组无明显差异(P>0.05)。结论闭角型青光眼急性发作后角膜内皮细胞密度显著低于正常人,细胞平均面积增大,角膜中央厚度明显增加;慢性闭角型青光眼和原发性开角型青光眼患者角膜内皮及角膜中央厚度均与正常对照无明显差异。Objective To explore the morphological changes of corneal endothelium in patients with primary glaucoma and its clinical significance. Methods Fifty-four eyes of 32 patients with primary glaucoma and 32 eyes of 32 patients hospitalized at the same period of time without glaucoma were collected. Non-contact specular microscope was performed on the central cornea and endothelial images were analyzed by computer. Intraocular pressure (IOP) was measured by Goldman applanation tonome-try and the central corneal thickness( CCT) by ultrasonic pachometers. Results Corneal endothelium density was significantly lower in patients with acute primary angle closure glaucoma attack (aPACG) (2 060 cells·mm-2±314 cells· mm-2) than that in con-trols(2 876 cells·mm-2 ±341 cells·mm-2) and the area of endothelium became bigger in the aPACG group than in control group (P < 0. 05). The endothelium density and morphology was (2 704 ± 430) cells·mm-2 in primary open-angle glaucoma (POAG) eyes and(2 806 ±253) cells·mm-2 in chronic primary angle closure glaucoma (cPACG) eyes respectively and there were no significant difference from normal group (P >0. 05). The mean CCT of aPACG group was 569. 7 μm,33.7 μm thicker than that of control group(P< 0.05). There was not significant difference in mean CCT between the other two groups and control group. Conclusion There was a significant decrease in the corneal endothelial cell density and a significant increase of CCT in eyes after acute attack of angle closure glaucoma. The endothelial cell population in eyes with cPACG and primary open-angle glaucoma were not significantly different from those of the normal population.

关 键 词：原发性青光眼 角膜内皮 角膜内皮显微镜 角膜中央厚度 

分 类 号：R775[医药卫生—眼科] R772[医药卫生—临床医学]