糖尿病与非糖尿病白内障病人人工晶体植入后角膜内皮形态学分析  

A COMPARATIVE OBSERVATION OF CORNEAL ENDOTHELIUM AFTER ECCE+IOL IN DIABETIC AND NON-DIABETIC PATIENTS

作　　者：蒋华[1] 王焕旭[1] 张康兰[1] 林庆华[1] 姜莉华[1] 

机构地区：[1]济南军区总医院 [2]山东浪潮集团计算机事业本部 [3]济南市中心医院

出　　处：《解放军医学杂志》1997年第6期428-430,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：糖尿病、非糖尿病组（对照组）各２３例，分别在人工晶体植入术（ＥＣＣＥ＋ＩＯＬ）前后进行角膜内皮显微镜观察和计算机图像分析。对照组术后３个月角膜内皮细胞（ＣＥＣ）、形状系数（ＦＣ）和变异系数（ＣＶ）恢复正常（Ｐ＞０．０５），以后（至２年）ＣＥＣ密度（Ｄ）未继续下降。而与对照组比较，糖尿病组术前ＣＥＣ面积（Ａ）正常，但周长（Ｐｅ）、长径（Ｌ）、ＣＶ增大，ＦＣ减小（Ｐ＜０．０１）；术后２年内各形态定量指标较术前及同期对照组差异有显著性意义（Ｐ＜０．０５或０．０１），Ｄ持续下降，表明形态定量检测可判断ＥＣＣＥ＋ＩＯＬ术后ＣＥＣ预后状况，尤其对糖尿病患者十分重要。Twentythree patients with diabetes mellitus (DM) and 23 nondiabetic persons as controls were examined by specular microscopy and computerassisted image analysis techniques before extracapsular cataract extraction with intraocular lens implantation (ECCE+IOL) and after the operation. The results showed that, at 3 months postoperatively, the corneal endothelial cells (CEC)in nondiabetes had a normal figure coefficient (FC) and a normal coefficient of variation (CV) (P>0.05) as compared to their respective preoperative values. No continuing cell loss were discovered in 2 years after the operation. But when compared with the normal controls, the preoperative diabetic CEC showed a normal area with greater perimeter, long axis, CV and a lower FC(P<0.01). In 2 years after operation, all the morphometric indexes of CEC in DM were persistently abnormal as compared to the normal controls at same intervals and the CEC in DM demonstrated continuing cell loss. The study indicated that the morphometric examination could help us estimate the expectant conditions of CEC after ECCE+IOL. It is paramount important for the patients with DM.

关 键 词：糖尿病 人工晶体 角膜内皮 形态学 

分 类 号：R587.2[医药卫生—内分泌] R779.66[医药卫生—内科学]