蒙古族原发性闭角型青光眼小梁组织的超微结构  

Ultrastructure of trabecular tissue in primary angle-close glaucoma of Mongolia

作　　者：崔巍[1] 孙晓雷[1] 李红霞[1] 

机构地区：[1]内蒙古自治区医院眼科,呼和浩特010017

出　　处：《眼科研究》2010年第7期650-653,共4页Chinese Ophthalmic Research

摘　　要：目的探讨蒙古族青光眼高发病率的原因,为寻找蒙古族原发性闭角型青光眼(PACG)的发病机制提供理论依据。方法蒙古族PACG患者30例,汉族PACG患者30例,均取常规小梁切除术眼的小梁组织。PACG诊断按照中华医学会眼科学会青光眼学组制定的标准。应用电子显微镜观察小梁组织的超微结构,其中包括小梁薄板胶原纤维轴、小梁内皮细胞、小梁薄板皮质区及小梁网眼。正常对照组为蒙古族正常人眼、汉族正常人眼各20例。结果蒙古族正常人眼小梁薄板胶原纤维走行相对紊乱,但无断裂现象;胶原纤维轴与基底膜结构界线不清并有渗透现象;蒙古族PACG小梁网中胶原纤维走行相对小梁薄板长轴的方向发生改变,可见断裂;小梁薄板内皮细胞核溶解,细胞器减少;小梁薄板皮质区薄厚不均,与断裂的胶原纤维有明显的分界线,并有玻璃样变性;小梁网眼有不同程度的堵塞和变窄。从正常人眼来看,蒙古族与汉族相比小梁组织超微结构异常的病例增加,二者比较差异有统计学意义,包括胶原纤维轴结构异常(χ2=4.360,P=0.025),小梁内皮细胞数异常(χ2=6.570,P=0.013),小梁薄板皮质区(χ2=7.140,P=0.035)和小梁网眼异常(χ2=5.430,P=0.020)。蒙古族PACG和汉族PACG在小梁网超微结构的比较中异常病例增加,二者比较差异有统计学意义,包括胶原纤维轴结构异常(χ2=4.250,P=0.026),小梁内皮细胞数异常(χ2=7.180,P=0.037),小梁薄板皮质区(χ2=6.540,P=0.013)以及小梁网眼异常(χ2=5.270,P=0.019)。结论蒙古族PACG发病率高的机制不仅是由于存在浅前房、窄房角等高危因素,而且可能与其小梁网的超微结构异常有关。Background Research showed that the incidence of primary angle close glaucoma （PACG） is higher in Mongolia population than the Han nationality,but the mechanism is still under investigation.Objective This study tried to investigate the ultrastructure of anterior chamber angle tissue in primary angle-close glaucoma （PACG） in Mongolia and explore the relationship between the anatomic factor and incidence of PACG in Mongolia nationality.Methods The trabcular meshwork tissue was obtained from 30 Mongolia patients and Han nationality patients with PACG during the filtering surgery.The PACG was diagnosed upon the criteria of Glaucoma Group of Chinese Ophthalmology Association.The ultrastructure of trabcular meshwork,including collagen fibers,endothelial cells,cortical area,trabecular meshwork hole were examined under the transmission electron microscope.Twenty samples of trabecular meshwork were from Mongolias and 20 Han nationality donors respectively.Results The characters of trabecular tissue of normal Mongolia was as follows：the collagen fibers of trabecular meager plate was intact but arranged disorderly.No well-defined boundary was displayed between collagen fibers axis and basal membrane.In Mongolia PACG patients,the disorder of trabecular meager fiber plate,rupture of collagen fibers,karyolysis of endothelial cell of trabecular meager plate,lessen of cellular organs were seen.The cortex bank of trabecular meager plate showed a definite lines with broken collagen fibers and hyaline degeneration.The narrow of trabecular meshwork also was found.The numbers of samples of ultrastructure abnormality in normal population of Mongolia nationality were increased in compared with those of Han nationality,including the significant differences in collagen fibers abnormality（χ2=4.360,P=0.025）,endothelial cells abnormality （χ2=6.570,P=0.013）,cortical areas abnormality （χ2=7.140,P=0.035） and trabecular meshwork hole （χ2=5.430,P=0.020）.The numbers of samples of ultrastructure abnormality in Mongoli

关 键 词：青光眼 蒙古族 小梁网 超微结构 

分 类 号：R775.2[医药卫生—眼科]