糖尿病视网膜病变严重程度与角膜内皮细胞变化之间的相关性  

Correlation between severity of diabetic retinopathy and changes of corneal endothelial cells

作　　者：吴雪梅[1,2] 郭长梅[1] 王雨生[1] 张晓光[1] 张鹏[1] 罗亚娟[1] 张艳[1] 

机构地区：[1]第四军医大学西京医院眼科,全军眼科研究所,陕西省西安市710032 [2]陕西省榆林市第一医院眼科

出　　处：《眼科新进展》2010年第10期964-966,共3页Recent Advances in Ophthalmology

摘　　要：目的了解糖尿病视网膜病变(diabetic retinopathy,DR)严重程度与角膜内皮细胞细胞形态和数量变化的相关性。方法采用日本Topcon角膜内皮计对101例(201眼)确诊为DR的患者行5个方位角膜内皮检查,以DR新的国际临床分级标准进行分期,比较不同分期DR之间角膜内皮细胞密度、平均面积、面积标准差、面积变异系数、六角形细胞比例以及中央角膜厚度等各参数的变化。结果Ⅰ期患者平均角膜内皮细胞面积为(380.11±33.42)μm2、内皮细胞密度为(2741.03±247.45)mm-2、六角形细胞比例为(52.14±6.85)%、平均中央角膜厚度(0.59±0.03)mm;而Ⅴ期患者各数值已分别变为(412.26±52.88)μm2、(2508.39±398.60)mm-2、(48.99±5.74)%和(0.55±0.03)mm。以上各指标在Ⅰ期和Ⅱ期间差异均无统计学意义(均为P>0.05),但Ⅲ期、Ⅳ期和Ⅴ期平均角膜内皮细胞面积、内皮细胞密度及平均中央角膜厚度与Ⅰ期、Ⅱ期比较,差异有统计学意义(P<0.05)。Ⅳ期、Ⅴ期六角型细胞比例和细胞面积变异系数与Ⅰ期、Ⅱ期比较,差异有统计学意义(均为P<0.05)。结论随着DR严重程度增加,角膜内皮呈现细胞密度降低、平均细胞面积增加、六角形细胞比例及平均中央角膜厚度数值减少。提示糖尿病可对患者的视网膜和角膜组织造成明显损害,且二者损害程度一致。Objective To investigate correlation between severity of diabetic retinopathy（DR）and changes of morphologies and numbers of corneal endothelial cells.Methods The corneal endothelial cells of 101 cases（201 eyes）with DR were evaluated at 5 directions using Topcon corneal specular microscope（Japan）and the changes of endothelial cell density,average area,standard deviation,coefficient of variation,the proportion of hexagonal cells,as well as central corneal thickness and other parameters of corneal endothelial cells were compared in different phases of DR.Results The average corneal endothelial cell area,endothelial cell density,proportion of hexagonal cells and average central corneal thickness were（380.11±33.42）μm2,（2 741.03±247.45）mm2,（52.14±6.85）% and（0.59±0.03）mm for patients at stageⅠ,respectively,were（412.26±52.88）μm2,（2 508.39±398.60）mm-2,（48.99±5.74）% and（0.55±0.03）mm for patients at stageⅤ,respectively.No significant difference was found between patients at stageⅠ and at stage Ⅱ in each index（all P0.05）,but there were statistical differences for patients at stageⅠ or stage Ⅱcompared with patients at stage Ⅲ,stage Ⅳ and stage Ⅴ in average corneal endothelial cells area,endothelial cell density and average central corneal thickness（all P0.05）.Conclusions With the development of DR,there is a tendency that corneal endothelial cells show decreasing densities of cells,percentage of hexagonal cells and the average corneal thickness,and increasing the average cell area,which indicate that DR has obvious damage to retinal and corneal tissues,and the degree of damage is coincident.

关 键 词：糖尿病视网膜病变 角膜内皮细胞 中央角膜厚度 

分 类 号：R774.1[医药卫生—眼科]