先天性眼球震颤患者眼外肌栅栏样神经终末结构的变化  

Changes of palisade ending of extraocular muscle in patients with congenital nystagmus

作　　者：崔丽红[1] 徐丽[2] 李若溪[2] 郝宏党[3] 赵堪兴[1] 

机构地区：[1]天津市眼科医院天津市眼科学与视觉科学重点实验室天津市眼科研究所天津医科大学眼科临床学院,300020 [2]沈阳市第四人民医院眼科,110032 [3]辽宁中医药大学电镜室,沈阳110032

出　　处：《中华实验眼科杂志》2011年第2期159-161,共3页Chinese Journal Of Experimental Ophthalmology

摘　　要：背景眼外肌本体感受器传人信号在控制眼位及双眼共轭运动中起重要作用。栅栏样神经终末是眼外肌本体感受信息传人的主要来源，其结构和功能异常可能与眼球震颤的发生有关。目的探讨先天性眼球震颤（CN）患者眼外肌栅栏样神经终末结构的变化。方法对10例CN患者实施中间带移位术，获取术中截除的眼外肌，2例因眼外伤行眼球摘除术患者的眼外肌作为对照组。眼外肌组织切片经醋酸铀、柠檬酸铅双染色后应用透射电子显微镜观察超微结构，并对CN患者眼外肌栅栏样神经终末结构与正常人进行对照。结果CN患者眼外肌栅栏样神经终末有不同程度的改变，轻度改变包括外囊层部分断裂、不连续，电子密度不均匀；囊内雪旺细胞的细胞核不规则，有髓神经纤维髓鞘板层分离，轴突内线粒体肿胀、嵴断裂，有髓样体结构形成；严重改变时可出现本体感受器的异常、雪旺细胞的细胞核坏死、囊内神经成分溶解消失及细胞器明显减少。结论CN患者眼外肌栅栏样神经终末结构有明显改变，此改变可能与CN的病因或发病机制有关。Background The afferent signals of proprioceptor in extraocular muscles play an important role in controlling eye position and conjugate movement. Palisade ending in the extraocular muscles is the main source of proprioceptive information,and its abnormalities in structure and function may be associated with the occurrence of nystagmus. Objective This study was to observe the changes of palisade ending in the extraocular muscles of patients with congenital nystagmus （CN） and discuss the probable mechanism. Methods Modified Kestenbaum procedure was performed on 10 patients with CN, and the extraoeular muscle samples were collected during the operation. Normal extraocular muscle samples were obtained from the enucleated eyeballs after ocular wound. The ultrathin sections of extraocular muscles were prepared and double-staining by uranyl acetate and lead citrate. The morphological changes of the palisade ending of extraoeular muscles were examined under the transmission electron microscopy. Written informed consent was obtained from each subject before surgery. Results The uhrastructure of palisade ending in the extraoenlar muscle of CN subjects showed the different degrees of alterations. The mild changes included the collapse and disconnection of external capsules and the nonhomogeneous electron-dense substracts. The degeneration and dissociation of myelin in nerve endings, swelling and vacuolation of mitochondria were also exhibited. Myeloid body was found in axon. In the severe patients, the necrosis of Schwann＇ s cells, dissolve of axon and disappear of capsules were seen. Conclusion The palisade ending of extraocular muscle in the patients with CN are obviously abnormal in comparison with normal one. These alterations are probably associated with the etiology and pathogenesis of CN.

关 键 词：先天性眼球震颤 眼外肌 本体感受器 栅栏样神经终末结构 

分 类 号：R77[医药卫生—眼科]