Ⅱ型糖尿病患者角膜的共聚焦显微镜观察  

The corneal structure observed with confocal microscopy in type Ⅱ diabetes mellitus

作　　者：马聪慧[1] 王丽娅[1] 李晶[1] 

机构地区：[1]河南省眼科研究所河南省角膜病重点实验室,郑州450003

出　　处：《眼科》2011年第3期151-154,共4页Ophthalmology in China

摘　　要：目的共聚焦显微镜下观察Ⅱ型糖尿病患者角膜上皮下神经纤维以及角膜各层细胞密度和形态学改变。设计比较性病例系列。研究对象选取确诊为Ⅱ型糖尿病的患者20例(20眼)为病例组和就诊于眼科门诊的无糖尿病的老年性白内障患者20例(20眼)为对照组。方法病例组和对照组均进行角膜共聚焦显微镜检查,对所得的图片和结果进行分析。主要指标角膜上皮下神经纤维密度、角膜上皮基底细胞密度、角膜浅基质细胞密度、角膜中基质细胞密度、角膜深基质细胞密度、角膜内皮细胞密度、内皮细胞的变异系数和六角形百分比。结果糖尿病组与对照组相比,上皮下神经纤维密度明显减少(t=-4.951,P=0.000);角膜浅基质细胞密度、中基质细胞密度和深基质细胞密度均有显著下降(P值均=0.000);角膜内皮细胞变异系数增加(t'=3.652,P=0.001),六角形百分比减少(t=-3.778;P=0.001)。结论共聚焦显微镜下显示Ⅱ型糖尿病患者角膜上皮下神经纤维密度和各层细胞密度下降。Objective To observe the changes of corneal morphological character and densities of corneal subepithelial nerve plexus under confocal microscopy in the patients with type Ⅱ diabetes mellitus. Design Comparative case series. Participants Twenty eyes of twenty patients with diabetes mellitus and twenty eyes of twenty patients with age-reXated cataracts and without diabetes mellitus were enrolled. Methods Patients and controls were all checked with confocal microscopy, and the pictures of confocal microscopy were analyzed. Main Outcome Measures The densities of corneal subepithelial nerve plexus, corneal basal cell, anterior stroma cell, mid- dle stroma cell, posterior stroma cell, endothelial cell, pleomorphism and polymegathism of endothelial cell. Results The densities of corneal subepithelial nerve plexus was significantly decreased in diabetic group than in control group （t=-4.951, P=0.000）. Compared with control group,the cell densities in anterior,middle and posterior stroma were decreased significantly （all P=0.000） in diabetic group. The addition of endothelial cell pleomorphism （t＇=3.652,t=-3.778） and the decreasing of endothelial cell polymegathism in dia- betic group （P=0.001） were dramatically distinctive with control group. Conclusions The decreasing of the densities of corneal cell and subepithelial nerve plexus were observed with confocal microscopy in patients with diabetes mellitus compared with the normals. （Ophthalmol CHN, 2011, 20： 151-154）

关 键 词：共聚焦显微镜 糖尿病 角膜结构 

分 类 号：R587.1[医药卫生—内分泌] R772.2[医药卫生—内科学]