单纯性先天性上睑下垂患者提上睑肌形态学磁共振测量研究  

Levator palpebrae superioris evaluation in congenital blephroptosis:pathogenesis investigation by magnetic resonance imaging analysis

作　　者：孙倩[1] 李冬梅[1] 姜虹[2] 王振常[2] 郝磊[1] 

机构地区：[1]首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科学与视觉科学重点实验室,100730 [2]北京同仁医院放射科

出　　处：《眼科》2012年第3期201-205,共5页Ophthalmology in China

摘　　要：目的利用磁共振扫描对单纯性中重度先天性上睑下垂患者和正常人提上睑肌肌肉横截面积和厚度进行比较,旨在揭示先天性上睑下垂可能的发病机制。设计横断面研究。研究对象14～22岁单眼或双眼发病的单纯性中重度先天性上睑下垂患者20例(27眼)为病例组,14～23岁正常人20例(40眼)为对照组。方法对27只患中重度上睑下垂眼、病例组的13只未下垂眼和40只正常眼在自然闭眼状态下进行提上睑肌的磁共振扫描,沿肌肉走行测量,以视神经出球平面作为测量零点,分别向前间隔0.5 cm测2点,向后间隔0.5 cm测2点,在斜冠状面测量5个点的提上睑肌肌肉横截面积(S2、S1、S0、S-1、S-2),在斜矢状面测量5个点的提上睑肌肌肉厚度(T2、T1、T0、T-1、T-2)。主要指标磁共振图像斜矢状面提上睑肌厚度与斜冠状面横截面积。结果各个测量点患眼提上睑肌的厚度T2=1.05±0.27,T1=1.04±0.26,T0=1.00±0.24,T-1=0.89±0.28,T-2=0.79±0.26与截面积S2=2.66±1.25,S1=2.51±1.29,S0=2.39±1.28,S-1=1.78±0.96,S-2=1.09±0.42,较正常人提上睑肌厚度T2=1.48±0.08,T1=1.40±0.09,T0=1.32±0.10,T-1=1.21±0.07,T-2=1.10±0.06与截面积S2=4.83±0.71,S1=4.53±0.75,S0=4.50±0.68,S-1=3.13±0.56,S-2=1.85±0.48明显下降,差异均有统计学意义(P均=0.000);正常人的双眼之间无差异(P均>0.05);正常人与患者的非下垂眼基本无差异(P均>0.05);患者的下垂眼与非下垂眼有差异(P均<0.05)。结论中重度先天性上睑下垂患者提上睑肌较正常人薄,其病因可能与提上睑肌发育不良有关。Objective To reveal the pathogenesis of congenital blephroptosis by comparing the thickness and cross sectional area of the levator palpebrae superioris （LPS） on magnetic resonance imaging （MRI） between patients suffered from moderate to severe congenital blephroptosis （aged from 14 to 22） and healthy volunteers （aged from 14 to 23）. Design Cross-sectional study. Participants Twenty-seven sick eyelids and 13 normal eyelids of 20 patients and 40 healthy eyelids of 20 volunteers were enrolled. 13 normal eyelids of the unilateral congenital blephroptosis patients were also included. Methods Twenty-seven sick eyelids and 13 normal eyelids of 20 patients who had unilateral or bilateral blephroptosis and 40 healthy eyelids of 20 volunteers were evaluated by MRI. MRI was taken when the eyes were naturally closed. The origin of the measurement was chosen at the point where the optic nerve left the eyeball. 2 points with 0.5 mm in space forward and 2 points with 0.5 mm in space backward from the origin were set. Based on each setting points, the cross-sectional area was measured on coronal MRI, while the height of the LPS was measured on sagittal MRI. Main Out-come Measures The cross-section area of LPS measured on coronal MRI and the height of LPS measured on sagittal MRI. Results The data of the patients was in normal distribution, while the data of the volunteer was not. So the nonparameter test was used in data analysis of the two groups. The cross-sectional area （S2=2.66±1.25,S1=2.51±1.29,S0=2.39±1.28,S-1=1.78±0.96,S-2=1.09±0.42） and the height （T2=1.05±0.27,T1=l.04±0.26,T0=1.00±0.24,T-l=0.89±0.28,T-2=0.79±0.26） of LPS in patients＇ sick eyes decreased significandy compared with volunteers＇ （T2=1.48±0.08,Tl=1.40±0.09,T0=-1.32±0.10,T-1=1.21±0.07,T-2=1.10±0.06, S2=4.83±0.71,S1=4.53± 0.75, S0=4.50±0.68, S-1=3.13±0.56, S-2=1.85±0.48 ）（all P〈0.001 ）. As for the unilateral patients, the cross-sectional area and the height of LPS of the sick eyes showed significant di

关 键 词：上睑下垂 提上睑肌 发育不良 磁共振成像 

分 类 号：R779.6[医药卫生—眼科]