不同类型白内障晶状体上皮细胞的组织病理学观察  

Histopathologic study of lens epithelial cells in different types of cataracts

作　　者：段海霞 曹志星 管怀进[3] 张天一[4] 

机构地区：[1]广东省珠海市第二人民医院眼科,519020 [2]广东省珠海市第二人民医院病理科,519020 [3]南通大学附属医院眼科中心,226001 [4]南通大学电镜教研室,226001

出　　处：《中华实验眼科杂志》2014年第6期502-505,共4页Chinese Journal Of Experimental Ophthalmology

基　　金：江苏省卫生厅重大课题基金项目（K200409）

摘　　要：背景 白内障的发生与晶状体上皮细胞（LECs）结构和功能的受损有直接关系,而白内障LECs的特征性形态学变化是目前证实细胞结构和功能受损最有力的证据,了解不同类型白内障的LECs形态变化对于研究不同环境或不同疾病对LECs的生物学行为有重要意义. 目的 观察不同类型白内障LECs的形态学变化.方法 在白内障摘出手术过程中分别收集年龄相关性白内障、糖尿病性白内障及高度近视并发性白内障的晶状体前囊膜各15片,各种类型白内障的前囊膜分别进行锥虫蓝-茜素红（TB-AR）染色和苏木精-伊红染色,评估LECs的活性和形态,并在透射电子显微镜下观察各种类型白内障LECs的超微结构改变,对不同类型白内障的LECs生物学行为进行比较.结果 TB-AR染色结果表明,年龄相关性白内障LECs大小不等,呈多边形,镶嵌样排列,少量细胞死亡,细胞膜模糊不清,细胞核呈圆形;糖尿病性白内障LECs水肿,体积增大,细胞大小不等;而高度近视并发白内障LECs体积较小,大部分细胞死亡.苏木精-伊红染色显示,年龄相关性白内障晶状体囊膜为一均质膜,LECs层呈单层排列,多数细胞结构完整,紧密贴附于前囊膜上;糖尿病性白内障前囊膜部分区域LECs与囊膜间有空隙,细胞核大小不等;高度近视并发性白内障LECs较小,形态不规则,细胞着色深.透射电子显微镜下观察发现,年龄相关性白内障前囊膜及多数LECs形态正常,细胞间以及细胞与囊膜间连接尚可;糖尿病性白内障LECs之间以及细胞与囊膜间也可见紧密连接,但显示细胞水肿,细胞间隙扩大,高度近视并发性白内障LECs可见细胞质嵌合突起,细胞质内有空泡变性.结论 年龄相关性白内障、糖尿病性白内障和高度近视并发性白内障均以LECs的变性、坏死、凋亡为共同的细胞学基础,但糖尿病性白内障和高度近视并发性白内障的LECs改变明显重于年龄相关性白Background Cataract was directly associated with the damage to the structure and function of lens epithelial cells （LECs）.In those patients who suffer from cataracts,morphologic changes of LECs is the most compelling evidence confirming loss of cellular structure and function of LECs.So,learning about the morphological changes of LECs of the different types of cataracts is very important for study on biological behaviors of LECs in different environments or diseases.Objective This study was to evaluate the morphological and ultrastructural changes of the LECs in different types of cataracts.Methods Anterior capsular member from age-related cataracts,diabetic cataracts and high myopia complicated cataract were obtained during the cataract surgery and 15 pieces for each.Trypan blue and alizarin red （TB-AR） stain,haematoxylin and eosin stain were performed in the samples to assess the viability and morphology of LECs.The ultrastructural change of LECs was observed under the transmission electron microscope.The features of the LECs were compared among the different types of cataract.Results TB-AR stain showed that LECs were polygon in shape with the mosaic arrangement and round cell nucleus,and a few dead cells were seen in the samples age-related cataract.In the diabetic samples,LECs largened from swelling with different sizes.More dead cells were found in the high myopia complicated cataract.Haematoxylin and eosin stain exhibited that the anterior capsular membrane presented a homogeneuous membrane,and monolayer LECs attached firmly anterior capsular membrane in the samples of related cataract.Majority of the cells had the intact structure.However,the interspaces between cells and capsular membrane were found in diabetic cataract.Also,smaller LECs were seen in high myopia complicated cataract with the irregular cell morphology.Under the transmission electron microscope,LECs presented the normal shape,intact intercellular tight junction and well attachment between cells and capsular membrane in the samples o

关 键 词：晶状体 上皮细胞 锥虫蓝-茜素红染色 苏木精-伊红染色 超微结构 

分 类 号：R776.1[医药卫生—眼科]