单纯性先天性上睑下垂患者提上睑肌的超声生物显微镜测厚及组织学观察  

Thickness and histopathology of levator palpebrae superioris muscle in patients with simplex congenital blepharoptosis

作　　者：金书红[1] 白慧玲[2] 王一鹏[1] 李松涛[1] 张红鸽[3] 

机构地区：[1]安阳市眼科医院眼科,455000 [2]河南大学,开封475001 [3]安阳市人民医院病理科,455000

出　　处：《中华实验眼科杂志》2015年第10期940-944,共5页Chinese Journal Of Experimental Ophthalmology

摘　　要：背景 单纯性先天性上睑下垂是先天性上睑下垂中较常见的一种,多需手术治疗.有研究表明,提上睑肌的发育异常可能与该病的发生相关.目的 观察单纯性先天性上睑下垂患者提上睑肌腱膜的厚度及组织病理学改变.方法 采用前瞻性队列研究方法,连续纳入2012年3月至2014年4月在安阳市眼科医院就诊的单纯性先天性上睑下垂患者56例85眼,根据提上睑肌下垂程度分为轻度上睑下垂组15眼、中度上睑下垂组25眼、重度上睑下垂组19眼和单眼患者对侧眼组26眼,同期选取同年龄段的正常人13人26眼作为正常对照组.利用超声生物显微镜（UBM）分别测量各组受检眼提上睑肌腱膜厚度,采用刻度尺测量提上睑肌的活动范围,对不同程度上睑下垂组手术过程中收集的提上睑肌腱膜标本行组织病理学观察.结果 重度、中度、轻度上睑下垂组,正常对照组和单眼患者对侧眼组受检眼提上睑肌厚度值分别为（0.331±0.018）、（0.373±0.026）、（0.539±0.023）、（0.557±0.024）和（0.547±0.028） mm,5个组间总体比较差异有统计学意义（F=1.681,P=0.043）,其中重度上睑下垂组和中度上睑下垂组提上睑肌腱膜厚度值均明显小于正常对照组、单眼患者对侧眼组和轻度上睑下垂组,差异均有统计学意义（均P＜0.05）,重度上睑下垂组提上睑肌腱膜厚度值明显小于中度上睑下垂组,差异有统计学意义（P＜0.05）.提上睑肌组织病理学观察发现,不同程度单纯性先天性上睑下垂患者的提上睑肌纤维发育异常,主要表现为肌纤维排列紊乱、肌纤维玻璃样变性、肌纤维间结缔组织增生和肌内膜的中断或消失.重度上睑下垂组提上睑肌严重玻璃样变性和严重结缔组织增生的眼数分布均明显多于轻度和中度上睑下垂组,而中度上睑下垂组明显多于轻度上睑下垂组,差异均有统计学意义（均P＜0.01）.轻度、中度和重度上睑Background The simplex congenital blepharoptosis is the common blepharon motor dysfunction disease.Some researches have shown that congenital blepharoptosis is related to the hypoplasia of levator.Objective This study was to investigate the thickness and pathological features of levator palpebrae superioris aponeurosis in congenital blepharoptosis patients.Methods A prospective cohort study was carried out in Anyang Eye Hospital from March 2012 to April 2014.Eighty-five eyes of 56 patients with congenital blepharoptosis were divided into mild （15 eyes）, moderate （25 eyes） and severe blepharoptosis （19 eyes） groups, and the fellow eyes of monocular blepharoptosis was used as fellow eye group （26 eyes）.Twenty-six eyes of 13 normal subjects were recruited for the normal control group.The thickness of levator aponeurosis was measured by ultrasound biomicroscope （UBM） , and the shifting range of levator aponeurosis was detected by using measuring scale.Levator aponeurosis specimens were collected during the levator palpebrae superioris shortening surgery for the pathological examination.The study was approved by the medical ethics committee of Anyang Eye Hospital, and the patients or their guardian signed the informed consent.Results The thickness of levator aponeurosis was （0.331±0.018）, （0.373±0.026）, （0.539± 0.023） , （0.557 ± 0.024） and （0.547 ± 0.028） mm in the severe blepharoptosis group, moderate blepharoptosis group,mild blepharoptosis group, normal control group and fellow eye group, respectively, showing a significant difference among them （F =1.681, P =0.043）.The thickness values of levator aponeurosis were considerably lower in the severe blepharoptosis group and moderate blepharoptosis group than those in the mild blepharoptosis group,fellow eye group and normal control group （all at P〈0.05） , and the thickness value of levator aponeurosis was significantly reduced in the severe blepharoptosis group compared with the moderate blepharoptosis group （P�

关 键 词：上睑下垂 先天性 生物测量 超声生物显微镜 提上睑肌腱膜 组织病理学 

分 类 号：R779.6[医药卫生—眼科]