计算机辅助绘图软件AutoCAD对不同程度干眼角膜上皮下神经的定量分析研究  

Quantitative analysis of the corneal subbasal nerves in different degrees of dry eye with AutoCAD

作　　者：程燕[1] 吴洁[1] 朱海峰[1] 程钰[1] 朱秀萍[1] 

机构地区：[1]陕西省眼科研究所陕西省眼科学重点实验室西安市第一医院眼科,710002

出　　处：《中华眼科杂志》2016年第3期186-191,共6页Chinese Journal of Ophthalmology

基　　金：陕西省社会发展科技攻关项目（2015SF206）

摘　　要：目的评价计算机辅助绘图软件AutoCAD在干眼诊断中的实际应用价值及不同程度干眼患者角膜神经的变化。方法选择临床诊断为轻度、中度及重度干眼患者及对照组患者各30例，对所有研究对象的双眼进行共焦显微镜检查，应用AutoCAD对角膜中央基底层下上皮神经丛的长度进行测量，换算成神经纤维密度（mm／mm^2）。同时记录神经的分支数量和弯曲度评分。并将不同级别干眼患者的神经密度、分支数量及弯曲度评分与对照组采用方差分析进行统计学比较。结果应用AutoCAD能对共焦显微镜观察的角膜中央基底层下上皮神经进行定量测定；轻度干眼患者的神经密度为（16．70±3．43）mm／mm^2，对照组为（15．87±2．75）mm／mm^2，差异无统计学意义（P=0．880），但其分支数量[（13．43±2．46）支／图]及神经弯曲度[（3．10±0．80）分]明显增加（P〈0．001）；但是中度、重度干眼患者的神经密度[中度干眼神经密度（11．19±2．34）mm／mm^2，重度干眼神经密度（5．56±1．76）mm／mm^2]与对照组比较差异有统计学意义（F=114．739，P〈0．001），以重度干眼为著，神经密度显著降低，弯曲度差异无统计学意义（P=0．557）。结论AutoCAD应用于共焦显微镜图像的角膜神经定量分析具有实际应用价值；角膜中央基底层下上皮神经密度、分支数量及弯曲度的改变与干眼的分级有关，可作为临床干眼程度评价的有效指标。Objective To evaluate the practical value of AutoCAD in quantitative analysis of corneal subbasal epithelial nerves with different degrees of dry eye. Methods Ninety patients were divided into groups of mild, moderate, and severe dry eye, 30 patients （60 eyes） in each group. And 30 healthy volunteers were recruited as the normal control group. Confocal microscopy was used to observe the length of the subbasal epithelial nerve plexus. The images were analyzed by AutoCAD software to determine the density （mm/mm2）, the number of branches, and the curvature score of the subbasal epithelial nerves. These data of patients with dry eye and the controls were statistically compared, by analysis of variance（ANOV）. Results By AutoCAD software, quantitative analysis of the corneal subbasal epithelial nerves was successfully performed. The nerve density in the patients with mild dry eye[ （16.70±3.43）mm/mm^2] was not significantly different from the controls[（15.87 ± 2.75） mm/mm^2] （P=0.880）, but the number of nerval branches 13.43±2.46 and the curvature 3.10±0.80 increased significantly （P〈0.001）. The nerve density in the patients with moderate and severe dry eye was significantly different from that in the normal control group （F= 114.739, P〈0.001）. The neural density was significantly lower in the patients with severe dry eye than the controls, but there was no significant difference in the curvature scores between the two groups （P= 0.557）. Conclusions AutoCAD software is useful in the quantitative analysis of corneal nerve images under a confocal microscope. The corneal subbasal epithelial nerve density, the number of branches, and the curvature of the nerves are related to the degree of dry eye, and may be used as clinical indicators. （Chin J Ophthalmol, 2016, 52：186-191）

关 键 词：干眼综合征 上皮 角膜 眼神经 神经纤维 图像处理 计算机辅助 显微镜 检查 共焦 

分 类 号：R777.34[医药卫生—眼科] TP391.7[医药卫生—临床医学]