代谢综合征对角膜内皮细胞形态学影响的临床研究  

Clinical research on corneal endothelial changes in patients with metabolic syndrome

作　　者：李进容 刘苏[1] 王茜[1] 李新星[1] 

机构地区：[1]重庆医科大学附属第二医院眼科,重庆市400000

出　　处：《中华眼科医学杂志（电子版）》2016年第2期68-74,共7页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

基　　金：重庆市科委基金项目(No.cstc2013jcyj A10074)

摘　　要：目的探讨代谢综合征(MS)对角膜内皮细胞形态学的影响。方法收集2015年3月至2015年10月期间在重庆医科大学附属第二医院内分泌科住院的患者124例(229只眼)进行研究。对全部患者进行腹围、血脂、血压及血糖检测,并根据上述检测结果进行判别和分组,共分为糖尿病组、高血压组、血脂异常组、代谢综合征组及对照组等五组。用非接触式角膜内皮镜对全部患者进行角膜内皮形态学检查。正态分布检验采用单样本Kolmogorov-Smirnov检验,角膜内皮细胞的平均密度(ECD)、细胞变异系数(ECCV)及六角形细胞比例(H%))等三项参数经检验均呈正态分布,采用均数±标准差表示,组间数据方差齐性采用Levene检验,多组间均数的比较采用方差分析,当差异有统计学意义时,进一步采用LSD法进行两两比较;以P<0.05为差异有统计学意义。结果全部患者共分为五组,分别为糖尿病组,血糖异常包括腹围偏高患者共18只眼,年龄(64.2±10.2)岁;高血压组,血压包括腹围偏高患者共26只眼,年龄(67.0±11.9)岁;血脂异常组:两项血脂任何一项异常包括腹围偏高共57只眼,年龄(67.9±10.9)岁;代谢综合征组,五项指标均异常共78只眼,年龄(66.0±11.1)岁;对照组,五项指标均正常共50只眼,平均年龄(69.0±10.6)岁。所有组间比较发现年龄差异无统计学意义(F=0.96,P>0.05),性别差异亦无统计学意义(χ~2=0.68,P>0.05),糖尿病组、高血压组及血脂异常组与对照组间的腹围差异亦无统计学意义(F=0.87,P>0.05)。对照组、糖尿病组、高血压组、血脂异常组及代谢综合征组ECD分别为(2767.7±277.0)cells/mm^2、(2384.7±449.5)cells/mm^2、(2642.3±370.3)cells/mm^2、(2642.8±270.6)cells/mm^2及(2664.8±371.3)cells/mm^2,经方差分析,差异有统计学意义(F=2.12,P<0.05),进一步两两比较,糖尿病组较对照组降低,差异有统计学意义(t=3.17,P<0.05)。各组ECCV分别为(33.4±3.8)、(35.5±4.5)、(38.2±5.6)�Objective This study evaluated the differences of corneal endothelial morphology in metabolic syndrome（ MS） and its components compared with agematched, healthy control subjects.Methods 124 cases（ 229 eyes） of patients who were collected from March 2015 to October 2015 during the Second Affiliated Hospital of Chongqing Medical University,Department of Endocrinology. Of all patients were abdominal circumference,blood lipids,blood glucose,blood pressure,and detection,and the detection results are identified and grouped according to is divided into diabetic group, hypertension group,hyperlipidemia group,metabolic syndrome group and control group. The corneal endothelial morphology examination of all patients with non-contact specular microscope. All eyes were performed on noncontact specular microscopy. The values between different teams and control subjects were compared with Independent sample t-test. Normal distribution test using the one sample Kolmogorov-Smirnov test,the three parameters of ratio of corneal endothelial cells of the average density（ ECD）,coefficient of variation in cell（ ECCV） and hexagonal cells（ H%）,after the examination showed a normal distribution,the mean and standard deviation said that groups data homogeneity of variance by Levene test,between the group mean compared using analysis of variance,when there was a statistically significant difference. Further,the LSD method for pairwise comparison,to P〈 0. 05,the difference was statistically significant. Results All patients were divided into five groups,respectively as the diabetic group glucose abnormalities including abdominal circumference was higher in patients with a total of 18 eyes,（ 64. 2 ± 10. 2） years of age; hypertension,blood pressure,including abdominal circumference was higher in patients with a total of 26 eyes,（ 67. 0 ± 11. 9）years of age; dyslipidemia group： two lipid any abnormalities include high waist circumference 57 eyes,（ 67. 9 ± 10. 9） years of age; metabolic syndrome group： fi

关 键 词：角膜 内皮细胞 代谢综合征 非接触式角膜内皮显微镜 

分 类 号：R589[医药卫生—内分泌] R772.2[医药卫生—内科学]