葡萄膜炎并发性白内障患者晶状体前囊膜的超微结构特点  

Ultrastructure of the lens anterior capsule in secondary cataract associated with uveitis under an electron microscope

作　　者：杨梦璐[1] 杨柳[1] Yang Menglu, Yang Liu(Department of Ophthalmology, Peking University First Hospital, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Belting 100034, Chin)

机构地区：[1]北京大学第一医院眼科视觉损伤与修复教育部重点实验室,100034

出　　处：《中华眼科杂志》2018年第5期357-362,共6页Chinese Journal of Ophthalmology

基　　金：国家自然科学基金（81670841）

摘　　要：目的了解葡萄膜炎并发性白内障患者晶状体前囊膜的超微结构特点。方法横断面研究。选取2016年8月至2017年3月因并发性白内障于北京大学第一医院眼科行超声乳化白内障吸除术的葡萄膜炎患者7例（7只眼）[男性2例，女性5例，年龄为（49±20）岁]，以年龄相关性白内障作为对照[3例（3只眼），均为女性，年龄54、71、74岁]。术中撕取前囊组织，透射电镜观察前囊膜上皮细胞，记录细胞形态、细胞之间连接、细胞核、细胞器等结构变化。葡萄膜炎并发性白内障患者细胞形态、细胞核及细胞器变化的比例和细胞凋亡的比例采用±s或中位数（范围）进行统计学描述。结果7例（7只眼）葡萄膜炎并发性白内障患者的晶状体前囊膜均可见上皮细胞极性消失，所有细胞（100%）均呈梭形，而3例（3只眼）年龄相关性白内障患者分别仅有28.00%、16.67%、16.67%的细胞呈梭形。7例（7只眼）葡萄膜炎并发性白内障患者晶状体前囊膜上皮细胞之间紧密连接破坏，细胞核核质正常的上皮细胞比例为8.33%（0-16.67%），染色质密度增加的细胞比例为47.07%±22.28%，核固缩细胞比例为38.02%±19.61%，核碎裂细胞比例为9.96%±8.10%；上皮细胞内线粒体中至重度肿胀；上皮中凋亡细胞占全部细胞的比例为48.16%±26.66%，而3例（3只眼）年龄相关性白内障患者晶状体前囊膜上皮细胞中凋亡细胞比例分别为0、8.33%、0。典型自噬小体仅见于年龄相关性白内障晶状体前囊膜上皮细胞中。结论葡萄膜炎并发性白内障患者晶状体前囊膜上皮细胞超微结构改变较重，主要表现为细胞凋亡增加及自噬过程抑制。ObjectiveTo observe the ultrastructure of lens epithelium cells in cataract associated with uveitis.MethodsA cross-sectional study. Seven patients（7 eyes） received phacoemulsification in Peking University First Hospital from August 2016 to March 2017 due to complicated cataract associated with uveitis[2 males and 5 females,with an average age of （49±20） years] and 3 patients of age-related cataract （3 eyes, females, aged 54, 71, 74 years） were enrolled. Anterior capsule samples were collected during surgery. Transmission electron microscopy was performed. The cell morphology, the proportion of cell nuclear and organelle changes and the proportion of apoptosis in cataract associated with uveitis were described statistically by ±s or median （range）.ResultsSpindle-shaped epithelial cells were observed in cataract associated with uveitis （100%）, while 28.00%,16.67%,16.67% of spindle-shaped epithelial cells were observed in age-related cataract. The organelle changes included mitochondria swelling and damage to the tight cell junction in cataract associated with uveitis. The tight junction between two cells was damaged in different degrees, only 8.33% （0-16.67%）of the cell nuclei appeared normal, and increased chromatin density（47.07%±22.28%）, nuclear pyknosis（38.02%±19.61%） and nuclear fragmentation （9.96%±8.10%） were observed in cataract secondary to uveitis. The apoptosis rate was （48.16%±26.66%） in cataract associated with uveitis and correlated to the duration of intraocular inflammation. While the apoptosis rate were 0, 8.33%, 0 in age-related cataract patients. No autophagosome was observed in cataract associated with uveitis.Conclusions Ultrastructure changes existed in lens epithelium cells in cataract associated with uveitis. The increased rate of apoptosis and inhibition of autophagy could be the possible mechanism of cataract formation in uveitic eyes.

关 键 词：葡萄膜炎 白内障 晶体前囊 上皮细胞 

分 类 号：R779.6[医药卫生—眼科]