维吾尔族假性剥脱综合征患者角膜内皮形态学分析  

Clinical Analysis of Corneal Endothelial Morphology in Pseudoexfoliation Syndrome in a Uyghur Population

作　　者：杨永利 林芳 杨玉洁 牛童童 Yang Yongli;Lin Fang;Yang Yujie;Niu Tongtong(Department of Ophthalmology,Xinjiang Military District General Hospital of Chinese People's Liberation Army,Urumchi 830000,China)

机构地区：[1]中国人民解放军新疆军区总医院眼科,乌鲁木齐830000

出　　处：《中华眼视光学与视觉科学杂志》2021年第6期421-426,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的:对比分析维吾尔族假性剥脱综合征(PEX)、剥脱综合征性青光眼(PEXG)、原发性开角型青光眼(POAG)及年龄相关性白内障(ARC)角膜内皮形态学差异。方法:回顾性病例对照研究。选取2019年7月至2020年8月在中国人民解放军新疆军区总医院全军眼科中心就诊治疗的维吾尔族PEX患者76例(76眼),PEXG患者82例(82眼),POAG患者64例(64眼)以及ARC患者76例(76眼)分别作为PEX组、PEXG组、POAG组及ARC组。收集各组患者角膜内皮细胞密度(ECD)、六角型细胞比例(HEX)、变异系数(CV)、角膜中央厚度(CCT)(眼前节OCT)等资料。多组间比较采用单因素方差分析,组间两两比较采用LSD-t检验。结果:ARC组、PEX组、PEXG组及POAG组ECD分别为(2565±202)/mm^(2)、(2286±178)/mm^(2)、(2104±376)/mm^(2)、(2206±206)/mm^(2)。PEX组、PEXG组及POAG组ECD低于ARC组,差异有统计学意义(t=5.16、6.19、6.58,均P<0.001);PEXG组ECD低于PEX组、POAG组,但差异无统计学意义;与ARC组相比,PEX组、PEXG组以及POAG组CV较高,HEX较低,差异均有统计学意义(均P<0.001);PEX组CCT与ARC组相比差异无统计学意义;PEXG组CCT较PEX组薄,差异有统计学意义(t=2.25,P=0.02),较POAG组也薄,但差异无统计学意义。结论:维吾尔族PEX患者ECD减少,PEXG患者CCT变薄,提示在对PEX、PEXG患者行手术治疗时应更注意对角膜的保护。Objective:To compare the differences in corneal endothelial morphology in pseudoexfoliation syndrome(PEX),pseudoexfoliation glaucoma(PEXG),primary open angle glaucoma(POAG)and age-related cataracts(ARC)in a Uyghur population.Methods:A retrospective study was conducted of patients that included 76 eyes with PEX,82 eyes with PEXG,64 eyes with POAG and 76 eyes with ARC who had received treatment from July 2019 to August 2020.Corneal endothelial cell density(ECD),coefficient of variation(CV)in cell size,and percentage of hexagonal cells(HEX)were measured using a non-contact specular microscope,while central corneal thickness(CCT)was measured with an anterior segment OCT.One-way ANOVA was used for comparison between multiple groups,and LSD-t test was used for pairwise comparison between groups.Results:The ECD was 2565±202/mm^(2),2286±178/mm^(2),2104±376/mm^(2),and 2206±206/mm^(2) in the ARC,PEX,PEXG,and POAG groups,respectively.Compared with the ARC group,the ECD in the PEX,PEXG and POAG groups had all decreased,and the differences were statistically significant(t=5.16,6.19,6.58,P<0.001).The ECD in the PEXG group was lower than that in the PEX and POAG groups,but the differences were not statistically significant.The percentages of HEX were lower in the PEX,PEXG and POAG groups compared with the ARC group,while the CV in cell size was greater,the differences were statistically significant(P<0.001).The difference between the CCT in the PEX group and ARC group was not statistically significant.The CCT of the PEXG group was lower than that of the PEX group,and the difference was statistically significant(t=2.25,P=0.02).The CCT of the PEXG group had a downward trend compared with POAG,but the difference was not statistically significant.Conclusions:This research shows that in eyes with PEX syndrome,ECD is significantly descreased,and CCT is significantly thinner in PEXG eyes,suggesting that more attention should be paid to the protection of the cornea when performing surgical treatment on PEX patients.

关 键 词：假性剥脱综合征 剥脱综合征性青光眼 角膜内皮细胞密度 角膜中央厚度 

分 类 号：R772.2[医药卫生—眼科]