共同性斜视患者眼外肌的光镜和超微结构研究

The Study of Microsture and Ultrastructure on Extraocular Muscles in Comitant Strabismus

目的 :研究共同性斜视患者眼外肌的组织形态学改变 ,为探讨斜视的发病机制奠定基础。方法 :取 6 0例共同性斜视患者和 2 0例眼球摘除者的眼外肌组织标本 ,每例标本 1/2行HE染色 ,光镜下观察 ;1/2标本作超薄切片 ,行透射电镜观察。结果 :光镜下可见肌纤维排列疏松 ,肌纤维数量较少 ,间质成分多。小年龄组中可见萎缩变性的横纹肌细胞和排列混乱的肌纤维。而大年龄组则只有少量萎缩变性的肌细胞排列在大量胶原纤维结缔组织中。电镜下整个眼肌组织结构模糊 ,肌膜不完整 ,细胞内结构紊乱 ,细胞核固缩。且在大龄组中肌丝紊乱 ,肌纤维弯曲排列、间隙变宽以及空泡样改变更明显。结论 :共同性斜视患者眼外肌有明显的改变 ,且病程越长 ,肌纤维的损害程度越重。从组织学的角度进一步完善了共同性斜视的发病机理。

Objective:To investigate the histo morphological changes of microstructure and ultrastructure on extraocular muscles in comitant strabismus and provide the basis for expounding the pathogenesis of strabismus.Method:The histological samples of extraocular muscles in 60 strabismus and 20 extracted eyes were collected and sliced.Half of every one was stained by HE method and observed by light microscopy,the other half one was observed by electron microscopy.Result:There was less muscle fiber in loose order and more matrix in extraoclular muscles in strabismus.In younger group,there were atrophic and degenerated striated muscular cells and mixed fiber.In older group,there were few those muscular cells within much collagen connective tissue.Observed by microscopy,histological structure of extraocular muscles was clounded,with imcomplete cell membrance,disordered cell organs and pyknotic nucleus.It was obvious in older group that extraocular muscle fiber was disordered and curved,interval widened and cells vacuolated.Conclusion:Extraocular muscles vary obviously in comitant strabismus.With the prolonging of course of disease,the injury of muscles aggravates.The histological observatior is helpful to expound the pathogenesis of strabismus.