原发性青光眼患者角膜内皮形态研究

Morphological study of corneal endothelium in primary glaucoma

目的研究原发性青光眼角膜内皮形态改变。方法住院原发性青光眼56例(89只眼),按诊断标准分为急性原发性闭角型青光眼(aPACG)、慢性原发性闭角型青光眼(cPACG)、原发性开角型青光眼(POAG)3组,同期住院白内障和正常人40例(40只眼)作为对照组。4组均用角膜内皮细胞计检查并用配套的计算机辅助测量分析系统对图象处理分析,指标有单位面积细胞密度、最小细胞面积、最大细胞面积、平均细胞面积、平均细胞面积的标准差、细胞面积的变异系数和六角形细胞所占比例。全部资料用社会科学统计软件包(SPSS)进行统计学分析。结果单位面积细胞密度对照组为(2876.32±257.85)cells.mm-2,显著高于原发性青光眼组。aPACG:(2607.36±431.97)cells.mm-2,P=0.041;cPACG:(2582.42±379.89)cells.mm-2,P=0.001;POAG:(2637.69±342.60)cells.mm-2,P=0.028。慢性原发性闭角型青光眼组的最大细胞面积、平均细胞面积、细胞面积的标准差均高于对照组(MAXP=0.005,AVEP=0.025,SDP=0.031)。结论原发性青光眼患者角膜内皮单位面积细胞密度明显低于正常人,差异有统计学意义;慢性原发性闭角型青光眼组的最大细胞面积、平均细胞面积、细胞面积的标准差均高于正常人组,差异有统计学意义。

Objective To exploro the morphological changes of corneal endothelium in primary glaucoma. Methods Fifth-six patients （89eyes） with primary glaucoma and fourth patients （40eyes） without glaucoma were coUeeted. The corneal endothelium cell density, rninimun cell area, mmaximun cell area, average cell area, percentage of hexagonal cell density and cell size variation cofflcent were determined with non-contact specular microscopy, the endothelial images were analyzed by computer. The data were analyzed by statistical program for social sciences （ SPSS）. Results Corneal endothelium cell density were significant lower in patients with primary glaucoma, aPACG ： （ 2607.36 ±431.97 ） cells, mm^-2 P =0.041 ;cPACG： （2582.42± 379.89 ）cells. mm^-2 , P = 0.1301 ;POAG： （2637.69± 342.60 ） cells, mm^-2 , P =0. 028 than that in control group（2876.32 ±257.85） cells, mm^-2. Mmaximun cell area（MAX 1090.86±652.42 P = 0.005 ） , average cell area（AVE 404.67 ±130.18 P =0.025） and standard deviation of average area （SD 157.91 ±101.08 P = 0.031 ） were significant increase in patients with chronic primary angle closure glaucoma than that in control group （ MAX 796.13±172.05um^2, AVE350.47 5 32.50 um^2 , SD 121.00±18.97 ）. There were not significant difference among three primary glaucoma groups. Conclusion The corneal endothelium cell density was significant lower in patients with primary glaucoma. Mmaximtm cell area, average cell area and standard deviation of average area were significant increase in patients with chronic primary angle closure glaucoma than that in control group. There were not significant difference among three Primary glaucoma groups.