应用电子计算机分析糖尿病患者角膜内皮细胞形态学的改变

Computer assisted morphological analysis of corneal endothelial cells in diabetes mellitus

目的：探讨糖尿病患者角膜内皮细胞的形态学变化及其临床意义。方法：采用角膜内皮显微镜和计算机图像分析技术，对６７例糖尿病患者的１２８只角膜和６７例正常人１３４只角膜进行活体角膜内皮细胞形态学定量分析。结果：糖尿病患者角膜内皮细胞形态变形，大小不均，呈不稳定状态。与正常人相比细胞密度和面积无明显变化，但面积变异系数、周长和最大长径均显著增大，形状系数显著减少（Ｐ＜０．０１）；糖尿病Ⅰ型和Ⅱ型、有和无眼底病变的糖尿病患者之间各检测指标均无显著差异。结论：对糖尿病患者角膜内皮细胞进行形态定量分析对指导糖尿病患者眼病治疗和判断预后均十分重要。

Objective: To study the morphological changes of corneal endothelial cells in diabetes mellitus (DM) and to evaluate the clinical significance of these changes. Methods: 128 eyes from 67 patients with DM and 134 eyes from 67 age matched nondiabetic persons as normal controls were examined by specular microscopy and computer assisted image analysis techniques. The morphologies of the individual corneal endothelial cells in vivo were quantitatively analysed.Results: Compared to the normal controls, the corneal endothelium in DM showed no difference in cell density and cell area but demonstrated significantly a higher coefficient of variation, perimeter, long axis and a lower figure coefficient. No significant differences in the data between type Ⅰ and type Ⅱ DM and between DM with and without retinopathy were discovered. Conclusion: The diabetic corneal endothelium is morphologically abnormal in a pattern of uneven size and irregular shape and in a less stable condition. To quantitatively analyse these changes is very important for making a plan of treatment and estimating the prognosis of eye diseases in DM.