国人蒙古族原发性闭角型青光眼发病机制的研究

Studies of mechanism of Chinese Mongolia primary angle closure glaucoma

目的 探讨国人蒙古族原发性闭角型青光眼的发病机制,为治疗蒙古族原发性闭角型青光眼提供临床依据.方法 采用病例对照研究方法.研究分为蒙古族正常人组,蒙古族青光眼组,汉族正常人组,汉族青光眼组.应用亚硝酸还原酶法测房水及血清一氧化氮浓度;应用流式细胞仪测定小梁细胞的凋亡率;利用透射电镜观察小梁组织的超微结构;利用UBM观察测量眼前段生物学指标;并对四组数据进行统计学处理.结果 四组房水及血清一氧化氮浓度性差异无统计学意义.蒙古族和汉族眼小梁细胞凋亡率比较,有种族差异,小梁网的超微结构亦有差异.蒙古族与汉族比较正常人眼前段结构有角膜小、前房浅、晶状体厚且相对位置偏前,统计学处理有显著差异.结论 蒙古族闭角型青光眼的高发病率与蒙古族人眼前段的结构异常、小梁细胞凋亡率高、小梁网的超微结构异常等因素有关,其中眼前段的结构异常是发病的高危因素.

Objective To investigate the mechanism of Chinese Mongolia primary angle closure glaucoma （PACG）, the basis for the clinical treatment of Chinese Mongolia primary angle closure glaucoma （PACG） .Methods This study contained four groups： Mongolia PACG, Han nationality PACG, normal Mongolia and normal Han nationality. The NO concentration in serum and aqueous humor was detected by nitric acid reductase method; the apoptosis rate of trabecula cells was measured with flow cytometry; the trabecular tissue was observed and photographed by electron-microscopy; the anterior chamber structure was examined by ultrasound biomicroscopy in all four groups. Results （1） The NO concentration in serum and aqueous humor was not significant difference in all four groups.（2） The apoptosis rate of trabecula cells was significant difference between Mongolia and Han nationality. （3） The micro-structure of trabecular tissue of Mongolia was different from Han nationality.（4） The anterior chamber structure of normal Mongolia was different from Han nationality, and had characters such as： a smaller corneal diameter, shallow anterior chamber, thick and forward lens with significant differences. Conclusions The high rate of primary angle closure glaucoma （PACG） of Mongolia is related with abnormal anterior chamber structure, the high apoptosis rate of trabecula cells and change of the micro-structure of trabecular tissue and many other factors, among which abnormal anterior segment structure is the high risk factors of occurrence of Chinese Mongolia primary angle closure glaucoma （PACG）.