甲状腺相关眼病眼眶病理生理学研究

A study on pathophysiology of thyroid-associated ophthalmopathy orbital

目的:探讨甲状腺相关眼病眼眶组织病理学改变。方法:选取我院2005年7月～2009年9月收治的30例甲状腺相关眼病患者的资料,患者行眼眶减压术和复视矫正术治疗,对患者的眼眶和眼外肌脂肪结缔组织进行HE染色、Masson染色、L26免疫组化染色、UCHL1染色,阅读切片,分析甲状腺相关眼病的组织病理学特点,为临床诊断提供依据,提高诊断正确率。结果:活动期甲状腺相关眼病患者病理切片表现为肌纤维大小不均匀、增大,呈圆形、梭形或者不规则形肌细胞和间质组织间有大量葡胺聚糖堆积,部分肌纤维周界不清,眼眶脂肪组织水肿,部分血管形成套袖征;静止期甲状腺相关眼病眼外肌退变,眼眶脂肪和眼外肌纤维增生明显,部分眼外肌纤维化。结论:活动期甲状腺相关眼病眼外肌和眼眶脂肪以葡胺聚糖聚集、炎性细胞、免疫细胞浸润为主,静止期患者以眼眶组织退变和纤维化为主,可以为临床诊断甲状腺相关眼病提供依据。

Objective： To evaluate thyroid associated orbital pathological changes. Methods： In our hospital in July 2005- September 2009 30 cases were treated in patients with thyroid associated data, patients with orbital decompression and correction of diplopia in the treatment of patients with orbital fat and connective tissue of extraocular muscle the HE staining, Masson staining, L26 immunohistochemistry, UCHL1 staining, reading sections of thyroid associated histopathological characteristics provide the basis for clinical diagnosis, improve diagnostic accuracy. Results： The patients with thyroid associated ophthalmopathy biopsy showed non-uniform muscle fiber size, increases were round, spindle-shaped or irregular-shaped muscle cells and interstitial tissue between the accumulation of a large number of meglumine glycans, some of the perimeter of muscle fiber unclear, orbital fat, edema, angiogenesis sleeve some sign; quiescent thyroid associated degeneration of the extraocular muscles, orbital fat and extraocular muscle fibrosis was significantly, some of extraocular muscle fibrosis. Conclusion： The activity of thyroid associated ophthalmopathy extraocular muscle and orbital fat to meglumine GAG accumulation, inflammatory cells, infiltration of immune cells, quiescent orbital tissue of patients with degeneration and fibrosis mainly for clinical diagnosis of thyroid provide the basis for related eye disease.