老年性白内障晶状体上皮细胞的形态学变化

Morphologic alterations of lens epithelial cells in patients with age-related cataract

目的 观察老年性白内障晶状体上皮细胞的形态学改变 ,探讨其与白内障形成的关系 .方法 采集老年性白内障晶状体囊外摘除术中取出的前囊膜 ,采用铺片及 HE染色、平板包埋及制备超薄切片等技术 ,分别在光镜和电镜下观察晶状体上皮细胞的密度、细胞形态和超微结构变化 .结果 白内障晶状体上皮细胞密度较正常晶状体明显减小 (P<0 .0 1) ,6 0岁以上组细胞密度低于 6 0岁以下组 (P<0 .0 1) .光镜下 ,形态异常的细胞散在分布 ,胞质疏松、淡染、空泡形成 ,细胞核大小不等 ,染色质淡染或浓染成块状 .在电镜下 ,异常细胞之间间隙增大 ,胞质中中间丝稀疏 ,细胞器变性 ,有空泡形成 .结论 老年性白内障晶状体上皮细胞密度降低 ,并与年龄有关 ,年龄增大 ,细胞数量减少 .细胞发生退行性改变 ,异常的细胞散在分布 .提示白内障的形成与晶状体上皮细胞数量减少 ,细胞变性、功能降低有关 .

AIM To observe the morphological changes in lens epithelial cells (LEC) of age-related cataracts (ARC) and to inspect whether it plays a role in the formation of cataract. METHODS Thirty-five flat preparations of human lens epithelium attached to the anterior capsule obtained during extracapsular cataract extractions were studied. Of these, 31 stained with HE were used for quantitative cell density determination and hisopathological examination with light microscopy and 4 were prepared for ultrastructural study with transmission electron microscopy. RESULTS Mean cell density in age-related cataract was 4470 mm -2, significantly lower than that in normal lenses (P<0.01). Lens epithelium of patients above 60 showed a lower cell density than that of younger patients (P<0.01). Light microscopically, the abnormal cells were characterized by enlarged size, light-stained cytoplasm and vaculation in cytoplasm. The nuclei were obviously various in size, with the larger ones stained light and the smaller ones stained dark. Under electron microscope, the lens epithelium consisted of abnormal-appearing cells which exhibited swollen mitochondria, a large amount of vacuoles, decreased intermediate filaments and expanded extracellular lacunae. CONCLUSION The decrease of LEC and appearance of degenerated cells found in the epithelium of age-related cataract indicate that these changes may be associated with the formation of cataract.