高度近视眼角膜内皮细胞相关指标的临床研究

The study on the related parameters of corneal endothelial cells in patients with high myopia

目的探讨不同年龄高度近视眼患者角膜内皮细胞密度、形态学特点及屈光度对其的影响。方法以高度近视患者122例(244只眼)为观察组,选择参加体检的健康志愿者108例(216只眼)作为对照组。采用角膜内皮镜对患者双眼角膜中央内皮细胞进行检查,获取细胞密度、细胞平均面积、变异系数及六角形细胞比例等指标,分析年龄、屈光度与细胞密度、细胞平均面积、变异系数及六角形细胞比例的相关性。结果观察组角膜内皮细胞密度及六边形细胞比例均低于对照组[(2 831.67±299.60)·(mm2)-1与(3 257.4±212.52)·(mm2)-1,(60.05±6.678)%与(68.95±5.32)%];细胞平均面积及变异系数均高于对照组[(357.04±38.15)·(μm2)-1与(312.12±17.42)·(μm2)-1,(35.26±5.60)%与(29.32±3.34)%]。观察组的屈光度与内皮细胞密度和细胞平均面积无相关性(r=0.107、-0.121),而与变异系数呈负相关性(r=-0.189),与六边形细胞比例呈正相关性(r=0.236)。年龄和细胞密度、细胞平均面积、变异系数及六角形细胞比例显著相关性(r分别为-0.294、0.281、0.390、-0.303);利用线性回归分析显示,年龄和细胞密度、细胞平均面积、变异系数及六角形细胞比例具有线性回归关系(r值分别为0.294、0.281、0.477、0.406)。结论高度近视眼患者随近视度数的增加角膜内皮细胞变异系数增加,六角形细胞比例下降,且随着年龄增加内皮细胞密度降低,形态发生改变。

Objective To investigate the influence on density and morphology in patients with high myopia in different age Methods 122 patients （244 eyes ） with high myopia were recruited. The corneal endothelial cell density,averaged cell area,coefficient of variation and the proportion of hexagonal cells were measured by corneal specular microscope. The Pearson correlation coefficient （r） was performed to evaluate the relationship between age, diopters and cell density, corneal endothelial cell density, averaged cell area, coef- ficient of variation and the proportion of hexagonal cells. Results The corneal endothelial cell density was （2 831.67 ± 299.60） cells· （ μm2 ） - 1, averaged cell area （ 357.04 ± 38.15 ） · （ μm2 ） -1 ; coefficient of variation （ 35.26 ±5.60） %, and the proportion of hexagonal cells （ 60.05 ± 6. 678 ） %. There was no statistically significant relationship between the diopter and the endothelial cell density （ r = 0. 107, P 〉 0.05 ） and the average area （ r = - 0. 121, P 〉 0.05 ） ; while the diopter was negatively correlated with coefficient of variation （ r = - 0. 200, P 〈 0.05 ） and positively with the proportion of hexagonal cells （ r = 0. 162, P 〈 0. 05 ）. Meanwhile statistically significant correlation were found between age and corneal endothelial cell density, averaged cell area and coefficient of variation and the proportion of hexagonal cells （ r value was - 0. 294,0. 281,0. 390, - 0.303 respectively, P 〈 0. 05 ）, which was found in LINE regression （ r value was 0. 294,0.281,0. 477,0. 406 respectively, P 〈 0.05 ）. Conclusion The coefficient of variation of corneal endothelial cells is in- creased and the proportion of hexagonal cells decreased with the increase of the diopter in patients with high myopia. The cell density is decreased and the changes in morphology of corneal endothelial cells appeared with age.