骨眶老化的形态学基础研究

Morphological basis of aging of the bony orbit

目的 应用CT图像后处理技术分析大连地区汉族人群眶区骨老化的形态学特点,为面部年轻化临床诊疗及综合评价提供一定的参考资料.方法 抽取大连大学附属新华医院的303例颅骨发育正常的汉族成人患者眼眶128层螺旋CT扫描资料为研究样本,按年龄分为青年组（20～39岁）、中年组（40 ～59岁）、老年组（≥60岁）;借鉴国外学者的研究方法,对CT原始图像进行二维、三维重建,观察并测量眶顶长度、眶底长度、眶上角、眶下角、眶口宽度、眶口面积及眶上缘和眶下缘形态,并对数据进行统计学分析.结果 （1）在男性研究对象中,老年组的眶底长度较中年组显著增大（P=0.005）;老年组的眶口宽度较中年组有所增大（P=0.017）;眶宽轴上的40点至眶上缘的垂直距离,老年组较青年组（P=0.012）、老年组较中年组（P=0.020）均有所增大.（2）在女性研究对象中,老年组的眶口面积较中年组有所减小（P=0.013）;眶宽轴上的90点至眶下缘的垂直距离,老年组较青年组显著增大（P=0.008）;余测量指标均无组间统计学差异.结论 大连地区汉族人群随着老化发生了眶区骨容量的改变,而且骨沉积或者骨吸收的发生在男性和女性之间可能有所不同;局部形态学改变或不如西方学者的研究结果那样明显.

Objective To analyze the morphological features of aging of the bony orbit of Dalian Han population through the application of computerized tomography （CT）,to provide some reference for the clinical diagnosis,treatment,and comprehensive assessment in facial rejuvenation.Methods Orbital data from 303 Han nationality adult subjects with normal development of the skull were obtained randomly by 128-slice helical CT scan in the Xinhua Hospital Affiliated to Dalian University.These subjects were divided into three age groups：the young group （20 to 39 years）,the middle-aged group （40 to 59 years） and the elderly group （no less than 60 years）.Each CT scan original image underwent two-dimensional and three-dimensional reconstructions,drawing lessons from the research methods of foreign scholars.The following measuring projects were observed and measured：orbital roof length,orbital floor length,the angle between the orbital roof and the anterior wall of the frontal bone,the angle between the orbital floor and the anterior wall of the maxilla,orbit aperture width,orbit aperture area,and curvilinear shape analysis of the superior orbital rim and the inferior orbital rim.The data were analyzed statistically.Results （1） In our male subjects,the orbital floor length was found to have a significant increase statistically from the middle-aged to the elderly group （P =0.005）,and the orbital aperture width had a statistical increase from the middle-aged to the elderly group （P=0.017）.The height from 40 points along the orbital aperture width axis to the supraorbital rim increased statistically from the young to the older group （P =0.012） and from the middle-aged to the older group （P=0.020）.（2） In our female subjects,the orbital aperture area had a statistical decrease from the middle to the elderly group （P =0.013）,and the height from 90 points along the orbital aperture width axis to the infraorbital rim increased statistically significantly from the young to the elderly group （P=0.008）.Other measurements showed no statistical differences between the age groups.Conclusion Among the Dalian Han population there is a change of orbital bone volume with aging.There may be some differences between male and female in the characteristics of bone remodeling of aging of the bony orbit.Their bony orbit morphological change may not be as obvious as those subjects Western scholars studied.