眼部疾病与青少年脊柱侧凸的病因学的相关性研究进展

Research progress of correlation between ocular diseases and etiology of adolescent scoliosis

我国青少年脊柱侧凸发病率约为3%~5%,其中80%~85%为病因不明的特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS),即青春期或骨骼成熟前发生的结构性脊柱侧凸畸形,在冠状面上测得的Cobb角>10°,并且伴有脊柱旋转,而无其他器质性疾病。脊柱侧凸不仅阻碍了青少年脊柱的生长发育,也对青少年的心理健康产生极大的负面影响。眼部疾病是眼球及其附属结构出现结构异常或功能障碍的一类常见的临床疾病。眼部疾病不但给患者的生活带来了不便,甚至可能诱发眼部以外的疾病。最近有研究表明,各种眼科疾病可能对脊柱侧凸的发生具有潜在的影响,且相当一部分患有某些眼科疾病的患者脊柱侧凸的发病率高于正常人。因此,本文主要就眼部疾病与脊柱侧凸之间的病因学联系,对近15年以来的相关研究进行了总结,为脊柱侧凸与眼部疾病的病因学研究提供指导与方向。经过整理发现,眼科疾病与脊柱侧凸之间的联系主要集中在以下四个各方面:脉络膜厚度与脊柱侧凸、Goldenhar综合征、基因水平、斜视与脊柱侧凸。其中,基因水平上的联系最为复杂,目前已经发现约40种基因或染色体的异常可导致眼部疾病与脊柱侧凸两种疾病并发;Goldenhar综合征,也称小儿眼-耳-脊椎综合征(oculo-auriculo-vertebral spectrum),最早揭示了眼部疾病与脊柱侧凸之间的关系,但目前其统计学关系尚不清晰;国内外关于脉络膜厚度、斜视的相关研究较少,均为统计学研究,仅揭示与脊柱侧凸之间有联系,且脉络膜厚度的研究存在很多缺陷,有待进一步的研究。

The morbidity of scoliosis in adolescents in China is about 3%-5%,80%-85%of the patients are adolescent idiopathic scoliosis(AIS),whose etiology is unknown.Scoliosis is a structural spine disease occurring during puberty or before skeletal maturation.Scoliosis has a greatly negative impacton not only the growth and development of adolescent spine,but also the mental health of adolescents.Ocular disease is a common clinical disease in which the eye ball and its accessory structures have structural abnormalitiesordys function.Ocular disease snotonly bring in convenience to patients's life,but also may induce diseases in other organs.Recent studies have shown that various ocular diseases may have a potential impact on scoliosis,and quite a fewof patients with certain ocular diseases have higher incidence rate of scoliosis.Therefore,in this article,the etiological relationship between eye diseases and scoliosis will be summarized,which provides guidance and direction for the etiological research of scoliosis and eye diseases.After sorting out,we found that the relationship between ophthalmic diseases and scoliosis mainly concentrated in the following four aspects:choroidal thickness and scoliosis,Goldenhar syndrome,gene level and strabismus.Among them,the genetic relationship is the most complex,about 40 kinds of gene or chromosome abnormalities have been found to cause ocular diseases and scoliosis;Goldenhar syndrome,also known as oculo-auriculo-vertebral spectrum,first revealed the relationship between ocular diseases and scoliosis,but the current statistical relationship is still very vague.There are few studies on choroidal thickness and strabismus at home and abroad,which are statistical studies,only revealing the relationship between choroidal thickness and scoliosis,and there are many defects in the study of choroidal thickness,which need further research.