先天性上睑下垂患者提上睑肌腱膜纤维特征及其与病情的相关性

The characteristics of levator aponeurosis in patients with congenital ptosis and their correlation with the disease

目的探讨先天性上睑下垂患者提上睑肌腱膜纤维特征及其与病情的相关性。方法前瞻性病例研究。纳入2016年1月至2020年1月我院收治的50例(76只眼)先天性上睑下垂患者为研究对象;入院后根据患者病情的严重程度分为轻度组17例(25只眼)、中度组20例(31只眼)和重度组13例(20只眼),比较3组患者提上睑肌腱膜纤维特征,并分析其与病情的相关性。结果Ⅰ型胶原分布、Ⅲ型胶原分布、肌球蛋白分均随着患者病情的严重程度增加而增加(P<0.05),其余比较差异无统计意义(P>0.05);肌球蛋白分布、肌红蛋白分布评分轻度组低于中度组,中度组低于重度组,差异均有统计学意义(P<0.05),提上睑肌厚度轻度组高于中度组,中度组高于重度组差异均有统计学意义(P<0.05);logistics回归分析显示Ⅰ型胶原分布、Ⅲ型胶原分布、肌球蛋白分布是影响先天性上睑下垂患者的影响因子。结论Ⅰ型胶原分布、Ⅲ型胶原分布、肌球蛋白分均随着患者病情的严重程度增加而增加,且Ⅰ型胶原分布、Ⅲ型胶原分布、肌球蛋白是先天性上睑下垂患者病情的影响因素。

Objective To investigate the characteristics of the levator aponeurotic fibers in patients with congenital ptosis and their correlation with the disease.Methods This retrospective case-control study enrolled 76 eyes of 50 congenital ptosis patients who were admitted to our hospital from January 2016 to January 2020.According to the severity of their illness,the patients were divided into mild groups(17 cases,25 eyes),moderate group(20 cases,31 eyes)and the severe group(13 cases,20 eyes).The characteristics of the levator aponeurosis fibers of the levator aponeurosis were compared between the three groups and their correlation with the disease was analyzed.Results The distribution of type Ⅰ collagen,type Ⅲ collagen,and myosin scores all increased with the severity of the patient's condition(P<0.05),and the remaining differences were not statistically significant(P>0.05).The myoglobin distribution score of the mild group was lower than the moderate group,and the moderate group was lower than the severe group.The differences were statistically significant(P<0.05).The levator muscle thickness of the mild group was higher than that of the moderate group.The difference between the group and the severe group was statistically significant(P<0.05).Logistics regression analysis showed that the distribution of type Ⅰ collagen,type Ⅲ collagen,and myosin distribution were influencing factors in patients with congenital ptosis.Conclusions The distribution of type Ⅰ collagen,type Ⅲ collagen,and myosin score increase with the severity of the patient’s condition,and the distribution of type Ⅰ collagen,type Ⅲ collagen,and myosin are the conditions of patients with congenital ptosis Influencing factors.