CAJ | 학술논문

目的研究共同性外斜视内直肌纤维黏连蛋白表达变化,探讨眼外肌中纤维黏连蛋白表达与共同性外斜视发病的关系.方法选择共同性外斜视患者常规手术切除的内直肌段35例为外斜视组,男19例,女16例,年龄2～46岁(平均20.9岁),外斜视度-45△～-90△(平均斜视度-67.5△),有家族史者8例,并将其分成间歇性外斜视和恒定性外斜视2个亚组,分别为16例和19例.正常组选20例角膜移植供体内直肌作为对照,男12例,女8例,年龄15～28岁(平均18.8岁).用免疫组化Sp法标记内直肌纤维黏连蛋白的表达,图像分析系统测定其平均吸光度(A)值.分析纤维黏连蛋白表达含量在正常组、间歇性外斜视和恒定性外斜视两亚组间及不同性别间、阴阳性家族史间的差异,分析其与斜视度、患者年龄之相关性.所得数据采用单因素方差分析、q检验、t检验及直线相关分析进行统计学处理.结果间歇性外斜视亚组的FN平均A值为0.5821±0.0792,恒定性外斜视亚组为0.4729±0.0872,正常组为0.5914±0.0547,其中恒定性外斜组FN表达低于正常组和间歇性外斜组(q =7.0314,6.1177,P＜0.01),正常组与间歇性外斜视组FN表达差异无统计学意义(q =0.5271,P＞0.05).FN在患者不同性别、有无家族史之间分别比较,差异无统计学意义(t=1.1317,1.6327,P＞0.05),与患者年龄以及斜视度数无关.结论纤维黏连蛋白含量的下降与可能与共同性外斜视发病和发展有关,纤维黏连蛋白可能是内直肌收缩功能的保护因素.
목적 연구공동성외사시내직기섬유점련단백표체변화,탐토안외기중섬유점련단백표체여공동성외사시발병적관계.방법 선택공동성외사시환자상규수술절제적내직기단35례위외사시조,남19례,녀16례,년령2～46세(평균20.9세),외사시도-45△～-90△(평균사시도-67.5△),유가족사자8례,병장기분성간헐성외사시화항정성외사시2개아조,분별위16례화19례.정상조선20례각막이식공체내직기작위대조,남12례,녀8례,년령15～28세(평균18.8세).용면역조화Sp법표기내직기섬유점련단백적표체,도상분석계통측정기평균흡광도(A)치.분석섬유점련단백표체함량재정상조、간헐성외사시화항정성외사시량아조간급불동성별간、음양성가족사간적차이,분석기여사시도、환자년령지상관성.소득수거채용단인소방차분석、q검험、t검험급직선상관분석진행통계학처리.결과 간헐성외사시아조적FN평균A치위0.5821±0.0792,항정성외사시아조위0.4729±0.0872,정상조위0.5914±0.0547,기중항정성외사조FN표체저우정상조화간헐성외사조(q =7.0314,6.1177,P＜0.01),정상조여간헐성외사시조FN표체차이무통계학의의(q =0.5271,P＞0.05).FN재환자불동성별、유무가족사지간분별비교,차이무통계학의의(t=1.1317,1.6327,P＞0.05),여환자년령이급사시도수무관.결론 섬유점련단백함량적하강여가능여공동성외사시발병화발전유관,섬유점련단백가능시내직기수축공능적보호인소.
Objective To study the changes of fibronectin in the resected medial rectus muscles in patients with concomitant exotropia and to have a better understanding about the pathomorphological changes of extraocular muscles in the genesis and development of concomitant exotropia. Methods Thirty-five concomitant exotropic patients were chosen as exotropic group and 20 normals were selected as control group.In the exotropic group,the age range 2 to 46 years old (mean,20.9 ys),deviation range -45△ to -90△ (mean,-67.5△),19 males,16 females,and 8 cases have the family history.Exotropic patients were divided into intermittent exotropic group 16 cases and constant exotropic group 19 cases.In the control group,the age range 15 -28 years old(mean,18.8 years),12 males and 8 females.All the resected tissues of the medial rectus muscles were obtained from patients with concomitant exotropia during resection surgery and cornea donators.Fibronectin was measured its mean average optical by Sp method of immunohistochemistry using image analyzer.The amounts of fibronectin in the resected muscle of patients were compared with normals,as well as correlated clinical data of patients such as different types of exotropia,age,degree of deviation,gender and positive family history.Results The amounts of fibronectin in the resected medial rectus muscle of patients with constant exotropia (0.4729 ± 0.0872 ) were significantly lower than those of normals (0.5914 ± 0.0547 ) and intermittent exotropic group ( 0.5821 ± 0.0792 ) respectively ( q =7.0314,6.1177,P ＜ 0.01 ),while patients with intermittent exotropia did not show significantly lower amounts of fibronectin than those with normals ( q =0.5271,P ＞ 0.05 ). Neither gender nor positive family was correlated with the amounts of fibronectin( t =1.1317,1.6327,P ＞ 0.05 ) and the amounts of fibronectin had no correlation with age and degree of deviation.Conclusion The amounts of fibronectin were correlated with the course of development of concomitant exotropia. Some of these changes may play a role in the pathogenesis of exotropia from intermittence to constancy,which indicates a further clue to the nature of this disease.