中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2009年
2期
115-121
,共7页
林浩添%刘祖国%凌士奇%许传超%赵伟%李青%梁凌毅
林浩添%劉祖國%凌士奇%許傳超%趙偉%李青%樑凌毅
림호첨%류조국%릉사기%허전초%조위%리청%량릉의
角膜%眼烧伤%烧伤,化学%淋巴管生成%角膜移植
角膜%眼燒傷%燒傷,化學%淋巴管生成%角膜移植
각막%안소상%소상,화학%림파관생성%각막이식
Cornea%Eye bums%Burns,chemical%Lymphangiogenesis%Corneal transplantation
目的 探讨人角膜碱烧伤后新生淋巴管的生长情况及其影响因素.方法 回顾性系列病例研究.分析2005年1至12月期间在中山大学中山眼科中心因角膜碱烧伤住院手术治疗的22例(22只眼)患者.记录患眼的烧伤时间(IT)和损伤等级(ID),并测量炎性反应指数(II)和角膜新生血管的相对面积(BVA);应用双重酶组织化学、免疫组织化学染色及透射电镜检测角膜标本的新生淋巴管(LVC)和血管(BVC);采用苏木素-伊红染色检测多形核白细胞(PMN)浸润情况.结果 采用配对Student t检验、Pearson相关检验及Stepwise回归进行统计学分析.结果 22例患者观测结果 IT为(57.62±31.72)个月、ID为(12.00±2.76)分、II为(2.32±2.63)分、BVA为29.79%±18.61%、BVC为(14.45±9.29)个、LVC为(2.73±4.57)个、PMN为(13.45±13.09)个,其中7例(占32%,IT<64个月)同时存在角膜新生淋巴管(8.6±3.8)个和血管(22.3±11.1)个,LVC总数为60个,占发生新生淋巴管的角膜中总管腔数(BVC和LVC,378个)的16%.LVC与IT、ID、BVA、PMN、II的相关系数分别为-0.673、0.604、0.755、0.806、0.873,均P<0.05;进一步回顾分析得出LVC近似等于II和BVA分别和特定的常数相乘后取和所得的淋巴管指数(LI).透射电镜从微观上证实了碱烧伤人角膜组织中存在具有典型结构特征的新生淋巴管和炎性细胞浸润.结论 碱烧伤后部分角膜组织存在新生淋巴管,通过II和BVA可间接估计其发生情况.LI是一项评估碱烧伤角膜新生淋巴管的有用临床参数.(中华眼科杂志,2009,45:115-121)
目的 探討人角膜堿燒傷後新生淋巴管的生長情況及其影響因素.方法 迴顧性繫列病例研究.分析2005年1至12月期間在中山大學中山眼科中心因角膜堿燒傷住院手術治療的22例(22隻眼)患者.記錄患眼的燒傷時間(IT)和損傷等級(ID),併測量炎性反應指數(II)和角膜新生血管的相對麵積(BVA);應用雙重酶組織化學、免疫組織化學染色及透射電鏡檢測角膜標本的新生淋巴管(LVC)和血管(BVC);採用囌木素-伊紅染色檢測多形覈白細胞(PMN)浸潤情況.結果 採用配對Student t檢驗、Pearson相關檢驗及Stepwise迴歸進行統計學分析.結果 22例患者觀測結果 IT為(57.62±31.72)箇月、ID為(12.00±2.76)分、II為(2.32±2.63)分、BVA為29.79%±18.61%、BVC為(14.45±9.29)箇、LVC為(2.73±4.57)箇、PMN為(13.45±13.09)箇,其中7例(佔32%,IT<64箇月)同時存在角膜新生淋巴管(8.6±3.8)箇和血管(22.3±11.1)箇,LVC總數為60箇,佔髮生新生淋巴管的角膜中總管腔數(BVC和LVC,378箇)的16%.LVC與IT、ID、BVA、PMN、II的相關繫數分彆為-0.673、0.604、0.755、0.806、0.873,均P<0.05;進一步迴顧分析得齣LVC近似等于II和BVA分彆和特定的常數相乘後取和所得的淋巴管指數(LI).透射電鏡從微觀上證實瞭堿燒傷人角膜組織中存在具有典型結構特徵的新生淋巴管和炎性細胞浸潤.結論 堿燒傷後部分角膜組織存在新生淋巴管,通過II和BVA可間接估計其髮生情況.LI是一項評估堿燒傷角膜新生淋巴管的有用臨床參數.(中華眼科雜誌,2009,45:115-121)
목적 탐토인각막감소상후신생림파관적생장정황급기영향인소.방법 회고성계렬병례연구.분석2005년1지12월기간재중산대학중산안과중심인각막감소상주원수술치료적22례(22지안)환자.기록환안적소상시간(IT)화손상등급(ID),병측량염성반응지수(II)화각막신생혈관적상대면적(BVA);응용쌍중매조직화학、면역조직화학염색급투사전경검측각막표본적신생림파관(LVC)화혈관(BVC);채용소목소-이홍염색검측다형핵백세포(PMN)침윤정황.결과 채용배대Student t검험、Pearson상관검험급Stepwise회귀진행통계학분석.결과 22례환자관측결과 IT위(57.62±31.72)개월、ID위(12.00±2.76)분、II위(2.32±2.63)분、BVA위29.79%±18.61%、BVC위(14.45±9.29)개、LVC위(2.73±4.57)개、PMN위(13.45±13.09)개,기중7례(점32%,IT<64개월)동시존재각막신생림파관(8.6±3.8)개화혈관(22.3±11.1)개,LVC총수위60개,점발생신생림파관적각막중총관강수(BVC화LVC,378개)적16%.LVC여IT、ID、BVA、PMN、II적상관계수분별위-0.673、0.604、0.755、0.806、0.873,균P<0.05;진일보회고분석득출LVC근사등우II화BVA분별화특정적상수상승후취화소득적림파관지수(LI).투사전경종미관상증실료감소상인각막조직중존재구유전형결구특정적신생림파관화염성세포침윤.결론 감소상후부분각막조직존재신생림파관,통과II화BVA가간접고계기발생정황.LI시일항평고감소상각막신생림파관적유용림상삼수.(중화안과잡지,2009,45:115-121)
Objective To explore the lymphangiogenesis process in alkali burned human cornea and to discuss factors modulating this process. Methods It was a retrospective case series study. Twenty-two cases (22 eyes) of hospitalized patients suffering from alkali burned cornea and requiring keratoplasty from January to December 2005 were analyzed retrospectively. Before surgery, injury time (IT) and injury degree (ID) were recorded. Furthermore, inflammation index (II) and relative area of new blood vessels (BVA) were measured. Cornea specimens were assessed for lymphatic vessel counting (LVC) and blood vessel counting (BVC) via immunohistochemical staining and transmission electronic microscopy. Meanwhile, HE staining was also performed to observe infiltration of polymorphonuclear (PMN) leucocytes in corneal tissues. Student t-test, Pearson correlation test and Stepwise regression analysis were used to investigate the influencing factors. Results In these 22 cases, IT was (57.62±31.72) months; ID was (12.00±2.76) scores; II was (2.32±2.63) scores; BVA was (29.79%±18.61%); BVC was (14.45±9.29) units; LVC was (2.73±4.57) units and PMN was (13.45±13.09) units. In 7 patients with IT more than 64 months (accounted for 32% of 22 cases), lymphangiogenesis[(8.6±3.8) units] and hemangiogenesis [(22.3±11.1)units] were beth present. In these 7 patients, the whole number of LVC was 60 units, constituting 16% of all vessels (BVC+LVC =378 units). The correlation coefficient of LVC with IT, ID, BVA, PMN and II was-0.673, 0.604, 0.755, 0.806 and 0.873, respectively. P value of all these correlations was less than 0.05. Further regression analysis revealed that LVC could be approximately calculated from II and BVA multiplying certain constant coefficients separately (resulting in lymphatic index, LI). Lymphatic vessels with characteristic ultrastructures and inflammatory cells were identified by transmission electronic microscopy. Conclusions Lymphatic vessels exist in part of alkali burned human corneas and may be estimated through II and BVA indirectly. Lymphatic index may be a convenient and useful clinical index for evaluating lymphangiogenesis in corneal alkali burn. (Chin J Ophthalmol, 2009, 45:115-121)