CAJ | 학술논문

目的研究共同性斜视患者眼外肌本体感受器(extraocular muscle proprioceptor,EMP)的形态学改变，为探讨斜视的发病机制提供依据。方法取28例共同性斜视患者和11例眼球摘除者的眼外肌，采用Holmes′法染色后在光镜及透射电镜下观察，并计算相同放大倍数下每例标本面积4 000 mm2的轴突中线粒体个数。结果光镜下可见位于眼外肌肌-腱连接处的EMP神经纤维终止于邻近单个梭外肌纤维的起始处或两侧；电镜下斜视患者EMP与对照组比较，结构紊乱，神经成分消失；每例标本面积4 000 mm2轴突中线粒体个数实验组明显少于对照组（P＜0.05）。结论斜视患者EMP结构的紊乱，导致EMP接收、传递信息功能异常，从形态学角度证实了EMP紊乱在共同性斜视发病机制中具有重要作用。
목적연구공동성사시환자안외기본체감수기(extraocular muscle proprioceptor,EMP)적형태학개변，위탐토사시적발병궤제제공의거。방법취28례공동성사시환자화11례안구적제자적안외기，채용Holmes′법염색후재광경급투사전경하관찰，병계산상동방대배수하매례표본면적4 000 mm2적축돌중선립체개수。결과광경하가견위우안외기기-건련접처적EMP신경섬유종지우린근단개사외기섬유적기시처혹량측；전경하사시환자EMP여대조조비교，결구문란，신경성분소실；매례표본면적4 000 mm2축돌중선립체개수실험조명현소우대조조（P＜0.05）。결론사시환자EMP결구적문란，도치EMP접수、전체신식공능이상，종형태학각도증실료EMP문란재공동성사시발병궤제중구유중요작용。
Objective　To investigate the morphological change of extraocular muscle proprioceptor (EMP) in concomitant strabismus and study its pathogenesis. Methods　The samples were obtained from the extraocular muscles of patients with concomitant strabismus and enucleated eyeballs. After being stained, the samples were examined under light microscopy (LM) and transmission electron microscopy (TEM) to count the number of the mitochondria in each sample in an area of 4 000 mm2 of the axon under the same amplification. Results　Under light microscopy, at the myotendinous junction of the extraocular muscle, the EMP nerve fibers were ended at the initial site or the bilateral sides of a nearby single extrafusal fiber. Under electron microscopy, the general architecture of the receptors in concomitant strabismus was completely disorganized. The nerve component in them had disappeared. The number of the mitochondria in 4 000 mm2 of the axon in the experimental group was significantly lower than that in the control group (P<0.05). Conclusion　The results indicate that in concomitant strabismus, the reception and transmission of proprioceptive information are abnormal, and the morphological EMP disturbance plays an important role in the pathogenesis of concomitant strabismus.