中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2009年
4期
344-349
,共6页
朱文卿%徐建江%孙兴怀%郑天玉%乐琦骅
硃文卿%徐建江%孫興懷%鄭天玉%樂琦驊
주문경%서건강%손흥부%정천옥%악기화
显微镜检查,共焦%结膜%上皮细胞%杯状细胞%树突细胞
顯微鏡檢查,共焦%結膜%上皮細胞%杯狀細胞%樹突細胞
현미경검사,공초%결막%상피세포%배상세포%수돌세포
Microscopy,confocal%Conjunctiva%Epithelial cells%Goblet cells%Dendritic cells
目的 探讨应用活体激光共焦显微镜观察正常人球结膜的组织结构.方法 横断而研究.2008年2月至7月选择50名无眼部外伤、感染及配戴接触镜史,且裂隙灯显微镜检查无异常的正常人的50只眼作为研究对象.使用激光共焦显微镜对其上方、下方、鼻侧及颞侧球结膜进行检查,各层图像均被记录,分析球结膜各层形态,并对上皮细胞、杯状细胞及树突状细胞密度进行计数.运用单因素方差分析对各层上皮细胞密度和各方位杯状细胞密度进行统计学分析,运用最小显著性差异分析组间差异.结果 球结膜上皮浅表层细胞体积较大,排列松散,胞核呈低反光,细胞平均密度为(1643±206)个/mm2.中间层细胞呈卵圆形,体积较小,排列紧密,胞核呈点状高反光,细胞平均密度为(4693±228)个/mm2.基底层细胞呈多边形,排列规整,有清晰而高亮的细胞边界,细胞平均密度为(4420±230)个/mm2.经统计学分析3种上皮细胞密度存在显著件差异(F=1160.312,P=0.000).类似杯状细胞的细胞呈圆形,胞体较大,胞内充满透亮颗粒,成团或散在分布,细胞的平均密度为(432±72)个/mm2.树突状细胞呈高反光颗粒,伴树枝状突起,分散于结膜各层,细胞的平均密度为(22±25)个/mm2.在结膜上皮与固有层之间,存在一层致密的高反光的基底膜.球结膜固有层由高度血管化的疏松结缔组织组成,可见大量小规则的条状纤维或大片的网状纤维,弥散分布小圆周高亮的游走细胞,还可清晰观察到血管中血液的流动.结论 活体激光共焦显微镜是研究球结膜组织结构的一种有效上具,为眼表疾病的临床诊断提供了快速而无创的检查手段.
目的 探討應用活體激光共焦顯微鏡觀察正常人毬結膜的組織結構.方法 橫斷而研究.2008年2月至7月選擇50名無眼部外傷、感染及配戴接觸鏡史,且裂隙燈顯微鏡檢查無異常的正常人的50隻眼作為研究對象.使用激光共焦顯微鏡對其上方、下方、鼻側及顳側毬結膜進行檢查,各層圖像均被記錄,分析毬結膜各層形態,併對上皮細胞、杯狀細胞及樹突狀細胞密度進行計數.運用單因素方差分析對各層上皮細胞密度和各方位杯狀細胞密度進行統計學分析,運用最小顯著性差異分析組間差異.結果 毬結膜上皮淺錶層細胞體積較大,排列鬆散,胞覈呈低反光,細胞平均密度為(1643±206)箇/mm2.中間層細胞呈卵圓形,體積較小,排列緊密,胞覈呈點狀高反光,細胞平均密度為(4693±228)箇/mm2.基底層細胞呈多邊形,排列規整,有清晰而高亮的細胞邊界,細胞平均密度為(4420±230)箇/mm2.經統計學分析3種上皮細胞密度存在顯著件差異(F=1160.312,P=0.000).類似杯狀細胞的細胞呈圓形,胞體較大,胞內充滿透亮顆粒,成糰或散在分佈,細胞的平均密度為(432±72)箇/mm2.樹突狀細胞呈高反光顆粒,伴樹枝狀突起,分散于結膜各層,細胞的平均密度為(22±25)箇/mm2.在結膜上皮與固有層之間,存在一層緻密的高反光的基底膜.毬結膜固有層由高度血管化的疏鬆結締組織組成,可見大量小規則的條狀纖維或大片的網狀纖維,瀰散分佈小圓週高亮的遊走細胞,還可清晰觀察到血管中血液的流動.結論 活體激光共焦顯微鏡是研究毬結膜組織結構的一種有效上具,為眼錶疾病的臨床診斷提供瞭快速而無創的檢查手段.
목적 탐토응용활체격광공초현미경관찰정상인구결막적조직결구.방법 횡단이연구.2008년2월지7월선택50명무안부외상、감염급배대접촉경사,차렬극등현미경검사무이상적정상인적50지안작위연구대상.사용격광공초현미경대기상방、하방、비측급섭측구결막진행검사,각층도상균피기록,분석구결막각층형태,병대상피세포、배상세포급수돌상세포밀도진행계수.운용단인소방차분석대각층상피세포밀도화각방위배상세포밀도진행통계학분석,운용최소현저성차이분석조간차이.결과 구결막상피천표층세포체적교대,배렬송산,포핵정저반광,세포평균밀도위(1643±206)개/mm2.중간층세포정란원형,체적교소,배렬긴밀,포핵정점상고반광,세포평균밀도위(4693±228)개/mm2.기저층세포정다변형,배렬규정,유청석이고량적세포변계,세포평균밀도위(4420±230)개/mm2.경통계학분석3충상피세포밀도존재현저건차이(F=1160.312,P=0.000).유사배상세포적세포정원형,포체교대,포내충만투량과립,성단혹산재분포,세포적평균밀도위(432±72)개/mm2.수돌상세포정고반광과립,반수지상돌기,분산우결막각층,세포적평균밀도위(22±25)개/mm2.재결막상피여고유층지간,존재일층치밀적고반광적기저막.구결막고유층유고도혈관화적소송결체조직조성,가견대량소규칙적조상섬유혹대편적망상섬유,미산분포소원주고량적유주세포,환가청석관찰도혈관중혈액적류동.결론 활체격광공초현미경시연구구결막조직결구적일충유효상구,위안표질병적림상진단제공료쾌속이무창적검사수단.
Objective To analyze the morphology of human bulbar conjunetiva by in vivo laser scanning confocal microscopy. Methods This research was a cross-sectional study. From February to July 2008, 50 eyes of 50 healthy subjects were enrolled in this study. They had no history of ocular trauma, infection or contact lens wear and had no found after routine slit-lamp examinations. In vivo laser scanning confocal microscopic examinations were performed on the superior, inferior, nasal and temporal bulbar conjunctiva and the images were recorded. The morphology of bulbar conjunctiva was analyzed and the density of epithelial cells, dendritic cells and goblet cells were calculated. One-way analysis of variance (ANOVA) was used to compare the means of epithelial cell densities in different layers and goblet cell densities in different positions. Subsequently the datum between two groups were analyzed by least significant difference (LSD). Results Superficial epithelial cells of bulbar conjunctiva were characterized as large loose-arranged cells with a hyporeflective nucleus. The mean density is (1643±206) cells /mm2.Intermediate epithelial cells were captured with features of oval small tight-arranged cells with a punctiform hyperrcflective nucleus. The mean density is (4693±228) cells/mm2. Basal epithelial cells appeared to be polygonal and regular-arranged within hyperreflocfive cell borders. The mean density is (4420±230) cells/mm2.There was a significant difference among three kinds of conjunctival epithelium (F = 1160.312,P =0.000). The presumed goblet cell was defined as a large hyperreflective oval-shaped cell with relatively homogeneous brightness, crowded in groups or mainly dispersed. The mean density is (432±72) cells /mm2. The dendritic cell appeared to be hyperreflective corpuscular particles with dendritic processes scattered among conjunctival epithelial cells. The mean density is (22±25) cells /mm2. The basement membrane, a prominent hyperreflective band, separated epithelial cells from subepithelial structure. Bulbar conjunctival substantia propria, beneath the basement membrane, was mainly composed of highly vascularized, loose connective tissues which were irregularly arranged fibers or a network of fibers, punctiform hyperreflective immune cells and sharp flows of blood vessels. Conclusion In vivo laser scanning confocal microscopy is a useful tool in the analysis of the bulbar conjunctival morphology, which provided a fast and noninvasive method for the diagnosis of ocular surface diseases.
