CAJ | 학술논문

目的观察糖尿病性视网膜病变(DR)患者角膜细胞密度及形态的变化.方法选用以激光为光源的眼科用HRT-Ⅲ共焦显微镜对55例(110只眼)DR患者(DR组)和20例(40只眼)无糖尿病的老年性白内障患者(对照组)的中央角膜进行观察,依据国际DR分期标准,充分散瞳眼底检查将DR组患者分为五组:DR-1期(1组)、DR-2期(2组)、DR-3期(3组)、DR-4期(4组)、DR-5期(5组),记录角膜上皮基底层、基质层及内皮层细胞的图像,并对DR组与对照组及DR组之间的结果进行比较、分析.结果共焦显微镜下可以观察到DR组与对照组以及DR组各组之间角膜各层细胞的变化,结果显示,DR各组与对照组相比,角膜上皮基底细胞、浅基质细胞、中基质细胞、深基质细胞以及内皮细胞的密度均有变化,内皮细胞变异率(CV)以及内皮细胞中六边形细胞比率(Hexagonality)差异有统计学意义(P ＜0.05); DR各组之间相比,角膜基底细胞密度除4组与5组之间(P =0.081)差异没有统计学意义外,其余各组间比较差异均有统计学意义.浅基质细胞密度各组间相比,差异有统计学意义并呈递减趋势.中基质细胞密度各组间相比差异有统计学意义并呈递减趋势.深基质细胞密度各组间除2组与3组之间(P =0.086)差异没有统计意义外,其余各组间比较均有显著差异呈递减趋势.内皮细胞密度除2组与3组(P =0.595)、4组与5组之间(P =0.638)差异没有统计意义外,其余各组间比较差异均有统计学意义.内皮细胞变异率除3组与4组之间(P--0.273)差异没有统计意义外,其余各组间比较差异均有统计学意义.内皮细胞中六边形细胞比率各组间比较差异均有统计学意义.结论共聚焦显微镜能够对活体角膜组织进行无创、实时动态和四维(三维加时间)观察,DR患者角膜各层细胞密度、内皮细胞变异率及内皮细胞六边形细胞比率均有变化.
목적 관찰당뇨병성시망막병변(DR)환자각막세포밀도급형태적변화.방법 선용이격광위광원적안과용HRT-Ⅲ공초현미경대55례(110지안)DR환자(DR조)화20례(40지안)무당뇨병적노년성백내장환자(대조조)적중앙각막진행관찰,의거국제DR분기표준,충분산동안저검사장DR조환자분위오조:DR-1기(1조)、DR-2기(2조)、DR-3기(3조)、DR-4기(4조)、DR-5기(5조),기록각막상피기저층、기질층급내피층세포적도상,병대DR조여대조조급DR조지간적결과진행비교、분석.결과 공초현미경하가이관찰도DR조여대조조이급DR조각조지간각막각층세포적변화,결과현시,DR각조여대조조상비,각막상피기저세포、천기질세포、중기질세포、심기질세포이급내피세포적밀도균유변화,내피세포변이솔(CV)이급내피세포중륙변형세포비솔(Hexagonality)차이유통계학의의(P ＜0.05); DR각조지간상비,각막기저세포밀도제4조여5조지간(P =0.081)차이몰유통계학의의외,기여각조간비교차이균유통계학의의.천기질세포밀도각조간상비,차이유통계학의의병정체감추세.중기질세포밀도각조간상비차이유통계학의의병정체감추세.심기질세포밀도각조간제2조여3조지간(P =0.086)차이몰유통계의의외,기여각조간비교균유현저차이정체감추세.내피세포밀도제2조여3조(P =0.595)、4조여5조지간(P =0.638)차이몰유통계의의외,기여각조간비교차이균유통계학의의.내피세포변이솔제3조여4조지간(P--0.273)차이몰유통계의의외,기여각조간비교차이균유통계학의의.내피세포중륙변형세포비솔각조간비교차이균유통계학의의.결론 공취초현미경능구대활체각막조직진행무창、실시동태화사유(삼유가시간)관찰,DR환자각막각층세포밀도、내피세포변이솔급내피세포륙변형세포비솔균유변화.
Objective To observe the corneal cell density and morphological changes in patients with diabetic retinopathy.Methods A total of 110 eyes (55 patients) with DR were enrolled in the study group and 40 eyes of 20 matched patients with age-related cataract and without diabetes mellitus as the control group,the study group was divided into five sub-groups according to the International Clinical Diabetic Retinopathy Scale:DR-1 (group 1),DR-2 (group 2),DR-3 (group 3),DR-4 (group 4),DR-5 (group 5).The mean corneal cell density and morphology were evaluated and statistical analyzed.Results The changes in the corneal cell density and morphology between the study group and the control group and the difference in the DR groups were observed with confocal microscopy.The decreased density of corneal basal epithelium,stromal cell and endothelial cell were observed,compared with the control group,the same result with the coefficient of variation (CV) and the percentage of Hexagonal cells (Hexagonality) of the endothelial cell.The difference between the DR groups:the difference of the density of the corneal basal epithelium was statistically significant except the group 4 and 5,the anterior and the mid-stromal cell density was statistically significant,the posterior stromal cell density was statistically significant except the group 2 and 3,the density of the endothelium cell was statistically significant except the group 2 and 3 and the group 4 and 5,the CV was statistically significant except the group 3 and 4 and the Hexagonality was statistically significant.Conclusions Corneal confocal microscopy is a growing technique for the study of the cornea at the cellular level,providing images comparable to ex vivo histochemical methods,the study show the changes in the corneal cell density and morphology in patients with diabetic retinopathy.