急性闭角型青光眼患者角膜内皮细胞形态学研究

目的：探讨急性闭角型青光眼(acute angle-closure glaucoma,AACG)患者角膜内皮细胞形态计量学变化，并分析影响角膜内皮细胞形态改变的相关因素。方法：选择单眼发病AACG患者27例54只眼，根据病情分为两组，以发作眼（27只眼）为实验组,未发作眼（27只眼）为对照组。将实验组按发作时最高眼压分为A1组(＜60mmHg)、B1组(≥60mmHg)；按病程分为A2组（＜7d）与B2组（≥7d）。所有患者均应用非接触型角膜内皮显微镜观察和测量角膜内皮细胞密度、六角形细胞的百分数、平均细胞面积等各项指标。对各组角膜内皮细胞各项测量指标行统计学分析。结果：实验组与对照组相比，实验组内皮细胞密度、六角形细胞的百分数均显著减小（P＜0.01），而平均细胞面积等指标显著增大（P＜0.01）。A1组与B1组、A2组与B2组相比内皮细胞密度、平均细胞面积等指标差异均有统计学意义（P＜0.05）。结论：AACG患者发作眼角膜内皮细胞密度明显下降，细胞多形性改变增加。角膜内皮细胞形态计量学改变与病程和眼压有显著相关。

A morphometric study of corneal endothelium in acute angle-closure glaucoma

Objective： To study the quantitative morphometric changes of the corneal endothelial cells in acute angle-closure glaucoma and its related factors． Methods: A total of 27 patients (54 eyes) with acute angle-closure glaucoma were divided into two groups based on the pathogenetic condition: the control group (eyes in pre-clinical stage, n=27) and the experimental group (eyes in the acute attack stage, n=27). The experimental group was subdivided into two groups based on the intraocular pressure: the A1 group (＜60mmHg) and the B1 group (≥60mmHg), and another two groups based on the course of the disease: the A2 group (＜7days) and the B2 group (≥7days). Cell density, percentage of hexagonal cells, and average cellular area of the corneal endothelium were determined by a non-contact specular microscope and a computer-aid image analysis system. The statistical significance of the above indexes was determined between the two groups. Results: Compared with the control group， cell density and percentage of hexagonal cells (P＜0.01) were significantly decreased in the experimental group but the average cellular area was significantly increased (P＜0.01). There were significant group and the B2 group (P＜0.05). Conclusions: Cell density is significantly decreased but cell pantomorphia is increased in eyes of the acute attack stage. The quantitative morphometric changes of the corneal endothelial cells significantly relate to the intraocular pressure with the course of the disease.