發(fā)布時間：2018-06-07 10:04

  本文選題：角膜 + 內皮細胞��； 參考：《中華眼科醫(yī)學雜志(電子版)》2016年02期

【摘要】：目的探討代謝綜合征(MS)對角膜內皮細胞形態(tài)學的影響。方法收集2015年3月至2015年10月期間在重慶醫(yī)科大學附屬第二醫(yī)院內分泌科住院的患者124例(229只眼)進行研究。對全部患者進行腹圍、血脂、血壓及血糖檢測,并根據上述檢測結果進行判別和分組,共分為糖尿病組、高血壓組、血脂異常組、代謝綜合征組及對照組等五組。用非接觸式角膜內皮鏡對全部患者進行角膜內皮形態(tài)學檢查。正態(tài)分布檢驗采用單樣本Kolmogorov-Smirnov檢驗,角膜內皮細胞的平均密度(ECD)、細胞變異系數(ECCV)及六角形細胞比例(H%))等三項參數經檢驗均呈正態(tài)分布,采用均數±標準差表示,組間數據方差齊性采用Levene檢驗,多組間均數的比較采用方差分析,當差異有統(tǒng)計學意義時,進一步采用LSD法進行兩兩比較;以P0.05為差異有統(tǒng)計學意義。結果全部患者共分為五組,分別為糖尿病組,血糖異常包括腹圍偏高患者共18只眼,年齡(64.2±10.2)歲;高血壓組,血壓包括腹圍偏高患者共26只眼,年齡(67.0±11.9)歲;血脂異常組:兩項血脂任何一項異常包括腹圍偏高共57只眼,年齡(67.9±10.9)歲;代謝綜合征組,五項指標均異常共78只眼,年齡(66.0±11.1)歲;對照組,五項指標均正常共50只眼,平均年齡(69.0±10.6)歲。所有組間比較發(fā)現年齡差異無統(tǒng)計學意義(F=0.96,P0.05),性別差異亦無統(tǒng)計學意義(χ~2=0.68,P0.05),糖尿病組、高血壓組及血脂異常組與對照組間的腹圍差異亦無統(tǒng)計學意義(F=0.87,P0.05)。對照組、糖尿病組、高血壓組、血脂異常組及代謝綜合征組ECD分別為(2767.7±277.0)cells/mm~2、(2384.7±449.5)cells/mm~2、(2642.3±370.3)cells/mm~2、(2642.8±270.6)cells/mm~2及(2664.8±371.3)cells/mm~2,經方差分析,差異有統(tǒng)計學意義(F=2.12,P0.05),進一步兩兩比較,糖尿病組較對照組降低,差異有統(tǒng)計學意義(t=3.17,P0.05)。各組ECCV分別為(33.4±3.8)、(35.5±4.5)、(38.2±5.6)、(36.7±6.1)及(38.7±7.3),經方差分析,差異有統(tǒng)計學意義(F=3.48,P0.05),進一步兩兩比較,高血壓組、血脂異常組和代謝綜合組較對照組升高,差異有統(tǒng)計學意義(t=3.82,2.42,4.61;P0.05)。各組H%分別為(58.0±7.2)%、(55.4±10.0)%、(53.2±9.9)%、(54.1±9.6)%和(51.0±10.5)%,經方差分析,差異有統(tǒng)計學意義(F=4.31,P0.05),進一步兩兩比較,糖尿病組、高血壓組、血脂異常組及代謝綜合組較對照組升高,差異有統(tǒng)計學意義(t=2.36,2.81,2.48,4.13;P0.05)。結論 MS中的異常指標(如血脂、血壓及血糖)對角膜內皮層結構均有不同程度的影響。且隨著其異常程度的增加,對角膜內皮層結構的影響更顯著。
[Abstract]:Objective to investigate the effect of metabolic syndrome (MS) on corneal endothelial cell morphology. Methods from March 2015 to October 2015, 124 patients (229 eyes) in the Endocrinology Department of the second affiliated Hospital of Chongqing Medical University were studied. Abdominal circumference, blood lipids, blood pressure and blood glucose were measured. According to the above results, the patients were divided into five groups: diabetic group, hypertension group, dyslipidemia group, metabolic syndrome group and control group. All the patients were examined with non-contact keratoendothelium. The normal distribution was tested by single sample Kolmogorov-Smirnov test. The average density of corneal endothelial cells, the coefficient of variation (Kolmogorov-Smirnov) and the ratio of hexagonal cells were all normal distribution, expressed by mean 鹵standard deviation. Levene test was used to test the homogeneity of data variance among groups, and the analysis of variance was used to compare the mean of multi-group data. When the difference was statistically significant, the LSD method was further used to carry out the pairwise comparison. Results all the patients were divided into five groups: diabetes mellitus group (18 eyes) with abnormal blood glucose including high abdominal circumference (64.2 鹵10.2) years old, hypertension group (26 eyes) with high blood pressure including abdominal circumference (67.0 鹵11.9) years old. In the dyslipidemia group, 57 eyes (67.9 鹵10.9) years old with high abdominal circumference, 78 eyes with abnormal five indexes (66.0 鹵11.1) years old in the metabolic syndrome group, 50 eyes in the control group were normal. The average age was 69.0 鹵10.6 years old. There was no significant difference in age and sex (蠂 2 / 0.68 / P 0.05). There was no significant difference in abdominal circumference between hypertension and hyperlipidemia group and control group (蠂 ~ (2 / 2) 0.68 / P _ (0.05), and there was no significant difference in abdominal circumference between hypertension and hyperlipidemia group and control group (P _ (0.05). The ECD of control group, diabetic group, hypertension group, dyslipidemia group and metabolic syndrome group were 2767.7 鹵277.0 cells / s / mmm / mmm respectively, 2384.7 鹵449.5 / s / mm / s respectively, and 2642.3 鹵370.3cells / s / r 2642.8 270.6)cells/mm~2 and 2664.8 鹵371.3cell / s / mmm-2 / 2 respectively. The difference was statistically significant by ANOVA, and there was a significant difference between the diabetic group and the control group (t 3.17 / P 0.05). The ECCV of each group was 33.4 鹵3.8m (35.5 鹵4.5) and 38.2 鹵5.6m (36.7 鹵6.1) and 38.7 鹵7.3 (respectively). The variance analysis showed that the difference was statistically significant (P 0.05). In the hypertension group, the hyperlipidemia group and the metabolic complex group were higher than those in the control group, and the difference was statistically significant. 53.2 鹵9.9%, 54.1 鹵9.6% and 51.0 鹵10.5%, respectively. The difference was statistically significant by ANOVA. Further comparison, diabetes mellitus group, hypertension group, dyslipidemia group and metabolic complex group were higher than those in control group, and the difference was statistically significant (t 2.32.81m2.84.13) P 0.050.The difference was significant (P < 0.05), and there was significant difference between the diabetes mellitus group, the hypertension group, the dyslipidemia group and the metabolic complex group (t 2.32.81.2.484.13) P 0.050.The difference was significant between the diabetic group, the hypertension group, the dyslipidemia group and the control group, and the difference between the two groups was statistically significant. Conclusion abnormal parameters in MS, such as blood lipid, blood pressure and blood glucose, have different effects on corneal endothelium structure. With the increase of abnormal degree, the structure of corneal endothelium was affected more significantly.
【作者單位】： 重慶醫(yī)科大學附屬第二醫(yī)院眼科;
【基金】：重慶市科委基金項目(No.cstc2013jcyj A10074)
【分類號】：R589;R772.2

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