代谢综合征对角膜内皮细胞形态学影响的临床研究

发布时间：2018-06-07 10:04

本文选题：角膜 + 内皮细胞　；参考：《中华眼科医学杂志(电子版)》2016年02期

【摘要】：目的探讨代谢综合征(MS)对角膜内皮细胞形态学的影响。方法收集2015年3月至2015年10月期间在重庆医科大学附属第二医院内分泌科住院的患者124例(229只眼)进行研究。对全部患者进行腹围、血脂、血压及血糖检测,并根据上述检测结果进行判别和分组,共分为糖尿病组、高血压组、血脂异常组、代谢综合征组及对照组等五组。用非接触式角膜内皮镜对全部患者进行角膜内皮形态学检查。正态分布检验采用单样本Kolmogorov-Smirnov检验,角膜内皮细胞的平均密度(ECD)、细胞变异系数(ECCV)及六角形细胞比例(H%))等三项参数经检验均呈正态分布,采用均数±标准差表示,组间数据方差齐性采用Levene检验,多组间均数的比较采用方差分析,当差异有统计学意义时,进一步采用LSD法进行两两比较;以P0.05为差异有统计学意义。结果全部患者共分为五组,分别为糖尿病组,血糖异常包括腹围偏高患者共18只眼,年龄(64.2±10.2)岁;高血压组,血压包括腹围偏高患者共26只眼,年龄(67.0±11.9)岁;血脂异常组:两项血脂任何一项异常包括腹围偏高共57只眼,年龄(67.9±10.9)岁;代谢综合征组,五项指标均异常共78只眼,年龄(66.0±11.1)岁;对照组,五项指标均正常共50只眼,平均年龄(69.0±10.6)岁。所有组间比较发现年龄差异无统计学意义(F=0.96,P0.05),性别差异亦无统计学意义(χ~2=0.68,P0.05),糖尿病组、高血压组及血脂异常组与对照组间的腹围差异亦无统计学意义(F=0.87,P0.05)。对照组、糖尿病组、高血压组、血脂异常组及代谢综合征组ECD分别为(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,经方差分析,差异有统计学意义(F=2.12,P0.05),进一步两两比较,糖尿病组较对照组降低,差异有统计学意义(t=3.17,P0.05)。各组ECCV分别为(33.4±3.8)、(35.5±4.5)、(38.2±5.6)、(36.7±6.1)及(38.7±7.3),经方差分析,差异有统计学意义(F=3.48,P0.05),进一步两两比较,高血压组、血脂异常组和代谢综合组较对照组升高,差异有统计学意义(t=3.82,2.42,4.61;P0.05)。各组H%分别为(58.0±7.2)%、(55.4±10.0)%、(53.2±9.9)%、(54.1±9.6)%和(51.0±10.5)%,经方差分析,差异有统计学意义(F=4.31,P0.05),进一步两两比较,糖尿病组、高血压组、血脂异常组及代谢综合组较对照组升高,差异有统计学意义(t=2.36,2.81,2.48,4.13;P0.05)。结论 MS中的异常指标(如血脂、血压及血糖)对角膜内皮层结构均有不同程度的影响。且随着其异常程度的增加,对角膜内皮层结构的影响更显著。
[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 卤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 卤10.2) years old, hypertension group (26 eyes) with high blood pressure including abdominal circumference (67.0 卤11.9) years old. In the dyslipidemia group, 57 eyes (67.9 卤10.9) years old with high abdominal circumference, 78 eyes with abnormal five indexes (66.0 卤11.1) years old in the metabolic syndrome group, 50 eyes in the control group were normal. The average age was 69.0 卤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 卤277.0 cells / s / mmm / mmm respectively, 2384.7 卤449.5 / s / mm / s respectively, and 2642.3 卤370.3cells / s / r 2642.8 270.6)cells/mm~2 and 2664.8 卤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 卤3.8m (35.5 卤4.5) and 38.2 卤5.6m (36.7 卤6.1) and 38.7 卤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 卤9.9%, 54.1 卤9.6% and 51.0 卤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.
【作者单位】：重庆医科大学附属第二医院眼科;
【基金】：重庆市科委基金项目(No.cstc2013jcyj A10074)
【分类号】：R589;R772.2

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