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翼状胬肉临床评估指标与其眼表改变相关性分析

时间:2006-11-26栏目:基础医学论文

  翼状胬肉临床评估指标与其眼表改变相关性分析
  
  赖兆光 黄丹平 宋亦悦 许诺
  
  【摘要】  【目的】 探讨原发性翼状胬肉大小?透明性等常用临床评估指标,分析其与翼状胬肉眼表损害的相关性?【方法】 随机选取于2010年5-7月,在中山眼科中心门诊就诊的初发的原发性翼状胬肉患者55例(71眼),其中男性26例(32眼),女性29例(39眼);记录翼状胬肉的大小(mm2)?生长时间(年)? 透明性(T1 —— 3级)?行结膜印记细胞学检查,记录翼状胬肉患者的结膜杯状细胞计数(个/视野)及上皮形态改变级别(0 —— 3级),计算各临床评估指标与结膜印记细胞学检查结果的相关系数?【结果】 55例患者的翼状胬肉大小为12.25 —— 29.75 mm2,平均(20 ± 4)mm2;胬肉生长时间3 —— 13年,平均(8 ± 3)年;胬肉透明性T1级4只眼,T2级37只眼,T3级30只眼;杯状细胞密度计数24.57 —— 55.80个/视野,平均(40 ± 8)个/视野;结膜上皮细胞形态0级14只眼,1级29只眼,2级28只眼分别计算各临床评估指标与翼状胬肉患者眼表损害程度的相关系数结果显示:翼状胬肉大小与结膜杯状细胞计数及上皮形态分级均未呈现相关性(r = -0.006, 0.129; P > 0.05);翼状胬肉透明性与杯状细胞计数及上皮形态改变呈现有相关性(r = -0.706, 0.782;P < 0.01);翼状胬肉生长时间与杯状细胞计数及上皮形态改变无统计学意义的相关性(r = -0.176, 0.119;P > 0.05)?【结论】 翼状胬肉透明性与其眼表损害呈现相关性,透明性越差,患者的眼表损害程度越大?可通过观察翼状胬肉的透明性,估计患者的眼表损害情况?
  
  【关键词】  翼状胬肉 ; 杯状细胞 ; 印记细胞学
  
  Abstract: 【Objective】To investigate the correlations between clinical characteristics of pterygium and the ocular surface changes in the patients with pterygium, and to determine indicators of the ocular surface damage. 【Method】 Fifty-five primary pterygium patients were randomly selected from the Zhongshan Ophthalmic Center clinic department in May 2010 to July 2010. The sizes of pterygium (mm2), duration of pterygium (year), and pterygium transparency grades (T1 —— 3) were recorded in these 55 patients (71 eyes) with primary pterygium, including 26 males (32 eyes) and 29 females (39 eyes)。 Conjunctival impression cytology were performed for observing the density of conjunctival goblet cells (cells/high-power [HP] visual field with 400×) and the grades of conjunctival epithelium (grade 0 —— 3)。 The correlation coefficient of pterygium clinical characteristics and conjunctival cytology changes was analyzed.【Results】 In all 71 eyes, the mean sizes of pterygium were (20±4) mm2 (ranging from 12.25 to 29.75) mm2; the mean durations of pterygium were (8 ± 3) years (ranging from 3 to 13) years. There were 4 eyes in (transparency grade 1) T1, 37 eyes in T2, and 30 eyes in T3 for pterygium transparency grade. The mean density of conjunctival goblet cells were 24.57——55.80/HP (ranging from 24.57 —— 55.80/HP)。 There were 14 eyes in the grade 0 of conjunctival epithelium, 29 eyes in the grade 1, and 28 eyes in grade 2. The transparency grade was significantly correlated with the number of conjunctival goblet cells and the Nelson's grade of conjunctival epithelium (r = -0.706, 0.782; P < 0.01)。 However, the size and the duration of pterygium had no correlation with the number of conjunctival goblet cells (r = -0.006,0.129;P> 0.05), and similar correlation at the grade of conjunctival epithelium (r = -0.176, 0.119; P> 0.05)。 【Conclusion】 The transparency of pterygium have significantly correlation to pterygium ocular surface damage. The worse transparency of pterygium have the worse degree of ocular surface damage. These ndings suggest that we can easily assess the ocular surface damage in patients with pterygium by observing the transparency of pterygium.
  
  Key word: pterygium; goblet cells; impression cytology
  
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