内直肌肌卫星细胞数量在共同性外斜视发病中的作用

目的观察共同性外斜视内直肌中M-钙黏蛋白标记的肌卫星细胞数量,探讨共同性外斜视的发病机制。设计病例对照研究。研究对象青岛大学医学院附属医院的共同性外斜视患者（18眼）的内直肌组织,健康眼（14眼）角膜移植供体内直肌。方法内直肌组织行组织病理学观察。横轴切片,行HE和M-钙黏蛋白（M-cadherin）免疫组化染色,双盲对照定量分析,分析肌卫星细胞数与病程、手术年龄以及肌细胞数的关系。主要指标斜视眼与健康眼内直肌横切面肌细胞数;M-cadherin表达阳性的肌卫星细胞数。结果斜视组内直肌横切面肌细胞数（120.50±57.26个/视野）显著低于正常组（180.36±8.78个/视野）（P=0.000）,与病程显著负相关（r=-0.919,P=0.000）;斜视组M-cadherin表达阳性的肌卫星细胞数（8.25±5.85个/5个视野）显著低于正常组（42.50±5.12个/5个视野）（P=0.000）,并和肌细胞数显著相关（r=0.849,P=0.000）;间歇性外斜视组M-cadherin表达阳性的肌卫星细胞数显著多于恒定性外斜视组（P=0.000）;M-cadherin表达阳性的肌卫星细胞数与病程（r=-0.648,P=0.005）、手术年龄（r=-0.600,P=0.01）显著负相关。结论共同性外斜视患者的内直肌进行性萎缩可能与其肌卫星细胞不足有关。

The role of musde satellite cells in the medial rectus on the mechanism of concomitant exotropia

Objective To evaluate the quantity of muscle satellite cells in medial rectus of the patients with concomitant exotropia.Design Case-control study.Participants 18 pieces of medial rectus from the patients with concomitant exotropia and 14 pieces of healthy medial rectus collected from corneal transplant doners.Methods Histopathological observation was performed after the samples were sliced along axis of abscissa and stained by HE and M-cadherin immunohistochemistry.Positive results was analyzed quantitively according to double-blind comparision,then the relashionships between the number of muscle satellite cells and duration of diseases,operation age,or quantity of muscle cells.Main Outcome Measures The amount of muscle cells on transection of medial rectus in strabismus group and nomal group;the amount of muscle satellite cells.Results The amounts of muscle cells on transection of medial rectus in strabismus group（120.50±57.26） were significantly lower than in normal medial rectus（180.36±8.78）（P=0.000） and significantly correlated negatively with duration of disease（r=-0.919,P=0.000）.The amount of muscle statellite cells in medial rectus in strabismus group（8.25±5.85） were significantly lower than in normal group（42.50±5.12）（P=0.000） and significantly correlated with the amounts of muscle cells（r=0.849,P=0.000）.The amount of muscle satellite cells was significantly correlated inversely with duration of disease（r=-0.648,P=0.005） and their ages being operated（r=-0.600,P=0.01）.The amount of muscle statellite cells on medial rectus from intermittent exotropia patients was much more than that from stable exotropia ones（P=0.000）.Conclusion Progressive atrophy of medial rectus in concomitant exotropia may be relevant to deficiency of the muscle satellite cells.