正常中国汉族儿童角膜的共焦显微镜研究

目的采用角膜激光共焦显微镜对正常中国汉族儿童活体角膜各层组织结构进行观察,分析正常中国汉族儿童角膜各层细胞的活体细胞形态学特征及密度。方法 49例6～13岁正常中国汉族儿童中央部角膜进行活体共焦显微镜检查,研究角膜各层结构的图象特点,并分析角膜各层细胞的密度,与成年人进行对比。结果中国汉族儿童正常角膜上皮表层细胞排列疏松,边界清楚,胞体较大,核反光较强,又称翼状细胞;基底层细胞排列紧密,呈规则的蜂巢状,胞质反光弱,正常情况下未见细胞核,细胞平均密度为5947.58±769.3个/mm2。前弹力膜为无细胞结构的膜状物,可见串珠状的神经纤维走行。基质层中可见在相对较暗的背景下明亮的角膜基质细胞核。角膜基质内有神经纤维分布。前基质层角膜细胞平均密度为1621.12±123.26个/mm2,后基质层角膜细胞平均密度为984.71±113.17个/mm2,前后基质层细胞密度有显著性差别（P〈0.05）。后弹力层中无细胞结构,为均一无结构组织。内皮细胞层表现为规则的六边形结构,细胞结构清晰,细胞平均密度为3682.38±251.87个/mm2。左右眼及男女之间角膜各层细胞密度的差异无统计学意义（P=0.341～0.611和P=0.194～0.855）。各层角膜细胞的面积和密度与性别和眼别无差异。中国汉族儿童角膜各层细胞的密度较正常成人高。结论角膜激光共焦显微镜能够在实时、活体和三维空间从细胞水平清晰观察中国汉族儿童活体角膜各层细胞的形态结构,可以对角膜各层结构进行定性和定量分析,在儿童角膜病的研究和临床诊断方面是十分有用的工具。

In vivo laser confocal microscopy of normal corneas of chinese Han children

Objective To study cellular morphology and density of the normal corneas of chinese Han children by laser confocal microscopy in vivo.Methods 98 corneas of 48 chinese Han children were examined by laser confocal microscopy in vivo.Images were recorded by continuously focusing the optical section through the full thickness central cornea.The images were analyzed visually for morphology of corneas and the densities of cells were countered by Heidelberg Tomograph II Cornea Module.The statistical study were analyzed by SPSS 10.0 soft package.The data were compared with adults.Results The borders of the surface epithelial cells were readily seen,as were the bright cell nuclei.Basal epithelial cells were separated by light cell boundaries with less bright reflection of cytoplasm and nuclei.The basal epithelial cell density was 5947.58±769.3 cells/mm2.The Bowman＇s layer appeared as an amorphous membrane and could be distinguished by the fine-beaded nerve plexus immediately associated with the basal cells.In the corneal stroma,only keratocyte muclei were visible against a darker background.The average apparent keratocyte density was 1621.12±123.26 cells/mm2 in anterior stroma.and 984.71± 113.17 cells/mm2 in the posterior stroma.The difference in apparent keratocyte density between the anterior and the posterior stroma was statistically significant（P0.05）.The mosaic of the regular hexagonal endothelial cells was seen.The average endothelial cell density was 3682.38±251.87 cells/mm2.The cell density of different layer cornea of Han children was higher than that of Chinese adults.Conclusions In vivo Laser confocal miscrocopy can offer qualitative and quantitative analysis in real-time and 3D condition to all layers of cornea of Chinese Han children.There is clinical value in early diagnosis and treatment and the study of pathological morphology of children＇s cornea.