超声乳化术对伴有糖尿病或高血压的白内障患者角膜内皮细胞的影响

摘要

目的：观察白内障超声乳化手术对伴有糖尿病或高血压的白内障患者角膜内皮细胞的影响。　　方法：采用临床病例对照研究，将白内障超声乳化手术患者104例174眼分为三组：单纯老年性白内障组（对照组）、老年性白内障伴发糖尿病组（糖尿病组）及老年性白内障伴发高血压组（高血压组），观察超声乳化术前、术后1 wk；1 mo角膜内皮细胞密度、六角形细胞比例、细胞变异系数等各参数的变化，采用SPSS 13．0统计学软件对数据进行统计学分析。　　结果：术前，与对照组相比，糖尿病组及高血压组角膜内皮细胞密度降低，六角形细胞比例下降，细胞变异系数增加，其中糖尿病组变异系数和六角形细胞比例变化与对照组间数据差异有统计学意义（均P＜0．05），高血压组六角形细胞比例变化与对照组间数据差异有统计学意义（P＜0.05）；术后，各组术后1 wk和1 mo角膜内皮细胞密度及六角形细胞比例均较术前明显下降，变异系数均较术前增大，差异均有显著性意义（均P＜0．01）。其中糖尿病组与对照组内皮细胞密度间差异具有统计学意义（P＜0．05），六角形细胞比例及变异系数间数据具有显著性差异（均P＜0.01）。高血压组与对照组六角形细胞比例和变异系数间数据均有显著性差异（均P＜0．01）。　　结论：白内障超声乳化术对角膜内皮细胞具有一定的损伤性，伴有高血压或糖尿病的白内障患者角膜内皮细胞更易受到损伤。对超声乳化术后产生的损伤也更为敏感。%AIM: To observe the influence of cataract phacoemulsification on corneal endothelial cell of cataract patients combined with diabetes or hypertension. METHODS: Clinical case -control study was used. Totally 104 cases (174 eyes) of patients who underwent phacoemulsification were divided into three groups:senile cataract patients, diabetes mellitus cataract patients and hypertension cataract patients. The changes of endothelial cell density ( CD ) , percentage of regular hexagonal cells ( 6A ), coefficient of variation ( CV ) between pre-operation and post-operation at 1wk, 1mo were compared.The data were analyzed statistically by means of SPSS 13.0 software. RESULTS: Pre-operative results: the percentage of CD and 6A cell were decreased and CV was increased in diabetes and hypertension group compared with control group.There were statistical differences in 6A and CV in diabetes group ( P <0.05 ). There were statistical differences in 6A in hypertension group (P<0.05).Post-operative results: the percentage of CD and 6A were decreased, and CV was increased after operation of 1wk and 1mo. There were significant differences in three groups ( P<0.01 ).CD had statistical differences ( P<0.05), CV and 6A had significant differences (P<0.01) between diabetes group and control group.6A and CV had significant differences ( P <0. 01 ) between hypertension group and control group. CONCLUSION:Cataract phacoemulsification has certain injury on corneal endothelial cell. Cataract patients combined with diabetes or hypertension are easier to be damaged than that of senile cataract in the phacoemulsification. They are more sensitive after surgery.