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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。
Objective To observe the histological structure of corneal layers in normal Han Chinese children using corneal laser confocal microscopy and to analyze the morphology and density of living cells in the corneal layers of normal Han Chinese children. Methods Forty-nine corneas from 6 to 13-year-old normal Han Chinese children were examined by live confocal microscopy. The image features of the corneal layers were studied. The density of the corneal layers was analyzed and compared with that of adults. Results The normal corneal epithelial cells in Chinese Han children arranged loosely with clear boundary, large cell body and strong nuclear reflex, also known as the wing cells. The basal cells arranged in a tight, regular beehive, cytoplasm reflex weak, under normal circumstances See the nucleus, the average cell density of 5947.58 ± 769.3 / mm2. The former stretch membrane is a cell-free membrane, showing beaded nerve fibers running. The stroma shows bright corneal stroma nuclei in a relatively dark background. There are nerve fibers in the corneal stroma. The average density of corneal cells in the anterior stroma was 1621.12 ± 123.26 / mm2, and the average density of corneal cells in the stroma was 984.71 ± 113.17 / mm2. There was a significant difference in the cell density between the anterior and posterior stromal layers (P <0.05). After the elastic layer of cell-free structure, uniform structure without organization. The endothelial cell layer showed a regular hexagonal structure with clear cell structure and an average cell density of 3682.38 ± 251.87 cells / mm2. There were no significant differences in the cell density between the left and right eyes and between the corneas (P = 0.341-0.611 and P = 0.194-0.855). The area and density of layers of corneal cells were not different from those of the sexes and eyes. The density of cells in Chinese Han children’s corneas is higher than that in normal adults. Conclusions Corneal laser confocal microscopy can clearly observe the morphological structure of the living corneal layers of Chinese Han children from the cell level in real time, living and three-dimensional space, and can qualitatively and quantitatively analyze the structure of corneal layers. In the research of children’s corneal disease and Clinical diagnosis is a very useful tool.