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目的：观察小梁切除术中应用丝裂霉素C（MMC）对角膜内皮细胞的影响。方法：收集2010 年9 月2011 年5 月在我院行小梁切除术的青光眼患者60 例（78 眼），随机分为术中应用丝裂霉素C 的36 例（46 眼）患者为A 组，术中不用丝裂霉素C 的24 例（32 眼）为B 组，分别观察术前、术后1 个月和术后3 个月两组眼压（IOP）、角膜内皮细胞的密度（CD）、平均细胞面积(AVG)及细胞面积变异系数(CV)，分析其数量的改变及两组间的差异。结果：A 组术前眼压为（35.4±13.7）mmHg，B 组术前眼压为（32.5± 13.5）mmHg 差异无统计学意义(P＞0．05)，A 组术后1 个月及术后3 个月眼压分别为（15.7±3.7）mmHg、（17.0 ±3.2）mmHg，均低于B 组的（19.4±3.7）mmHg、（20.2±2.1）mmHg，差异有统计学意义（P＜0.05）。A 组术前、术后1 个月及术后3 个月角膜内皮细胞密度分别为(2475±484)个／mm2、(2199±373)个／mm2、(2164±332)个／mm2；平均细胞面积分别为(431.4±67.6) μm2、 (480.6±66.8) μm2、(463.8±46.2) μm2 ；细胞面积变异系数分别为(31.1±7.4)%、(34.4±6.3)%、(31.2±7.5)%；术后1 个月及术后3 个月各参数与术前比较，差异均有统计学意义(P＜0．05)。B 组术前、术后1 个月及术后3 个月角膜内皮细胞密度分别为(2342± 94)个／mm2、(2185±215)个／mm2、(2074± 218)个／mm2；平均细胞面积分别为(453.9±94.8)μm2、(516.3± 100.8) μm2、(499.81± 106.4) μm2；细胞面积变异系数分别为(30.2± 3.0)%、(32.7±2.9)%、(31.4±4.3)%；除术后3 个月角膜内皮细胞与术前比较有意义 (P＜0.05)外，余参数术后1 个月及术后3 个月与术前比较差异均无统计学意义(P＞0.05)。术后1 个月A 组的角膜内皮细胞丢失率为10.4%高于B 组的6.1%，差异有统计学意义（P＜0.05）；术后3 个月A 组的角膜内皮细胞丢失率为11.1%高于B 组的 10.0%，差异无统计学意义(P＞0.05)。结论：小梁切除术中用丝裂霉素C 的降压效果比不用丝裂霉素C 的效果好，但短期内前者角膜内皮细胞的丢失率高于后者。

英文摘要:

Objective: To investigate the effect of mitomycin C on corneal endothelial cells in trabeculectomy. Methods: 60 patients (78 eyes) were diagnosed with glaucoma and operated trabeculectomy in our hospital from September 2010 to May 2011, they were collected and randomly divided into group A and group B. All cases had undergone test for intraocular pressure (IOP), corneal endothelial cell density（CD）, average cell area(AVG) and cell area of variation(CV) before 1 month and 3 months after the operation, to analyze the changes of the number and the differences between the two groups. Results: The intraocular pressure （IOP）before the operation were （35.4±13.7）mmHg in group A, and were （32.5±13.5）mmHg in group B. There was no significant difference between the two groups (P＞0.05). The intraocular pressure（IOP）in the group A was（15.7±3.7）mmHg and（17.0±3.2）mmHg at 1 month and 3 months after the operation. The IOP was lower than the（19.4±3.7）mmHg and（20.2 ±2.1）mmHg in the group B. There was significant difference between two groups(P＜0.05). The corneal endothelial cell density, average cell area, cell area of variation before and 1 month and 3 months after the operation were (2475±484)／mm2, (2199±373)／mm2, (2164±332)／mm2; (431.4±67.6) μm2, (480.6 ±66.8) μm2 ,(463.8±46.2) μm2, (31.1±7.4)%, (34.4±6.3) %, (31.2±7.5) %, respectively, in group A; The results for the group B respectively were (2342±94)／mm2, (2185±215)／mm2, (2074± 218)／mm2; (453.9±94.8)m2, (516．3± 100.8)m2, (499.81±106.4) m2; (30.2± 3.0) %, (32.7±2.9) %, (31.4±4.3) %. The first month and postoperative 3 months parameters and the comparison, are statistical. There was significant difference before the operation and 1 month or 3 months after the operation when endothelial cell density, average cell area, cell area of variation in group A were compared (P < 0.05). But there was no significant difference in group B (P＞0.05) except of the corneal endothelium after 3 months. The loss rate of corneal endothelium cells in the group A was 10.4% at 1 month after the operation, which was higher than the 6.1% in group B (P＜0.05). The loss rate of corneal endothelium cells in the group A was 11.1％at 3 months after the operation, which was higher than 10.0% that in group B (P＞0.05). Conclusion: The step-down effect of using mitomycin C is better than without mitomycin C in trabeculectomy，but the loss rate of corneal endothelial of the former is higher than the latter in short-term.

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