目的：观察前葡萄膜炎患者急性发病期角膜内皮细胞的形态特征,进一步探讨炎症时的新鲜角膜后沉着物（KP）对角膜内皮细胞的损害机制。方法：选取前葡萄膜炎首次急性发病的50例50眼患者,就诊时炎症持续时间≥3d,KP≥(+++),作为A组；炎症完全消退后,KP(-),作为B组；将对侧未发病眼作为正常对照组,C组。应用非接触型角膜内皮细胞计测量三组中央角膜内皮细胞的相关参量：包括单位面积细胞密度(cell density,CD)、六角形细胞频数(hexagonality,HG)、平均细胞面积(average size,AVG)、平均细胞面积的标准差(SD)、细胞面积的变异系数(CV),测量角膜中央厚度(CCT)。比较三组的测量结果并进行统计学分析。结果：急性发作组与正常对照组比较：HG,CD减少,AVG,SD,CV,CCT增大,差异均有统计学意义 (P<0.05)。炎症消退组与正常对照组比较：HG减少,CV增大,差异有统计学意义(P<0.05)。急性发作组与炎症消退组比较：HG减少,CV,CCT增大,差异有显著性(P<0.05)。三组间进行重复测量方差分析显示,CV,HG存在差异,有统计学意义（P＜0.05）。结论：前葡萄膜炎急性发病期的新鲜KP可导致角膜厚度增加,内皮细胞形态改变及功能下降,炎症消退后角膜厚度正常,细胞形态的改变持续存在。

AIM:To observe themorphological features of corneal endothelial cells in acute episode of anterior uveitis, and to explore the damage mechanism of corneal endothelial by fresh keratic precipitates (KP). METHODS:Fifty cases(50 eyes) with acute anterior uveitis of first time onset were selected in this study. Inflammation lasted for 3 days or more, KP≥(+++) as acute attack group (group A). Inflammation receded completely, KP(-) as group B. The opposite eye with no onset of acute anterior uveitis as group C. All people were measured by non-contact corneal specular microscopy, which included cell density(CD), hexagonality(HG), average size(AVG), standard deviation of the average cell area(SD), the variation coefficient of the cells in the area(CV), and the central corneal thickness(CCT) was measured. Then the data were compared and analyzed.RESULTS:Compared with group C, CD and HG of group A reduced, AVG, SD, CV, CCT of group A increased, the difference were statistically significant(P<0.05). Compared with group C, HG of group B reduced, CV increased, the difference was statistically significant(P<0.05). Compared with group B, HG of group A reduced, CCT and CV increased, which had statistical significance(P<0.05). Comparison among three groups showed that CV and HG had statistical significane（P＜0.05）.CONCLUSION:Fresh KP of acute anterior uveitis can increase the corneal thickness, change the form of endothelial cells and also reduce their function. After the alleviation of inflammation, corneal thickness tends to normal, but changing patterns of cells persisted.

陕西省卫生厅科学研究基金资助项目(No. 2010D01)