目的：探讨正常眼位及斜视儿童眼外肌、血清中胰岛素样生长因子-1(insulin-like growth factor-1， IGF-1)的表达差异，以期进一步认识斜视发病机制与IGF-1的相关性。

方法：根据患儿的眼位情况及斜视类型分组：共同性内斜视组67例86眼，共同性外斜视组129例183眼，正常眼位组23例23眼，运用免疫组织化学、免疫印迹及ELISA法分别检测各组儿童眼外肌及血清中IGF-1的含量，并行统计学分析。

结果：(1)免疫组织化学检测结果显示：IGF-1在眼外肌细胞中主要表达在胞浆，细胞外基质中有少量的表达。正常眼位组眼外肌中IGF-1含量明显多于共同性内斜视组及共同性外斜视组(P <0.05)。(2)免疫印迹法检测结果显示：正常眼位组与共同性内斜视组、共同性外斜视组相比较，眼外肌中IGF-1含量明显增多(P<0.05)。(3)正常眼位组、共同性内斜视组、共同性外斜视组儿童血清中IGF-1含量的差异无统计学意义(P >0.05)。

结论：共同性内斜及共同性外斜等儿童常见单纯眼位异常的发生，可能与眼球血供中IGF-1含量的多少相关性不大，其影响在于控制眼球运动的眼外肌局部IGF-1含量的多少，提示应用IGF-1在眼外肌局部注射对于治疗斜视等眼外肌相关疾病具有潜在的应用前景。

AIM: To explore the expression of insulin-like growth factor-1(IGF-1)in extraocular muscle and serum of children with normal eye position and strabismus, in order to further understand the correlation between pathogenesis of strabismus and IGF-1.

METHODS: Children were divided into 3 groups according to the position of eye and the type of strabismus as follow: concomitant esotropia group(67 cases), concomitant exotropia group(129 cases)and normal eye position group(23 cases). For each group of the children, the extraocular muscle were cut out and frozen for detecting the expression pattern of IGF-1 by means of immunohistochemistry and Western-blot. We also used ELISA to measure the serum level of IGF-1.

RESULTS:(1)Result detected by immunohistochemistry: IGF-1 was expressed mainly in the cytoplasm of extraocular muscle cells, small amount of IGF-1 was expressed in the extracellular matrix. The expression of IGF-1 in extraocular muscle of normal eye position group was significantly more than that of concomitant esotropia group and concomitant exotropia group(P<0.05).(2)Result detected by Western blot: compared with concomitant esotropia group and concomitant exotropia group,the expression of IGF-1 in normal eye position group was significantly increased(P<0.05).(3)The difference of serum level of IGF-1 among normal eye position group, concomitant esotropia group and concomitant exotropia group was not statistically significant(P>0.05).

CONCLUSION: The occurrence of simple abnormal eye position such as concomitant esotropia and concomitant exotropia in children may has few association with the level of IGF-1 in serum, but be associated with the expression of IGF-1 in extraocular muscle. It suggests that injecting IGF-1 into extraocular muscle may be a potiential application for curing strabismus.

湖南省科技计划立项项目(No.2010SK3075)