目的：分析甲状腺相关眼病(TAO)患者与正常人眼眶脂肪组织中脂肪特异性磷脂酶A2(AdPLA)mRNA 表达水平差异性。

方法：选取2016-12/2017-12在本院进行眼眶减压手术的37例37眼TAO(静止期Ⅲ级)患者作为观察组，选取同期正常眼眶脂肪组织35例35眼为对照组，其来源为美容、眼袋切除手术和上睑下垂矫正手术者； 使用眼球突出计检测观察组与对照组选取脂肪一侧眼球突出度，并计算两组对象BMI状况，使用西门子emotion16排螺旋CT对两组对象眼眶行CT检测，使用Image J检测选取脂肪一侧眼部脂肪体积状况，Real time PCR法检测眼眶脂肪组织内AdPLA mRNA表达状况。

结果：观察组与对照组平均年龄、BMI及性别对比差异均无统计学意义(P>0.05)； 观察组患眼内脂肪含量、眼球突出度及组织内AdPLA mRNA表达量分别为32.21±1.85mL、19.97±1.56mm、0.04±0.01高于对照组的24.05±1.64mL、14.07±1.48mm、0.01±0.003，差异均有统计学意义(P<0.05)。

结论：TAO患者眼内脂肪含量、眼球突出度及组织内AdPLA mRNA表达量均比正常人高，TAO患者眼部脂肪组织内AdPLA表达量升高造成了其脂肪水解量降低，脂肪堆积量增大使其眼球突出程度加重。

METHODS:Thirty-seven patients(37 eyes)with TAO(stationary stage Ⅲ)who underwent orbital decompression surgery in our hospital from December 2016 to December 2017 were selected as the observation group; in the same period, 35 cases(35 eyes)of normal orbital adipose tissue were selected as the control group, which the source of the normal eyelid tissue was cosmetic surgery, pouch resection and ptosis correction. The eyeball protrusion was used to measure the degree of protrusion of the eye on the fat side of the observation group and the control group, and the BMI status of the two groups was calculated. A 16-slice spiral CT from Siemens motion was used to perform CT examination of the eyelids of both groups of subjects. Image J was used to detect the fat volume of the fat side and real time PCR was used to detect the expression of AdPLA mRNA in the adipose tissue of the eyelids.

RESULTS: There was no significant difference in mean age, BMI, and gender between the observation group and the control group(P>0.05); the intraocular fatty acid content, ocular outgrowth and intracellular AdPLA mRNA expression in the observation group were 32.21±1.85mL, 19.97±1.56mm, and 0.04±0.01, higher than those in the control group 24.05±1.64mL, 14.07±1.48mm, 0.01±0.003, respectively, and the difference was statistically significant(P<0.05).

CONCLUSION: The intraocular fatty acid content, ocular outgrowth and intracellular expression of AdPLA mRNA in TAO patients are all higher than those in normal subjects. The increase of AdPLA expression in the adipose tissue of eyes of TAO patients resulted in a decrease in the amount of fat hydrolysis and an increase in fat accumulation and increased emphasis.