目的：了解小蘖碱对甲状腺相关眼病眼眶脂肪组织形态学的影响。 方法：将接受眼眶减压术的静止期甲状腺相关眼病（thyroid associated ophthalmopathy, TAO）患者48例随机分为4组，每组12例，第一至四组于接受眼眶减压术前口服小蘖碱0，4，8，12wk，行眼眶减压术时切除球后眼眶脂肪组织。将眼眶脂肪组织行冰冻切片、HE染色，分析脂肪细胞形态的变化。 结果：正常对照组眼眶脂肪细胞平均差异截面积为5909.4625±664.91(pixel²)，TAO患者术前使用小蘖碱0，4，8，12wk后脂肪细胞平均差异截面积分别为46077.5357±11263.27，19634.100±3512.43，17529.69±4342.99，27980.1304±6123.96(pixel₂)，正常对照组与TAO对照组及使用小蘖碱4wk的实验组差异明显，TAO对照组与各实验组间差异明显。正常对照组眼眶脂肪细胞平均截面积为13780.104±7542.28(pixel²)，TAO患者术前使用小蘖碱0，4，8，12wk后脂肪细胞平均截面积分别为45210.250±25854.40，45554.80±15544.69，39163.94±12696.71，27184.889±10703.85(pixel²)，正常对照组与各实验组差异明显，TAO对照组与术前使用12wk小蘖碱的实验组间有明显差异。 结论：TAO患者眼眶脂肪细胞较正常对照组平均截面积明显增大且截面积差异性增大，手术前使用小蘖碱一段时间后能够减少TAO患者眼眶脂肪细胞大小的差异性，使增大的脂肪细胞有一定程度的缩小。

AIM:To investigate the effect of berberine on the morphology of orbital adipose tissue in thyroid associated ophthalmopathy(TAO). METHODS:Forty-eight patients with TAO were randomly assigned to no berberine therapy (group 1, TAO control) or berberine therapy for 4 weeks (group 2), 8 weeks (group 3), and 12 weeks (group 4) before undergoing orbital decompression. The orbital adipose tissue was obtained from the surgery, and undergone frozen section and HE staining. The morphology of adipocyte was investigated. RESULTS:The mean deviation sectional area of orbital adipocytes in normal control were 5909.4625±664.91 (pixel²), in group 1, 2, 3 and 4 were 46077.5357±11263.27, 19634.100±3512.43, 17529.69±4342.99, 27980.1304±6123.96 (pixel²) respectively. There were significantly difference in mean deviation sectional area of orbital adipocytes between normal control and TAO control, normal control and group 1. There were significantly difference in mean deviation sectional area of orbital adipocytes among TAO control and all experimental groups. The mean sectional area of orbital adipocytes in normal control were 13780.104±7542.28 (pixel²), in group 1, 2, 3 and 4 were 45210.250±25854.40, 45554.80±15544.69, 39163.94±12696.71, 27184.889±10703.85(pixel²) respectively. There were significant differences in mean sectional area of orbital adipocytes between normal control and all experimental groups, between group 1 and group 4. CONCLUSION: The mean sectional area of orbital adipocytes in patients with TAO was larger than that of normal control. The difference in sectional area of orbital adipocytes in TAO patients was larger than that of normal control. Taking berberine can decrease the difference of orbital adipocytes size in patients with TAO, and reduce the size of enlarged adipocytes to some extent.

中国广东省中医药局科研课题资助项目（No. 2008030）