【摘要】 目的　观察平阳霉素局部注射治疗眼睑黄色瘤的临床疗效,探讨治疗前后黄色瘤组织病理学及超微结构的变化。方法　随机选择门诊诊治的眼睑黄色瘤患者 30例 (44只眼 ),分为治疗组及组织病理学观察组。治疗组 25例(34只眼 ),将 0 4%平阳霉素液注射 0 2ml用皮试针头直接注入黄色瘤瘤体内, 1次 /10d,观察注射后瘤体内的反应。组织病理学观察组 5例 ( 10只眼 ),均为双眼上睑黄色瘤, 1只眼按上述方法黄色瘤瘤体内注射平阳霉素 0 2ml,另 1只眼为对照组。1个月后,同时手术切除 5例双上眼睑的病变组织,一半送病理,光学显微镜下观察瘤体组织病理学变化并照相;另一半切成 1 0mm×1 0mm×1 5mm组织片电镜下检查,在透射电子显微镜下观察瘤体的超微结构并照相。结果　治疗组经 3~45个月观察, 25例眼睑黄色瘤全部消失,肤色恢复正常,且保持了眼睑的正常形态和功能。光镜观察:治疗组真皮浅层纤维细胞及纤维母细胞增生,其间散在少量泡沫细胞;对照组真皮浅层大量黄色瘤细胞 (泡沫细胞 )浸润。电镜观察:治疗组泡沫细胞内脂滴数量减少;对照组泡沫细胞内大量圆形或卵圆形脂滴。结论　平阳霉素可迅速抑制泡沫细胞增生,使黄色瘤消退,其治疗方法简便、安全、有效,值得临床推广应用。更多还原

【Abstract】 Objective To investigate the effects of Bleomycin A5 on the pathology and ultrastructure of eyelid xanthelasmas Methods Twenty five randomly selected outpatients from our hospital received 0 2 ml of a 0 4% Bleomycin A5 solution The drug was directly injected into the tumor every 10 days In other 5 cases(double up eyelids xanthelasma), one eye received 0 2 ml of 0 4% Bleomycin A5 injection once and another eye was used as controlling After one month,operations were performed to remove double up eyelids xanthelasma tissues, one half of the tissues were investigated by hisochemistry; the other half was cut into 1 0 mm×1 0 mm×1 5 mm pieces and investigated by electron microscopy Results The clinical investigation demonstrated that 25 cases of the Bleomycin treated tumors disappeared completely and the skin color recovered. The eyelids kept their normal morphology and function Histopathologic investigation of the Bleomycin treated groups showed fibroblasts hyperplasia and sparse foam cells in shallow derma In the control group, there are large foam cells in shallow layer of derma The ultrastructure of the treated specimens showed fat droplets decrease in foam cells in contrary to the control group Conclusions Bleomycin A5 can rapidly inhibit the proliferation of foam cells and induce xanthelasma disappearance Bleomycin A5 is an easy and safe method to treat eyelid xanthelasma and can be widely used in clinical work更多还原