上睑下垂是一种可以发生在各年龄层，影响美观与日常生活的疾病。主要分为先天性上睑下垂和获得性上睑下垂两大类。成年人群中以获得性上睑下垂中的老年性上睑下垂最为多见。目前学术界主流观点认为老年性上睑下垂的发病机制为上睑提肌腱膜断裂或者退行性变，而上睑提肌肌肉本身功能不受影响。与之相呼应的，关于骨骼肌与衰老关系的研究也发现眼外肌作为一个特殊的肌群具普遍具有高于普通骨骼肌的再生能力，并且有假说认为眼外肌可能不受衰老的影响。但是这些研究大都是在动物模型上开展的，并且研究对象多是协调眼球运动的三对眼外肌，具体到上睑提肌与衰老的研究目前还是十分稀少的。随着近期的一些研究在老年性上睑下垂患者的上睑提肌中发现了脂肪浸润的现象，对主流观点的质疑也越来越多。上睑提肌是否能够免受衰老的影响，在老年性上睑下垂患者中上睑提肌本身是否真的正常也成为相关领域研究人员的一个关注点。为了验证上睑提肌与衰老的关系，本研究选取了来自协和医学院遗体捐献中心的11具生前无相关眼部疾病的遗体的20份上睑提肌样本（不包含肌腱部分）进行了组织病理染色研究。11具遗体中6具为男性，5具为女性，20份样本中8份标本来自女性，12份来自男性。9份来自左眼，11份来自右眼。按照年龄将样本分为较年轻组（年龄65-79岁，5具遗体，平均年龄73.6±5.6岁 ，10份标本）和较年老组（年龄82-100岁，6具遗体，平均年龄88.5±6.5岁，10份标本），对每份标本分别进行HE染色、Masson染色和VG染色，光镜下观察肌纤维分布情况和完整程度、脂肪浸润、结缔组织增生等等情况。对每份标本的HE染色，随机选取三个高倍镜视野，用IPP软件计算肌纤维面积所占比例，取平均值作为标本的肌纤维面积比例；以同样的方法计算每份标本Masson染色结果的胶原纤维面积比例。根据数据本身的特点选用Mann-WhitneyU检验或者t检验分析年龄、性别、左右眼对肌纤维面积比例和胶原纤维面积比例的影响。 在20%较年轻组和20%较年老组标本中观察到不同程度的脂肪浸润情况。两组染色结果均有部分切片可见局部胶原纤维增生的情况（较年轻组3份标本，其中两份来源于同一具遗体；较年老组1份标本）。按年龄分组，较年轻组和较年老组之间肌纤维面积比例和胶原纤维面积比例均不存在统计学意义上的差距（P肌=0.112 P胶=0.226）；按性别分组，肌纤维面积比例和胶原纤维面积比例差距也不显著（P肌=0.452 P胶=0.537）；按照来源于左右眼分组，肌纤维面积比例和胶原纤维面积比例仍无明显差异（P肌=0.732 P胶=0.382）. 就本研究的结果来看：在年龄较大的成年人群中，部分人群的上睑提肌存在脂肪浸润；不同年龄层之间的上睑提肌肌纤维面积比例和胶原纤维面积比例不存在明显差异。同时无论是性别和还是标本来源（左眼或右眼）都不会对肌纤维面积比例和胶原纤维面积比例产生显著影响。

Ptosis is a disease that can occur at all ages which affect the appearance and can cause function lose in daily life. It is mainly divided into congenital ptosis and acquired ptosis. involutionnal blepharoptosis is the most common form in adults with acquired ptosis. At present, the mainstream view of the academic community believes that the pathogenesis of involutionnal blepharoptosis is levator aponeurosis disinsertion or degeneration, and the function of the levator palpebrae superioris muscle（LPS） remains normal. Correspondingly, research on the relationship between skeletal muscle and aging also found that extraocular muscles（EOMs） as a special muscle group generally have higher regenerative capacity than ordinary skeletal muscles, and there is a hypothesis that EOMs may not be affected by aging . However, most of these studies are carried out on animal models and the three pairs of EOMs that coordinate eye movements except LPS. The research on the LPS and aging is still very rare. As some recent studies have found that fat infiltration in the LPS of involutionnal blepharoptosis patients, there are more and more people doubt about the mainstream view. Whether the LPS can be protected from aging, and whether the LPS itself is really normal in elderly patients with involutionnal blepharoptosis has also become a concern of researchers in related fields. In order to verify the relationship between LPS and aging, this study selected 20 LPS samples (excluding the levator aponeurosis part) from 11 dead bodies without related eye diseases from the Life Donation Center of the Peking Union Medical College. Of the 11 dead bodies, 6 were males, 5 were females, 8 specimens were from females, and 12 were from males，9 from the left eye and 11 from the right eye. The samples were divided into younger groups (age 65-79 years, 5 dead bodies, average age 73.6±5.6 years, 10 specimens) and older groups (age 82-100 years, 6 dead bodies, average age 88.5 ±6.5 years old, 10 specimens), HE staining, Masson staining and VG staining were performed on each specimen, and the distribution and integrity of muscle fibers, fat infiltration, connective tissue hyperplasia, etc. were observed under light microscope. For HE staining of each specimen, randomly select three high magnification fields, the ratio of muscle fiber area was calculated with IPP software, and take the average as the ratio of muscle fiber area of the specimen; the ratio collagen fiber area of Masson staining of each specimen was calculated in the same way. According to the characteristics of the data itself, the Mann-WhitneyU test or t test was used to analyze the effects of age, gender, left/ right eyes on the ratio of muscle fiber area and collagen fiber area. Different degrees of fat infiltration were observed in specimens of 20% younger group and 20% older group. Localized collagen fiber hyperplasia was observed (3 specimens in the younger group, two of which were from the same dead body; 1 specimen in the older group). Grouped by age, there is no statistically significant difference between the ratio of muscle fiber area and collagen fiber area between younger and older groups (P muscle=0.112 P glue=0.226); grouped by gender, the ratio of muscle fiber area and The collagen fiber area ratio difference is also not significant (P muscle=0.452 P glue=0.537); according to the grouping from the left and right eyes, there is no significant difference between the muscle fiber area ratio and collagen fiber area ratio (P muscle=0.732 P glue=0.382). According to the results of this study: in older adults, some people have fat infiltration of the LPS; there is no significant difference between the ratio of the area of the levator muscle fiber and the area of collagen fiber between different age groups . At the same time, neither the sex nor the source of the specimen (left or right eye) will have a significant effect on the ratio of muscle fiber area and collagen fiber area.