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甲状腺相关眼病(TAO)是成人常见的眼眶疾病,眶周脂肪结缔组织中糖胺聚糖沉积是其主要的病理特征之一.透明质酸是糖胺聚糖的主要成分,具有高亲水性和黏弹性的特性,可大量吸水膨胀,其在眼眶组织聚集导致眶周结缔组织及眼外肌水肿和纤维化,进而出现TAO特征性的临床表现.眼眶成纤维细胞是透明质酸的主要来源,患者体内自身抗体和多种细胞因子可与成纤维细胞上促甲状腺激素受体(TSHR)及胰岛素样生长因子-1受体(IGF-1R)等结合,在透明质酸合成酶的作用下促进眼眶成纤维细胞合成透明质酸,导致眶周组织、外周血及体液中透明质酸含量增加,并在一定程度上为疾病诊断、病情判断及疗效和预后评估提供参考.“,”Thyroid-associated ophthalmopathy (TAO) is a common orbital disease in the adults,and glycosaminoglycan deposits in the periorbital connective tissue is one of important pathological features.Hyaluronic acid is the main component of glycosaminoglycan,which is extremely hydrophilic and viscoelastic,so that it is capable of binding many times its volume in water.Consequently,the extraocular muscle and adipose connective tissue become edematous and fibrotic,which may leads to the clinical symptoms of TAO.Orbital fibroblasts are main source of hyaluronic acid and they can express insulin-like grow factor-1 receptor,thyroid stimulating hormone receptor and other cytokine receptors.Autoantibodies and many cytokines can bind those receptors to promot the synthesis of hyaluronic acid under the existing of hyaluronan synthase,which may leads to an increase of hyaluronic acid concentration in periorbital tissue,peripheral blood and body fluid,and provide the basis on the diagnosis,activity assessment and therapeutic evaluation.