实验性早期糖尿病鼠视网膜神经组织病理改变  

Early Pathological Changes of Retinal Nerve Tissue in Experimental Diabetic Rat

作　　者：凌志红[1] 徐格致[1] 龚红华[2] 刘坤[2] 周国民[2] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,上海200031 [2]复旦大学医学院组胚解剖教研室

出　　处：《中国眼耳鼻喉科杂志》2004年第6期347-349,i005-i006,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的研究实验性早期糖尿病鼠视网膜神经组织病理改变。方法用链脲菌素(streptozotocin,STZ)建立大鼠糖尿病模型。3个月后,观察糖尿病鼠视网膜超微结构变化;在视网膜铺片、切片上,用原位末端脱氧核糖核苷酸转移酶标记技术(TdT-mediated x-dutp nick end labeling,TUNEL)检测视网膜神经节细胞凋亡数目的变化;作眼球冰冻切片,行免疫组织化学染色,在激光共聚焦显微镜下观察视网膜 Müller 细胞、胶质纤维酸性蛋白(Glial Fibriliary Acidic Protein,GFAP)、血管内皮生长因子(vascular Endothelial Growth Factor,VEGF)表达的改变。结果①3个月后,糖尿病鼠凋亡的视网膜神经节细胞数目较明显增加,阳性细胞位于血管外;②电镜观察发现糖尿病鼠视网膜感光细胞外节排列紊乱、Müller 细胞突起消失、神经节细胞有核染色质固缩等细胞凋亡的特征,但微血管内皮细胞、周细胞未见超微结构的变化;③糖尿病鼠视网膜 Müller 细胞有 GFAP、VEGF 的共表达。结论①糖尿病视网膜病变(Diabetic Retinopathy,DR)的病理改变除微血管外,还应包括视网膜神经组织;②糖尿病早期,视网膜神经组织的病理改变包括:Müller 细胞反应性胶质化增生、神经节细胞凋亡加速、感光细胞外节排列紊乱等,其中反应性胶质化增生的 Müller 细胞所分泌的 VEGF 可促进 DR 微血管病变的发生发展。Purpose To study the early pathological changes of retinal nerve tissue in experimental diabetic rat. Methods Diabetic rat model was produced by introperitoneal STZ administration.Three months after the SIZ administration, ultrastructural alterations were observed with electron microscope.In situ TUNEL assays were carried out on both paraffin embodied sections and whole-mounts of retina.Immuno-histological assays werer carried out on eryostat sections.The co- experssion of GFAP and VEGF was observed via a confocal laser scanning microscope.Results ①There are more apoptotic ganglion cells in the retina of diabetic rat than in that of the cotnrol group.All the apoptotic cells are out of the vasculature. ②Observable damages appear in both ganglion cells and Müller cells,but not in endothelial cells and peripheral cells of the microvasculature.③GFAP and VEGF are co-expressed in Müller cells of the diabetic rat in early stage.Conclusion ① Pathological changes of retinal nerve tissue are involved in the diabetic retinopathy.②Earty pathological changes of retinal nerve tissue include reactive gliesis of Müller cells,accelerated apeptosis of retinal ganglion cells and structural disorder of photoreceptor cell segments.VEGF that Müller cells of reactive gLiosis secrete may promote the production and development of the diabetic retinal microvascular disease.

关 键 词：实验 早期 糖尿病 鼠 视网膜病变 视网膜神经组织 病理学 视网膜超微结构 发病机制 

分 类 号：R587.1[医药卫生—内分泌] R774.1[医药卫生—内科学]