外伤眼迁移视网膜色素上皮细胞增生活性的观察  

Proliferation of migrated retinal pigment epithelium in injured eyes

作　　者：王恩普[1] 马志中[2] 李丹[1] 

机构地区：[1]空军总医院眼科,北京100036 [2]解放军总医院眼科,北京100853

出　　处：《眼科研究》2005年第5期477-480,共4页Chinese Ophthalmic Research

摘　　要：目的观察外伤眼经玻璃体切割手术获取的增生组织内迁移视网膜色素上皮(RPE)细胞增生活性随伤后不同时间、不同外伤类型变化的特点。方法利用细胞增生标志物Ki67和PCNA的单克隆抗体对22例外伤眼增生标本进行免疫组织化学染色。结果伤后迁移RPE细胞增生活性迅速升高,1.5个月前后分组比较,Ki67表达率(LI)分别为38.27%和10.82%(P=0.0000);PCNALI分别为32.91%和18.09%(P=0.0273)。病程延长和增生性玻璃体视网膜病变(PVR)加重,RPE细胞增生活性逐渐下降。1.5个月以内手术11例全部为开放伤合并视网膜脱离(RD),Ki67LI为38.27%,6例无RD病例Ki67LI为18%,(P=0.0031)。结论眼外伤后迁移RPE细胞增生活性迅速升高,合并RD是发生PVR的重要危险因素。早期实施玻璃体切割手术将有效地清除异常增生的RPE细胞,减少合并症的产生。Objective To observe the relationships between the proliferative status of migrated retinal pigment epithelium （RPE） and traumatic course or traumatic type of eye. Methods The tissue specimens were obtained from vitrectomy in 22 injured eyes. The proliferation of migrated RPE was detected by immunohistochemical technique with monoclonal antibodies of Ki- 67 and proliferative-cell-nuclear-antigen（ PCNA）. Results The proliferation of migrated RPE was promptly increased after the injury and reached the peak from 1 to 2 months. The labeling index（LI） of laKi-67 was 38.27% and 10.82% for 〈 1.5- and 〉 1.5-month of groups respectively（P = 0. 000 0） , and LI of PCNA was 32.91% and 18.09% in two groups, respectively （ P = 0. 027 3）. Fourteen of 16 eases with open injury complicated RD（87.5% ） and the vitrectomy was performed in 11 cases of them within 1.5 months with an averaging 22.2-day course and the LI of Ki-67 was 38.27%. The average course was 4.2 months （ P 〉 0. 0041 ） in 6 patients without RD and the expression rate of Ki-67 LI was 18% （P = 0. 0031 ） , while 2 in 6 patients had closed injury complicated RD （33.3%）. The proliferating activity of RPE was decreased as the prolongation of course and the development of PVR. In addition,LI of Ki-67 from RPE in open injury（35.5% ） within 5 months after injury was much higher than that of closed one（21.6% ,P =0. 047 2）. Similarly,L1 of Ki-67 in specimen obtained from the injured trace（35.08% ） was much higher than that of specimen far away from the trace（ 12.5% ,P = 0. 024 1 ）. Conclusion The fact that the proliferating activity of migrated RPE in trauman complicated RD is increased immediately after injury suggests that the RD plays important effects as a pathological factor during the development of traumatic PVR. So, the early vitrectomy can remove effectively the major proliferating RPE cells contributing to PVR,and eliminate the complications following the cellular proliferation.

关 键 词：增生性玻璃体视网膜病变 视网膜色素上皮细胞 Ki-67增生活性 

分 类 号：R779.1[医药卫生—眼科]