角膜碱烧伤早期羊膜移植治疗对t-PA和PAI-1活性的影响  

The activity of t-PA and PAI-1 in cornea alkali burn after early therapy of amniotic membrane transplantation

作　　者：韩晓丽[1] 郑永征[1] 王晓辉[1] 朱学军[1] 徐剑文[2] 何青[1] 徐国兴[1] 

机构地区：[1]福建医科大学附属第一医院眼科,福州350004 [2]福建医科大学人体解剖学与组织胚胎学系

出　　处：《眼科》2005年第5期330-334,共5页Ophthalmology in China

基　　金：福建省教育厅科研基金资助项目(k02023)

摘　　要：目的探讨羊膜移植在治疗早期兔角膜碱烧伤中的疗效及其对组织型纤溶酶原激活剂(tissue-typeplasminogenactivator,t-PA)和1型纤溶酶原激活剂抑制剂(plasminogenactivatorinhibitor1,PAI-1)活性的影响。设计随机对照实验研究。研究对象72只新西兰白兔,随机分为碱烧伤组、新鲜羊膜移植组、保存羊膜移植组及正常对照组,每组18只。右眼为实验眼。方法制作角膜碱烧伤模型,烧伤后30分钟实施手术。术后第14、30、60天,通过计算机图像分析系统分析角膜情况;并用发色底物法检测角膜组织浸液中t-PA和PAI-1的活性。主要指标角膜上皮荧光染色、角膜烧伤斑面积和平均光密度,t-PA及总PAI-1活性,t-PA/PAI-1比值。结果术后第14、30、60天,新鲜羊膜移植组及保存羊膜移植组t-PA活性和t-PA/PAI-1与碱烧伤组相比均显著下降(P<0.01)。术后第14天,新鲜羊膜移植组t-PA活性明显低于保存羊膜移植组(P=0.022),而总PAI-1活性明显高于保存羊膜移植组(P=0.001);术后第14、30天,t-PA/PAI-1明显低于保存羊膜移植组(P=0.000,P=0.030)。结论羊膜移植术后t-PA活性和t-PA/PAI-1显著下降,证实羊膜具有抑制炎症、抑制瘢痕、促进上皮愈合的功能;新鲜羊膜优于保存羊膜。Objectives To investigate the effect of amniotic membrane transplantation （AMT） for early alkali burn in rabbits and its influence on the activity of t-PA and PAL1. Design Randomized, comparative experimental study. Participants Seventy-two New Zealand white rabbits were randomly divided into four groups, that was, alkali burn （A） group, fresh amniotic membrane transplantation （fAN[T） group, preserved amniotic membrane transplantation （pAMT） group, and control （C） group. Every group included 18 rabbits. The right eye was served as experimental eye. Methods Models of corneal alkali burns were set up in three experimental groups. The right eye was respectively transplanted arrmiotic membrane in AMT group after 30min. 14 days, 30 days, and 60 days post-surgery, corneal conditions were observed with a computer image analysis system, and enzymatic activities of t-PA and PAL1 in corneal extracts were measured with chromogenic substrate method. Main Outcome Measures Clinical, histologic, and enzymatic activities examinations including fluoreseence stain in corneal epithelium, area of corneal lesion, the optical density level of corneal lesion, t-PA and total PM-1 competence, and t-PA/PAI-1 ratio. Results 14,30,60 days postoperatively, enzymatic activities of t-PA and t-PA/PAI-1 ratio in pAMT and fAMT were both lower than those in A （P 〈 0.01 ）. 14 days after operation, enzymatic activities of t-PA in fAMT decreased more obviously than those in pAMT（P = 0. 022）, while enzymatic activities of total PAL1 increased more obviously in fAMT than those in pAMT（P 0.001 ）, and 14,30 days after operation t-PA/PAI-1 ratio was lower in fAMT than that in pAMT（P = 0.000, P = 0. 030）. Conclusions Activities of t-PA and t-PA/PAI-1 ratio were decreasing after arrmiotic membrane transplantation, which confirmed on step that arrmiotic membrane play the role of suppressing inflammation, reducing scar, and promoting epithelium heal. fAMT is better for treatment than pAMT.

关 键 词：角膜 碱烧伤 羊膜移植 组织型纤溶酶原激活剂 纤溶酶原激活剂抑制剂 

分 类 号：R779.6[医药卫生—眼科]