异源性新鲜和保存羊膜移植后免疫相容性及组织学转归的比较研究  

A COMPARATIVE STUDY ON IMMUNOCOMPATIBILITY AND HISTOLOGICAL TURNOVER AFTER FRESH OR PRESERVED HUMAN AMNIOTIC MEMBRANE XENOTRANSPLANTATION

作　　者：张琪[1] 赵敏[1] 胡柯[1] 李鸿[1] 鲁静[1] 秦应祥[1] 

机构地区：[1]重庆医科大学附属第一医院眼科,重庆400016

出　　处：《中国修复重建外科杂志》2008年第5期619-624,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：重庆市科技攻关计划资助项目(2003-23)~~

摘　　要：目的对比新鲜与保存人羊膜异种移植后的免疫反应、组织改变及转归,客观评价不同类型羊膜的临床应用价值。方法取清洁级BALB/C小鼠150只,雌雄不限,体重18～20 g;建立BALB/C小鼠皮下埋植实验模型。按埋植物的不同将动物分为5组,分别为甘油保存羊膜(glycerin preserved amniotic membrane,GPAM)组、新鲜羊膜(fresh amniotic membrane,FAM)组、双层新鲜羊膜(double fresh amniotic membrane,DFAM)组、绒毛膜组(阳性对照组)和单纯手术组(阴性对照组)。各组分别于术后1、2、4、8及12周取材行大体观察、免疫组织化学法测定组织切片中主要组织相容性复合体(major histocompatibility complex,MHC)Ⅱ的表达,以及HE染色观察植片及周围组织的变化,并行炎性细胞计数。结果术后各组小鼠饮食、活动正常,创面均Ⅰ期愈合。各羊膜组移植区MHCⅡ表达和炎性细胞计数均明显弱于阳性对照组,差异有统计学意义(P<0.01);术后1、8、12周,各羊膜移植组间MHCⅡ抗原表达和炎性细胞计数两两比较,差异均无统计学意义(P>0.05);术后2～4周,FAM组与DFAM组MHCⅡ抗原表达和炎性细胞计数差异无统计学意义(P>0.05),但均略多于GPAM组(P<0.05);术后4周,各羊膜组移植区MHCⅡ抗原表达和炎性细胞计数均较2周前明显减少,差异有统计学意义(P<0.01)。HE染色观察:术后4周新鲜羊膜植片上羊膜上皮细胞仍存活;术后早期,成纤维细胞从基质层方向浸润羊膜,并在上皮附近合成胶原纤维囊包裹;术后12周,羊膜植片已与周围组织融合难以区分。结论人羊膜作为一种异源性移植材料,无论新鲜或保存,均具有良好的免疫相容性和组织相容性。含活上皮的新鲜羊膜较保存羊膜可能有更佳的修复重建效果。Objective To investigate the immunoreaction, histological reaction and turnover by comparing the xenotransplantation of fresh human amniotic membrane （HAM） with that of preserved HAM, and to analyze the clinical application value of different kinds of HAM preparations. Methods Subcutaneous implant models were established in 150 BALB/C mice, which were randomized into 5 groups of 30 mice each, based on different implants： fresh amniotic membrane （FAM）, double fresh amniotic membrane （DFAM）, glycerin preserved amniotic membrane （GPAM）, chorion （positive control） or merely operation （negative control）. The tissue samples from grafted area were observed with SABC and HE staining, and the inflammatory cells were calculated with light microscopy. 1, 2, 4, 8 and 12 weeks after surgery. Results The mice in all of groups were normal in eating and movin＆ and the wound surface healed well. In all of AM groups, the expression of MHC Ⅱ and the calculation of inflammatory cells were much less than those in chorion groups, showing significant differences （P 〈 0.01）. At 1, 8 and 12 weeks after surgery, there were no significant differences in the expression of MHC Ⅱ and the calculation of inflammatory cells in all of AM groups, compared with other groups （P 〉 0.05）. From 2 weeks to 4 weeks after surgery, there were no significant differences in the expression of MHC Ⅱ and the calculation of inflammatory cells between FAM and DFAM groups （P 〉 0.05）, but they were both more than those in GPAM groups, showing significant differences （P 〈 0.05）. At the 4th week after surgery, in all of AM groups, the expression of MHC Ⅱ and the calculation of inflammatory cells were less than those at the 2nd week, showing significant difference （P 〈 0.01）.The amniotic epithelium was still alive in fresh AM groups until 4 weeks after transplantation. Early after surgery, fibroblasts infiltrated AM from the substantia basilaris layer while made fibrous capsule around the epithelium. Af

关 键 词：新鲜羊膜 保存羊膜 异种移植 相容性 转归 

分 类 号：R779.6[医药卫生—眼科]