不同高分子生物材料抑制小梁切除后瘢痕的形成  

Inhibitory effect of various biopolymer materials on scar formation following trabecula resection

作　　者：沙倩[1] 乔喜珍 聂庆珠[1] 高殿文[1] 

机构地区：[1]中国医科大学附属盛京医院眼科,辽宁省沈阳市110004 [2]黑龙江省传染病防治院道外分院眼科,黑龙江省哈尔滨市150001

出　　处：《中国组织工程研究与临床康复》2009年第8期1513-1516,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:青光眼滤过后,滤过道的纤维化与瘢痕组织形成,是手术失败的主要原因,虽然抑制青光眼滤过术后瘢痕形成的药物和给药方法很多,但多不理想。目的:观察生物羊膜,聚乳酸膜及几丁糖膜在青光眼滤过手术后抑制瘢痕形成中的作用,从而为选择较为理想的抑制青光眼术后瘢痕形成的高分子生物材料在临床的应用提供实验依据。设计、时间及地点:随机对照,动物实验观察于2007-02/2008-04在中国医科大学中心实验室完成。材料:生物羊膜由江西瑞济生物工程有限公司提供,聚乳酸膜、几丁糖膜均由中国科学院提供。方法:24只新西兰大白兔随机分为4组:生物羊膜组、聚乳酸膜组、几丁糖膜组、对照组,6只/组。所有白兔均以左眼为手术眼,常规行小梁切除,右眼为空白对照眼,前3组于巩膜瓣下分别置入生物羊膜、聚乳酸膜,几丁糖膜3种生物降解膜,而对照组不再进行任何干预。主要观察指标:于术后1,3,7,14,28,56d分别观察新西兰大白兔的眼压、结膜滤过泡、前房的炎症反应情况。56d观察后取实验动物的眼球组织,进行病理组织学检查。结果:定性分析:与对照组比较,生物羊膜、聚乳酸膜、几丁糖膜组纤维细胞、炎症细胞均减少。定量分析:与对照组比较,术后1d后其他3组眼压明显降低,14d后降低更加明显,且生物羊膜组,聚乳酸膜组,几丁糖膜组眼压明显低于术前眼压(P<0.01),而3组之间比较无显著差异(P>0.05)。4组滤过泡在术后7d最为明显,但各组间两两比较无差别。术后28,56d,对照组较其他3组滤过泡缩小(P<0.05),有显著差异,而3组间两两比较无显著差异(P>0.05)。结论:生物羊膜、聚乳酸膜、几丁糖膜均可以有效的抑制青光眼滤过术后的瘢痕形成,其中生物羊膜效果最好。BACKGROUND： Fibration and scar formation are major factors for surgical failure following glaucoma filtration. Although there are so many drugs and methods to inhibit scar formation, they are not ideal. OBJECTIVE： To investigate the inhibitory effects of amniotic membrane, polylactic acid membrane, and chitosan membrane on scar formation following glaucoma filtration surgery so as to choose an ideal biopolymer material in clinical application. DESIGN, TIME AND SETTING： A randomized controlled study was performed at Central Laboratory of China Medical University between February 2007 and April 2008. MATERIALS： Amniotic membrane was provided by Ruiji Bioengineering Co., Ltd., Jiangxi; polylactic acid membrane and chitosan membrane were provided by Chinese Academy of Science. METHODS： A total of 24 New Zealand white rabbits were randomly divided into 4 groups： amniotic membrane group, polylactic acid membrane group, chitosan membrane group, and control group, with 6 rabbits in each group. The left eyes underwent routine trabecula resection, and the right eyes were considered as the controls. Amniotic membrane, polylactic acid membrane, and chitosan membrane were respectively installed under sclera flap in the three groups, but any treatment was applied in the control group. MAIN OUTCOME MEASURES： Intraocular pressure, conjunctival filtering bleb, and anterior chamber inflammation response were monitored at day 1,3, 7, 14, 28, and 56 post-operatively; eyeball tissue underwent histopathological examination at day 56 post-operatively. RESULTS： Qualitative analysis： fibrocytes and inflammatory cells were reduced in the amniotic membrane group, polylactic acid membrane group, and chitosan membrane group compared to control group. Quantitative analysis： At day 1 post-operatively, intraocular pressure was decreased in the three membrane groups compared to control group; at day 14 post-operatively, the pressure was decreased significantly, while the intraocular pressure in the three membrane groups was s

关 键 词：生物羊膜 聚乳酸膜 几丁糖膜 青光眼 滤过手术 

分 类 号：R318[医药卫生—生物医学工程]