几丁糖膜在兔实验性小梁切除术后抗瘢痕作用研究  

The antiscarring effects of chitosan film on trabeculectomy in rabbits

作　　者：邢小丽[1] 郝凤荣[2] 

机构地区：[1]天津医科大学眼科中心,天津300070 [2]大连医科大学附属第二医院眼科,辽宁大连116023

出　　处：《眼外伤职业眼病杂志》2009年第4期241-243,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的几丁糖制成膜状对兔实验性小梁切除术滤过泡作用。方法兔30只,双眼均行常规小梁切除术,每只兔随机选取1只眼为实验眼,植入几丁糖膜,另1只眼为对照眼,行常规小梁切除术不植入几丁糖膜。术后观察眼压,成纤维细胞计数,Kaplan-Meier分析法统计术后滤过泡情况。结果(1)眼压:实验组术后1、2、4周眼压与术前相比差异有统计学意义,第5周开始眼压与术前相比差异无统计学意义。对照组术后1周与术前相比差异有统计学意义,第2周开始眼压与术前相比差异无统计学意义。术后1～4周,6周,8周,12周实验驵与对照组眼压相比差异有统计学意义,实验组低于对照组,第5周差异无统计学意义。(2)实验组滤过泡存留时间与对照组相比差异有统计学意义。(3)成纤维细胞计数:1、2、6、12周实验组与对照组差异有统计学意义(t=-5.541,-5.713,-5.499,-3.063,P<0.05),3周差异无统计学意义。(4)光镜下实验组1～3周均可见滤过道通畅,几丁糖膜呈均质状,6周滤过道部分阻塞,12周时闭合。对照组第3周开始滤过道消失。结论兔小梁切除术后应用几丁糖膜能抑制成纤维细胞生长,降低眼压,延长滤过泡存留时间。Objective To evaluate the antifibrosis effects of chitosan film in rabbit trabecnlectomy. Methods Thirty rabbits underwent bilateral trabeculectomy. One eye was randomly sutured with chitosan film under scleral flap and conjunctiva flap after trabeculectomy. The fellow eye without chitosan film served as the control. Intraocular pressure, the longevity of filtering, pathological examinations. Results 1. IOP： IOP of the experimental eyes from postoperative weeks 1, 2, 4 was significantly difference, but there was no significant difference of IOP in postoperative 3 week. but those of the control group show significant difference only in 1 week（P =0.000）. IOP of 5w show no significant difference. Postoperative IOP of 1 -4w, 6w, 8w, 12w show significant difference between two groups. Those of 5 week show no significant difference. 2. The blebs survived longer in the eyes with chitosan film than those in the control eyes （X^2 = 24. 348, P 〈 0. 05）. 3. The counts of fibroblasts in 1,2,6 and 12 postoperative week were significant different with those of the control group （ t = - 5. 541, -5.713, -5.499,-3.063, P〈0.05 ）.In 3 week, there was no statistically difference （ t = - 2. 109, P 〉 0. 05 ）. 4. On histologic examinations, the filtering fistulas were open during the first three weeks in experimental group and chitosan film was observed and degradated gradually. In the sixth postoperative week, the chitosan film was partly degradated and the filtering fistula was partly blocked. In the twelfth postoperative week, the filtering fistula was totally blocked. But in the control group the filtering fistula was not observed from the third postoperative week. Conclusion The animal study initially showed ： the chitosan film using after trabeculectomy could suppress the growing of fibroblast, longer the bleb longevity, lower the lOP and prevent fibrosis of the filtering bleb during certain periods and there was no toxic and side effect.

关 键 词：小梁切除术 几丁糖膜 成纤维细胞 

分 类 号：R779.6[医药卫生—眼科]