生物羊膜在高眼压动物模型小梁切除术中的应用  

Application of biological amniotic membrane during trabeculectomy in high intraocular pressure rabbit models

作　　者：王建荣[1,2] 郭百灵[1,2] 张晨明[1,2] 王玉[1,2] 刘伟[1,2] 

机构地区：[1]济南市第二人民医院 [2]济南眼科医院眼科,山东省济南市250001

出　　处：《眼科新进展》2010年第2期120-123,共4页Recent Advances in Ophthalmology

基　　金：济南市科技发展计划基金资助(编号:20066010)~~

摘　　要：目的探讨生物羊膜在高眼压兔模型青光眼滤过术中的抗增殖作用。方法20只(40眼)健康同种系新西兰大耳白兔后房注入160Uα-糜蛋白酶诱导建立高眼压模型。随机选10只兔,一眼行标准小梁切除术(小梁切除组),另一眼行小梁切除+单层生物羊膜植入术(单层羊膜组);另10只兔一眼行小梁切除术联合在巩膜瓣下放置浸有0.4×103g.L-1丝裂霉素C(mitomycin C,MMC)的棉片3min(MMC组),另一眼行小梁切除+双层生物羊膜植入术(双层羊膜组)。分别在青光眼术后1d、3d、7d、14d、21d、28d空气栓塞法处死兔1～2只,取滤过泡周围组织应用免疫组织化学方法检测各组在眼球壁手术区组织中转化生长因子β1(transforming growth factorβ1,TGF-β1)的含量及手术区炎症细胞和成纤维细胞数。结果术后1d、3d单层及双层羊膜组炎症细胞较其余组多,7d后开始减少,各时间点单层与双层羊膜组之间差异均无统计学意义(均为P>0.05),而MMC组手术区炎性细胞数较单层、双层羊膜组及小梁切除组少(均为P<0.05)。术后1d、3d4组手术区成纤维细胞数目差异均无统计学意义,术后14d后单层及双层羊膜组成纤维细胞数目均低于MMC组及小梁切除组(均为P<0.05)。相同时间点单层及双层羊膜组TGF-β1表达均明显较小梁切除组弱(P<0.05);术后21d开始,单层及双层羊膜组TGF-β1表达小于MMC组(P<0.05)。结论在青光眼小梁切除术中联合应用生物羊膜能够拮抗TGF-β1的表达,起到抗瘢痕形成作用。Objective To investigate the anti-proliferative effects of biological amniotic membrane during trabeculectomy in high intraocular pressure rabbit models.Methods Twenty healthy conspecific New Zealand white rabbits （40 eyes） were induced with 160 U a-chymotrypsin to establish high intraocular pressure models.Ten rabbits were randomly chosen,one eye of each rabbit was treated with traditional trabeculectomy （trabeculectomy group）,and the other eye was treated with trabeculectomy combined with monolayer biological amniotic membrane implantation （monolayer amniotic membrane group）.About the other 10 rabbits,one eye of each rabbit was taken trabeculectomy combined with putting cotton slice,which immersed in 0.4×10^3 g·L^-1 mitomycin C（MMC） for 3 minutes,under scleral flap（MMC group）,and the other eye was operated with trabeculectomy combined with double layer biological amniotic membrane implantation（double layer amniotic membrane group）.One or two rabbits were sacrificed with air embolism at postoperative 1 day,3 days,7 days,14 days,21 days and 28 days.The tissues around filtering blebs were taken for detecting the concentration of transforming growth factor β1（TGF-β1） and numbers of inflammatory cells and fibroblasts in operating field of eyeball wall with immunohistochemistry.Results Inflammatory cells in monolayer and double layer amniotic membrane groups were more than those in other groups at postoperative 1 day and 3 days,began to decrease at postoperative 7 days,and no significant difference was found between monolayer amniotic membrane group and double layer amniotic membrane group at different times（all P〉0.05）.While number of inflammatory cells in MMC group was less than those in monolayer amniotic membrane group,double layer amniotic membrane group and trabeculectomy group（all P〈0.05）.There was no statistical difference in number of inflammatory cells among the four groups at postoperative 1 day and 3 days,and numbers of fibroblasts in monolayer or double layer a

关 键 词：生物羊膜 丝裂霉素C 青光眼 小梁切除术 

分 类 号：R779.6[医药卫生—眼科]