准分子激光兔角膜切削术后细胞凋亡和增殖  

The apoptosis and proliferation after photorefractive keratectomy

作　　者：李岩[1] 庞国祥[1] 詹素华[1] 金玉梅[1] 孙玉敏[1] 李莹[1] 李维业[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院眼科

出　　处：《中华眼科杂志》1999年第1期29-32,I003,共5页Chinese Journal of Ophthalmology

摘　　要：目的寻找准分子激光角膜切削术（ｐｈｏｔｏｒｅｆｒａｃｔｉｖｅｋｅｒａｔｅｃｔｏｍｙ，ＰＲＫ）术后细胞凋亡和激活增殖的动态联系，评价激光去除上皮（ｐｈｏｔｏｔｈｅｒａｐｅｕｔｉｃｋｅｒａｔｅｃｔｏｍｙ，ＰＴＫ）和机械刮除上皮（ｍｅｃｈａｎｉｃａｌｅｐｉｔｈｅｌｉａｌｓｃｒａｐｅ，ＭＥＳ）对凋亡和增殖的影响。方法对１８只兔按ＰＴＫ和ＭＥＳ行ＰＲＫ（－９．９０Ｄ，６．０ｍｍ直径），术后定期用活体共聚焦显微镜观察及制作病理切片，ＴｄＴ介导ｄＵＴＰ缺口末端标记（ＴｄＴｍｅｄｉａｔｅｄｔｅｒｍｉｎａｌｄＵＴＰｎｉｃｋｅｎｄｉｎｇｌａｂｅｌｉｎｇ，ＴＵＮＥＬ）原位显示凋亡细胞，激光扫描共聚焦显微镜观察凋亡细胞形态，定量统计比较凋亡水平差别。结果ＰＲＫ术后角膜基质细胞出现凋亡，程度与角膜基质细胞减少和其后增殖有关。ＰＴＫ组４小时角膜基质细胞凋亡和减少水平较ＭＥＳ组低，１个月时激活和增殖水平亦低。结论ＰＲＫ术后立即出现了角膜基质细胞减少和凋亡，其水平与后期基质细胞激活和增殖密切相关，推测基质细胞凋亡是引起创伤修复的起始因素；ＰＴＫＰＲＫ较ＭＥＳＰＲＫ基质细胞凋亡少和减轻术后激活水平。Objective To search the correlation between the apoptosis and proliferation of keratocytes and investigate the influence of phototherapeutic keratectomy (PTK) and mechanical epithelial scrape (MES) on keratocyte apoptosis and proliferation.Methods Rabbit corneas received photorefractive keratectomy (PRK, -9.9 diopters, 6mm diameter). Animals were evaluated subsequently up to 6 months after surgery by in vivo confocal microscopy. Corneas were prepared for H.E. staining, corneal cell apoptosis was evaluated by terminal deoxyribonucleotidyl transferase mediated dUTP nick end labeling (TUNEL) to detect DNA fragmentation. Results Loss of keratocytes and keratocyte death were found anteriorly in the remaining stroma at 4h after PRK. Activated keratocytes observed by confocal microscopy repopulated within 1 month. A significant elevation of apoptosis was detected in keratocytes and epithelium at 4h, 3d, 1m after PRK. The level of keratocyte apoptosis was parallel to the loss of keratocytes at the early stage and was correlated with keratocyte proliferation in the later stage, PTK PRK was associated with lower levels of central corneal apoptosis and activated keratocytes than MES PRK. Conclusion It is suggested that the loss of keratocytes and keratocyte apoptosis be correlated with keratocyte activation and proliferation, which may result in haze and regression after PRK,and PTK PRK induce lower level of early keratocyte apoptosis and late keratocyte activation than MES PRK.

关 键 词：细胞凋亡 准分子激光 角膜切削术 细胞增殖 

分 类 号：R779.63[医药卫生—眼科]