交联型异体脱细胞巩膜行眼部修复的试验研究  

The histological and antigenic study of acellular sclera in eyelid reconstruction

作　　者：聂丹瑶[1] 陈家祺[2] 

机构地区：[1]暨南大学附属深圳市眼科医院,518040 [2]中山大学附属眼科医院,510060

出　　处：《中国实用眼科杂志》2012年第7期864-868,共5页Chinese Journal of Practical Ophthalmology

基　　金：卫生部临床学科重点项目（No.2004-468）,国家自然科学基金（No.30271388）资助

摘　　要：目的将交联型异体脱细胞巩膜植入眼睑，研究其组织相容性及抗原性变化。方法将20只新西兰大白兔随机平均分为两组，去除睑板后，分别植入兔交联型脱细胞巩膜和异体巩膜，于植入后1、4、8、12周观察全身及局部光镜和免疫学变化。结果脱细胞巩膜和异体巩膜植入眼睑后第1周、4周、8周，两组间外周血IgG、IgA、IgM、C3、C4和CD4＋T细胞、CD8＋T细胞定量均无明显差异。术后1周、4周、8周、12周，植入局部的光镜显示：脱细胞巩膜组的炎症反应和淋巴细胞浸润要小于异体巩膜组，8周后植入的异体巩膜组织中央部发生少量坏死溶解现象，术后12周两组成纤维细胞及血管完全长人植片。术后1、4、8周，局部CD4＋T及CD8＋T细胞计数显示脱细胞巩膜组明显少于异体巩膜组。结论兔脱细胞巩膜植入眼睑后引起的免疫反应较同种异体巩膜小。Objective To find a method of acellular sclera preparation, investigate the histocom- patibility of acellular sclera implanted in rabbit eyelid and antigenic changes between sclera and acel- lular sclera. Methods Acellular sclera was prepared with 2% Triton X-100, DNase and RNase. Twenty New-Zealand white rabbits （20 right eyes） were divided into two groups randomly. Sclera and the acellular sclera were implanted the big tarsus with 3 mm X 10 mm in upper eyelid in two groups. The appearances, immunologic changes and inflammatory reaction of eyelids were observed with quantifying the immunoglobulins and complements, flow cytometry, HE stain and immunofluores- cence assay in 1, 4, 8, and 12 weeks postoperation. Results Acelullar sclera could be successful prepared with 2% Triton X-100. There were no statistical differences between two groups in IgG, IgA, IgM, C3,C4, CD4＋T cells and CD8＋T cells of blood （P 〉0.05）. In the 1st week, 4th week and 8th week, the average numbers of CD4＋T cells and CD8＋T cells in eyelid of sclera group were 25±7 and 11±4, 83±27 and 28±9, 69±24 and 22±7, while those of acelllar sclera group were 13±5 and 7±4, 26±11 and 13±21, 7±13 and 7±3 respectively. The inflammatory cells and lymphocytes in sclera were much more than those in acellular sclera. Conclusions Acellular sclera is easy to be prepared and can be used to repair the eyelid.

关 键 词：脱细胞基质 脱细胞巩膜 眼部修复 

分 类 号：R775[医药卫生—眼科]