新型视网膜缺血-再灌注损伤模型的建立及评价  

Establishment and evaluation of a novel retinal ischemia-reperfusion injury model

作　　者：温鑫 袁敏而[1] 李成[1] 曾婕婷 林晓峰 Wen Xin;Yuan Miner;Li Cheng;Zeng Jieting;Lin Xiaofeng(State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-Sen University,Guangzhou 510060,China;Department of Ophthalmology,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou 510120,China)

机构地区：[1]中山大学中山眼科中心眼科学国家重点实验室,广州510060 [2]中山大学孙逸仙纪念医院眼科,广州510120

出　　处：《中华实验眼科杂志》2020年第7期566-572,共7页Chinese Journal Of Experimental Ophthalmology

基　　金：广东省自然科学基金项目(2018A030313585);眼科学国家重点实验室专项经费项目(30306020240020130、3030902113030)。

摘　　要：目的:探索在新西兰兔视网膜中央动脉阻塞(CRAO)模型中行经睫状体平坦部玻璃体切割术(PPV)联合反搏术构建新型视网膜缺血-再灌注(RIR)损伤模型。方法:选用20只健康成年新西兰兔,按照随机数字表法随机分为2个组,每组10只:激光组单纯行视网膜动脉激光光凝术,反搏术组于光凝术后行PPV联合反搏术,均取右眼为实验眼,左眼作为正常对照组。通过荧光素眼底血管造影(FFA)、玻璃体腔氧分压(PO 2)评估灌注恢复情况,观察视网膜电图(ERG)的振荡电位(OPs)变化评估视网膜功能改变,苏木精-伊红染色法观察视网膜结构改变。结果:反搏术组术中即可观察到视网膜灌注恢复;术后2 h,FFA检查示所有眼视网膜动静脉完全恢复灌注,早期即见视网膜动脉充盈,随后静脉充盈,充盈时间无延迟,无血流中断。不同时间点反搏术组、激光组和正常对照组PO 2百分数总体比较,差异均有统计学意义(F分组=330.87,P<0.001;F时间=985.70,P<0.001),其中激光后、术后不同时间点反搏术组玻璃体腔PO 2百分数分别为(18.67±6.29)%、(38.82±1.48)%、(57.33±4.25)%、(84.51±3.91)%和(89.20±2.97)%,高于激光组的(23.24±1.95)%、(31.44±3.29)%、(40.21±3.05)%、(43.65±3.82)%和(58.07±2.93)%,差异均有统计学意义(均P<0.05)。不同时间点反搏术组、激光组和正常对照组OPs百分数总体比较,差异均有统计学意义(F分组=164.09,P<0.001;F时间=447.91,P<0.001),其中术后3 d、7 d、2周和1个月反搏术组OPs百分数分别为(47.23±2.73)%、(70.79±3.09)%、(78.39±3.63)%、(76.69±4.08)%和(82.18±1.78)%,较激光组的(46.83±2.89)%、(55.32±1.58)%、(51.08±4.02)%、(52.32±6.59)%和(53.46±6.46)%升高,差异均有统计学意义(均P<0.05)。反搏术组视网膜内层结构破坏较小,有髓神经纤维层(MFL)结构疏松,大量空泡状改变。激光组MFL、内丛状层、内核层和外丛状层结构紊乱,Müller细胞神经纤维破坏。结论:在新西兰兔Objective To explore the feasibility to establish a novel retinal ischemia reperfusion(RIR)injury model by applying pars plana vitrectomy(PPV)combined with retinal vascular counterpulsation in the central retinal artery occlusion(CRAO)model of New Zealand rabbit.Methods Twenty New Zealand adult rabbits were randomly divided into two groups by random number table,10 for each group.Rabbits in the laser group were treated with retinal laser photocoagulation only,while rabbits in the counterpulsation group were treated with PPV combined counterpulsation.The right eye of each New Zealand rabbit was used as the experimental eye and the left eye was used as the normal control(the normal control group).Fundus fluorescence angiography(FFA),oxygen partial pressure(PO 2)in vitreous cavity was performed to assess the recovery status of perfusion.Scotopic 3.0 oscillatory potentials(OPs)in electroretinogram(ERG)were used to evaluate the retinal function,and retinal pathological sections were used to evaluate the structural changes in the retina.The use and care of the animals complied with the Statement of the Association for Research in Vision and Ophthalmology(ARVO),and the study was approved by the Animal Research Committee of Zhongshan Ophthalmic Center,Sun Yat-sen University.Results In the counterpulsation group,retinal reperfusion was observed during counterpulsation processure.FFA examination at 2 hours after counterpulsation showed reperfusion of retinal blood stream in all the eyes.Retinal artery filling,followed by venous filling was observed in the early stage,with no delay in filling and no interruption of blood flow.The percentage of vitreous PO 2 was significantly different among the counterpulsation group,the laser group and the normal control group at different time points(F group=330.87,P<0.001;F time=985.70,P<0.001).The percentages of vitreous PO 2 in the counterpulsation group at different time points was(18.67±6.29)%,(38.82±1.48)%,(57.33±4.25)%,(84.51±3.91)%and(89.20±2.97)%,which were significantly hig

关 键 词：视网膜疾病 缺血-再灌注损伤 玻璃体切割术 动物模型 反搏术 

分 类 号：R779.6[医药卫生—眼科]