摘要
目的探讨胶原变化在后巩膜加固术(posterior scleral reinforcement,PSR)加固机制中所起的作用。方法选择新西兰大耳白兔50只,随机分为5组。每组均一侧眼行单条兜带式后巩膜加固术(手术眼),另一侧眼(对照眼)行与手术眼相同的操作但不放置加固带。于术后1、2、3、6、9个月分别处死一组动物,采用酶解反应盐酸水解法测定各组手术眼巩膜加固区及对照眼相应区羟脯氨酸(Hyp)密度值,同时做病理切片观察组织学改变。结果胶原含量变化:手术眼术后2、9个月移植区巩膜Hyp密度值显著高于其他各组,差异具有统计学意义(P<0.05);同组动物手术眼与对照眼比较,除术后9个月组外,余各组手术眼加固区Hyp密度值均低于对照眼相应区,差异具有统计学意义(P<0.01)。手术眼巩膜组织病理学变化:术后前6个月移植物胶原纤维发生不同程度变性、崩解及断裂,巨噬细胞吞噬变性的胶原纤维,移植物受到一定程度破坏;术后9个月移植物胶原与受体胶原融合,增生的胶原纤维排列规整。结论异种异体PSR后加固区胶原含量受移植免疫排斥反应造成的胶原破坏及创伤修复引起的胶原增生影响,加固作用与术后胶原总量增加、胶原亚型替换有关。
Objective To explore the effects of collagen changes in strengthening mechanisms after posterior scleral rein- forcement （PSR）. Methods 50 New Zealand big-eared rabbits were chosen and randomly divided into 5 groups. Single band PSR was performed in one eye of each group （operated eyes） , whereas in the other eye （control eyes） , the same operating process was made without placing reinforcing band. 1 , 2, 3, 6, 9 months after PSR, one group of rabbits were killed. Hyp density in sclera was detected by enzymolysic hydrochloric acid hydrolysis technique both in the implanted area of the operated eyes and the corresponding area of the control eyes. At the same time, tissue pathological slices were made to observe histologic changes. Results The change of collagen content： in the implanted area of operated eyes after PSR, Hyp density in 2-month and 9-month groups was obviously higher than that in other groups （P 〈 0.05）. Except in the 9-month group, Hyp density in implanted area of operated eyes was lower than that of the corresponding area of control eyes within the same group （P 〈 0.01 ）. The histopathological change of collagen of op- erated eyes sclera： within 6 months after PSR, collagen fibers in the implanted area were partly degenerated, disintegrated and bro- ken. Macrophages phagocytosed the degenerated collagen fibers and the transplanted bands were damaged to a certain degree. The newborn collagen fibers were in good order and transplants collagen assimilated acceptor 9 months after operation. Conclusion The collagen content in the implanted area after heterologous PSR is effected both by collagen damage produced by transplantative im- mune rejection and by collagen proliferation caused by wound healing. The mechanisms to reinforce the recipient sclera effectively result from collageng total volume increase and from the substitution among collagen subtypes.
出处
《临床误诊误治》
2012年第5期83-86,共4页
Clinical Misdiagnosis & Mistherapy
基金
国家自然科学基金资助项目(10272077)
关键词
近视
退行性
巩膜
外科手术
胶原
兔
Myopia, retrogression
Sclera
Surgical procedure, operative
Collagen
Rabbit
