新鲜羊膜和保存羊膜在碱烧伤眼表重建中的作用比较.doc

　　新鲜羊膜和保存羊膜在碱烧伤眼表重建中的作用比较 ：赵琳，王峰，孙乃学，熊全臣，王建明 【摘要】 目的观察比较新鲜羊膜和保存羊膜移植在兔角膜急性碱烧伤眼表重建中的作用，并探讨肿瘤坏死因子α(TNF-α)和血小板源性生长因子(PDGF)的疗效。方法建立兔角膜急性碱烧伤模型，设左眼为对照组，右眼为 治疗 组，并于24h内行新鲜羊膜或保存羊膜移植术(12眼/组)。术后观察双眼形态及角膜新生血管变化，酶联免疫吸附法检测房水中TNF-α的含量，免疫组化法检测角膜组织中PDGF-BB蛋白的表达情况。结果与对照组比较，治疗组炎症反应轻，角膜溃疡范围小，上皮再生速度快，新生血管长度短(Plt;0.05)。治疗组房水中TNF-α含量低于同期保存羊膜移植组和对照组，且下降速度快，角膜组织中PDGF-BB蛋白表达升高(Plt;0.05)。与保存羊膜移植组比较，新鲜羊膜移植组炎症反应更轻，TNF-α下降速度更快(Plt;0.05)，PDGF-BB表达水平更高(Plt;0.05)。结论在角膜急性碱烧伤眼表重建中，新鲜羊膜较保存羊膜效果更好，其作用与抑制TNF-α水平、促进PDGF表达有关。 【关键词】 碱烧伤;羊膜移植术;肿瘤坏死因子-α;血小板源性生长因子 　ABSTRACT: ObjectiveTo pare the therapeutic effect of fresh amniotic membrane transplantation (f-AMT) and preserved amniotic membrane transplantation (p-AMT) in ocular reconstruction of early corneal alkali burns model and to explore the role of tumor necrosis factor α (TNF-α) and platelet derived groodels mol/L sodium hydroxide. T or p-AMT ed in the right eyes (12 eyes/group, therapy group), and the left eyes served as controls. The morphologic changes of the eyes and the neovascularization (V) length at the top of corneal surface or from the anterior chamber easured by enzyme linked immunosorbent assay method after AMT procedure. Also, the PDGF-BB (a marker of PDGF) protein expression of corneal tissue munohistochemistry method.Resultspared oderate corneal inflammation, distinctive ulcer boundary, quick epithelium regeneration and shorter V length. In therapy group, TNF-α concentration ore quickly than that in control group (Plt;0.05). The PDGF-BB protein expression increased after ATM procedure. apred ilder inflammatory reaction, loniotic membrane transplantation is better than preserved amniotic membrane transplatation in ocular reconstruction of early-stage corneal alkali burns, ay be related to its inhibition of TNF-α concentration and increase of PDGF expression. 　　KEY EM培养液中，-80℃封闭保存，保存期2月。实验所用羊膜已征得产妇知情同意并经单位伦理委员会批准后使用。 　　1.3碱烧伤模型的制备5g/L盐酸丙美卡因表面麻醉，置开睑器，充分暴露眼表，以浸有1mmol/L NaOH溶液、直径6mm的单层圆形滤纸片置于兔角膜表面中央，70s后取下，立即用40mL生理盐水连续冲洗眼角膜表面2min。 　　1.