不同生物膜在兔角膜碱烧伤急性期应用的生物学反应

Biological response of the application of different biomedical films in acute stage of alkali-burned cornea

目的观察比较兔角膜碱烧伤急性期应用不同类型生物膜对角膜上皮愈合、炎症反应及胶原增生的生物学作用,为角膜碱烧伤急性期的临床治疗提供新的途径。方法新西兰大白兔12只,随机分为4组(每组3只)。1mmol·L-1NaOH溶液制作右眼角膜碱烧伤模型,烧伤30min后分别在4组兔的右眼角膜表面覆盖聚乳酸[poly(D,L-lacticacid),PDLLA]膜、PDLLA/胶原改性膜、PDLLA/壳聚糖膜及不覆盖膜(对照)。观察烧伤后12d各组兔右眼角膜上皮的愈合情况,取角膜行病理检查观察角膜上皮细胞生长情况、炎细胞浸润及胶原排列情况。结果PDLLA/壳聚糖膜移植组的兔角膜上皮愈合速度较快,炎症反应较轻,胶原排列较整齐;对照组角膜上皮部分修复,但胶原排列不如PDLLA/壳聚糖膜组整齐有序;PDLLA/胶原改性膜组及PDLLA膜组角膜上皮愈合程度次于对照组,有大量嗜酸性粒细胞聚集,胶原排列紊乱,肉芽组织增生活跃。结论兔角膜碱烧伤急性期应用PDLLA/壳聚糖膜能促进角膜上皮愈合,抑制纤维细胞的活性,诱导胶原有序排列。PDLLA/胶原改性膜及PDLLA膜作用不明显,并能加速早期溃疡形成。

Objective To observe the biomedical effects of different blomedieal films on corneal epithelial healing, inflammation and collagen proliferation in the acute stage of alkali-burned cornea, and provide a new method for clinical treatment on it. Methods Twelve New Zealand rabbits were chosen and divided into 4 groups randomly. Alkali-burned model was made in right cornea of each rabbit with 1 mmol·L^-1 NaOH. Poly（ D, L-lactic acid） （PDLLA）, PDLLA/collagen and PDLLA/chitosan films were transplanted into alkaliburned corneas of group 1,2 and 3 respectively. And no film was used in group 4 which was served as control. Clinical evaluations were performed daily with slit lamp. At 12th day after surgery, three corneas of each group were excised to observe histological changes such as corneal wound healing, inflammation and collagen proliferation. Results The wound healing rates of PDLLA/chitosan group was higher than that of others, collagen arranged most orderedly and the extent of inflammation was mild. Control group was next to PDLLA/ chitosan group. PDLLA/collagen and PDLLA group were the worst of all. Conclusion PDLLA/chitosan can promote the wound healing of acute stage of alkali-burned cornea tn vtvo and decrease the scar formation. The effect of PDLLA/collagen and PDLLA film is to promote corneal ulcer.