保存人羊膜用于兔眼表面重建的印痕细胞学研究

Impression cytology study of rabbit ocular surface reconstructed by preserved hunam amniotic membrane

目的：观察羊膜移植术在角膜缘缺陷兔眼表层重建中的作用，并探讨印痕细胞学检查法随访的价值。 方法：建立兔全角膜缘缺陷的动物模型，实验眼早期应用保存的人羊膜移植于受损区域，对照眼常规保守治疗，观察其角膜新生血管及上皮层愈合情况。上皮层愈合后，采用印痕细胞学检查，定期对角膜区上皮进行表层细胞学检查。 结果：对照眼角膜上皮层愈合较慢，新生血管粗大丰富，上皮细胞层不稳定，含有杯状细胞。羊膜移植的眼表面上皮层愈合快，新生血管细小，上皮层光滑、稳定，周边部在上皮愈合１ 个月后仍含有丰富的杯状细胞。 结论：羊膜移植能促进上皮细胞移行，抑制上皮细胞凋亡，获得稳定的眼表层。羊膜移植后，上皮仍表现为结膜型上皮。印痕细胞学检查简便、无创。

Objectives:To observe amniotic membrane transplantation for ocular surface reconstruction in rabbits corneals with limbal deficiency and evaluate the use of impression cytologic examination. Methods:Establishing rabbits models of corneal limbal stem cells deficiency.One group was treated with amniotic membrane treansplantation,the other group was used as control.Observing the conditions of corneal vascularization and epithelium healing.Impression cytologic examination was performed on the corneal surface weekly after the healing of the epithelium. Results:In corneals of the control group,epithelium healing was slow,new vessels were abundant and thick,and the new epithelia were unstable and contained goblet cells.In corneals of the treating group,epithelium healing was fast,new vessels were thin and the new epithelia were stable and smooth.Epithelia on the peripheral corneals still contained abundant goblet cells one month after the healing. Conclusions:Impression cytologic examination shows:amnoitic membrane transplantation can promote epithelial migration,prevent epithelial apoptosis and maintain a stable ocular surface.The surface is still covered with epithlial cells of conjuntival phnotype after amnoitic membrane transplantation.Impression cytologic examnation is a easy and atraumatic method,it can be successfully applied in ocular surface examination.