几丁糖防治结膜瘢痕与睑球粘连的实验研究

Experimental study on the effects of chitosan on the conjunctiva scar formation and symblepharon

目的探讨2%医用几丁糖在角结膜碱烧伤后防治结膜瘢痕、睑球粘连及促进创面愈合中的作用。方法26只新西兰大白兔,按随机数字法取21只制作兔重度角结膜碱烧伤模型,设右眼为几丁糖治疗组,左眼为模型对照组;另5只兔按随机数字法取5只眼作为正常对照组。观察角结膜碱烧伤后炎性反应、结膜瘢痕及睑球粘连发生情况。于烧伤后20、30 d行组织病理学观察,烧伤后30 d行天狼猩红染色比较结膜组织中胶原含量和纤维化瘢痕情况。结果医用几丁糖治疗组较模型对照组结膜修复快,结膜瘢痕和睑球粘连程度轻(u=2.1159,P<0.05);天狼猩红染色示烧伤后结膜胶原含量增高,瘢痕形成明显,但几丁糖治疗组瘢痕轻,胶原含量(Q=32.1450,P<0.01)和吸光度值(Q=22.4767,P<0.01)明显低于模型对照组。结论几丁糖可减轻角结膜碱烧伤后结膜瘢痕与睑球粘连的形成。

Objective To study the effects of chitosan on preventing symblepharon, reducing conjunctiva scar formation and promoting epithelial healing in the treatment of keratoconjunctival alkali burn. Methods Keratoconjunctival alkali burn model of New Zealand rabbits was induced in the present study. Twenty-one rabbits were randomly selected from 26 rabbits to induce the alkali burn. Right eyes were treated with chitosan （treatment group）, left eyes were non-treated （experimental control group）. Five rabbits were used as normal control group. The symblepharon, conjunctiva scar formation and the inflammatory reaction of cornea and conjunctiva were observed by slit lamp. Histopathologic studies were performed 20 and 30 d after alkali burn. The amount of collagen in the conjunctiva and the scar formation process was evaluated by sirius red staining 30 d after alkali burn. Results The degrees of the symblepharon and conjunctiva scar formation in the treatment group were less than those in the experimental control group （u = 2.1159, P 〈 0.05 ）. The amount of collagen in the conjunctiva was increased and the conjunctiva scar was formed after alkali burn, but the amount of collagen, which was evaluated by the area （Q = 32. 1450, P 〈 0.01 ） and integral spectra （Q =22.4767, P 〈0.01 ） of sirius red staining in the treatment group was much lower than that of the experimental control group. Conclusion Chitosan is effective in preventing symblepharon and reducing scar formation in the treatment of keratoconjunctival alkali burn.