非穿透性滤过手术联合壳聚糖膜植入的动物实验研究

The experimental study on chitosan membrane on nonpenetrating filtration in rabbits

目的观察在动物非穿透性滤过手术(NPFS)中应用壳聚糖膜后的组织反应及降眼压效果。方法壳聚糖膜来源于雪蟹壳。选取新西兰白兔22只(44眼),随机分为2组,实验组(A组)在单眼行NPFS联合壳聚糖膜植入,对照组(B组)在另眼单纯行NPFS。术后观察眼压、炎症反应和结膜滤泡情况,并分别于1、2、4、12、20、28、36、40和48周时取标本行组织学检查。结果术前两组眼压无显著性差异(P>0.05)。术后各时间点两组眼压均明显低于术前(P<0.01),且两组间眼压比较均有显著性差异(P<0.01)。超声生物显微镜检查(UBM)显示术后不同时间点两组均可维持手术腔隙。术后36周A组植入物部分吸收,植入材料有断裂现象,B组手术处可见组织间隙存在,但较手术早期减压腔隙减小。组织学检查显示,两组术后中性粒细胞数无显著性差异(P>0.05),成纤维细胞和嗜酸性细胞数有显著性差异(P<0.01)。术区总胶原纤维及Ⅰ、Ⅲ型胶原纤维含量有显著性差异(P<0.01)。结论壳聚糖作为非穿透性滤过手术的植入材料组织相容性良好,有一定的抑制纤维组织增生的作用,能够有效维持滤过,降眼压效果满意。

Objective To evaluate the effects of chitosan film on non-penetrating filtration surgery （NPFS） in rabbits. Merits Chitosan film was prepared with chitosan extracted from the shell of snow-crab. 22 New Zealand albino rabbits （44 eyes） were divided ran- domly into 2 groups （group A and group B）, 22 eyes for each group. The NPFS was performed in all the animals. Chitosan implant was used only in group A. Clinical observation was performed including wound healing, inflammatory reaction, filtering and intraocular pressure （IOP）. Pathological examination was clone at 1st, 2nd, 4th, 12th, 20th, 28th, 36th, 40th and 48th week, respectively. Results Intraoenlar pressure： no obvious side effects were noticed in group A and B before surgery （P〉0. 05）, while there were obvious different effects at different time points in each group and between group A and B （P〈0. 01）. UBM examination showed that a space was noticed at the operation site in group A and B after surgery. At 36th weeks, partial fracture and absorption of chitosan implant was noticed and the space was smaller in group B. Histological observation showed there was no significant difference in the number of neutrophils between two group A and B after surgery （P〉0. 05）. There was difference in the number of fibroblats and eosinophils between groups （P〈0. 01）. There were also differences in contents of total collagen, type-Ⅰ collagen and type-Ⅲ collagen （P〈0. 01）. Conclusion Chitosan may decrease IOP effectively in rabbit eye and was a suitable material for NPFS implants.