结膜细胞外基质移植的实验研究

Experimental Study on Conjunctival Extracelluar Matrix Transplantaiton

目的:观察结膜细胞外基质(extracellular matrix,ECM)作为结膜组织的替代材料用于结膜成形的特点及效果。方法:饲养42只大白兔,将其中6只大白兔的球结膜制作结膜缺损模型,并将剩余的大白兔随机分为3组,每组12只。实验组兔结膜采用组织工程技术制备的结膜ECM行结膜移植修补术,对照Ⅰ组采用新鲜异体结膜移植,对照Ⅱ组采用低温冷冻保存的羊膜移植,以观察移植修补术后结膜成形的情况,并行肉眼、镜下、免疫组化及淋巴细胞毒检查。结果:动物实验组,结膜ECM移植后1周可见新生血管自移植边缘长入,8周外观已接近正常结膜,无免疫排斥反应;光镜下可见移植后4周的移植区上皮已接近正常结膜上皮。对照Ⅰ组术后2周,移植片可见大量炎性细胞浸润。对照Ⅱ组术后4周,移植区仍有部分上皮未覆盖。结论:结膜ECM为目前比较理想的结膜替代材料,并可有效地用于角、结膜表面重建。

Objective： To investigate the characteristics and effects of conjunctival extracelluar matrix （ECM） as surrogate of conjuctiva in conjunctivoplasty. Methods： 6 of 42 rabbits were selected as model of conjunctiva defect. 36 of 42 rabbits were randomly divided into three groups undergoing conjunetivoplasty （ n = 12） ： experiment group with ECM grafts, control group Ⅰ with fresh allografts and control group Ⅱ with freezed amniotic memebrance grafts. The effects of conjunctivoplasty were observed and macroscope and microscope observation, immunohistochemical examination and lymphocytotoxity was performed. Results： In experiment group, The new vessels were implanted from the margin of grafts after 1 weeks, the grafts were similar to normal con- jucntica by macroscope observation after 8 weeks or by microscope observation after 4 weeks, there was no immunological rejection. In control group Ⅰ, there were still massive inflammatory cells infiltration in grafts after 2 weeks. In control group Ⅱ, there was defected epithelium in transplanted region after 4 weeks. Conclusion： Conjunctival ECM is ideal surrogate of conjuctiva for ocular surface reconstruction.