本文選題：基質(zhì)金屬蛋白酶 + 增殖性玻璃體視網(wǎng)膜病變��； 參考：《中南大學(xué)》2012年碩士論文

【摘要】：目的： 研究復(fù)雜性孔源性視網(wǎng)膜脫離患者玻切+C3F8填充術(shù)后玻璃體腔再生成液內(nèi)基質(zhì)金屬蛋白酶的含量,分析其表達(dá)與術(shù)后PVR形成及視網(wǎng)膜再脫離的關(guān)系,并觀察術(shù)后眼內(nèi)氣—液交換術(shù)次數(shù)對(duì)其的影響。 對(duì)象及方法： 患者為復(fù)雜性孔源視網(wǎng)膜脫離玻璃體視網(wǎng)膜術(shù)后采取氣體充填及再次眼內(nèi)氣液交換者75眼,其中男性42例,女性33例,年齡17～68歲,平均46±19.3歲,術(shù)前PVR—B～D2級(jí)�？自葱砸暰W(wǎng)膜脫離合并有脈絡(luò)膜脫離者32例,32眼。術(shù)后PVR再形成并視網(wǎng)膜再脫離13眼,成功62眼。玻璃體切割術(shù)中均成功平復(fù)視網(wǎng)膜,眼內(nèi)均為C3F8氣體充填,為延長(zhǎng)眼內(nèi)氣體充填時(shí)間,術(shù)后行1～4次徒手眼內(nèi)氣—液交換術(shù),同時(shí)獲取玻璃體腔再形成液。采用明膠酶譜分析法測(cè)定所獲樣本中MMP-9及MMP-2的含量。 結(jié)果： 1.無(wú)脈絡(luò)膜脫離的患者及合并有脈絡(luò)膜脫離的患者經(jīng)玻切術(shù)后取得的玻璃體腔再形成液中均檢測(cè)到MMP-9及MMP-2的表達(dá)。 2.術(shù)前合并脈絡(luò)膜脫離的復(fù)雜性視網(wǎng)膜脫離患者的玻璃體腔再形成液中MMP-2與無(wú)脈絡(luò)膜脫離的視網(wǎng)膜脫離患者有明顯區(qū)別,MMP-9無(wú)明顯區(qū)別,MMP-9與MMP-2的比值增加。 3.MMP-9及MMP-2的表達(dá)與術(shù)后PVR的再形成呈顯著正相關(guān)(r=0.63,P0.01)。MMP-2的活性在有PVR復(fù)發(fā)的RD組患者顯著高于無(wú)PVR組(P0.01)。MMP-9的變化在兩組間也有顯著差異(P0.05)。 4.MMP-2,MMP-9的含量隨著氣液交換的次數(shù)減少,MMP-9/MMP-2的比值也明顯下降,與取液次數(shù)呈反比關(guān)系. 結(jié)論： 1.玻切術(shù)后視網(wǎng)膜再脫離并伴有PVR形成及術(shù)前合并脈絡(luò)膜脫離是影響術(shù)后MMP-9和MMP-2表達(dá)的重要原因之一 2.玻切術(shù)后的對(duì)患者行徒手氣液交換可有效減少玻璃體腔液中MMPs的含量,并且隨交換的次數(shù)成反比。 3.測(cè)定玻璃體切割術(shù)后玻璃體腔液中MMP-9和MMP-2的含量,對(duì)如何監(jiān)測(cè)玻切術(shù)后眼內(nèi)組織修復(fù)情況的提供了一個(gè)簡(jiǎn)便可行的方法。
[Abstract]:Objective: To study the content of matrix metalloproteinases (MMPs) in vitreous cavity regenerative fluid of complex rhegmatogenous retinal detachment patients after vitrectomy with C3F8, and to analyze the relationship between the expression of matrix metalloproteinases and the formation of PVR and retinal detachment after vitrectomy. The influence of the times of intraocular gas-liquid exchange was observed. Objects and methods: After vitreoretinal surgery, 75 eyes were treated with gas filling and re-intraocular gas-liquid exchange after vitreoretinal surgery, including 42 males and 33 females, with a mean age of 46 鹵19.3 years, with a mean age of 46 鹵19.3 years. 32 cases (32 eyes) of rhegmatogenous retinal detachment complicated with choroidal detachment. Postoperative PVR reformation and retinal detachment in 13 eyes were successful in 62 eyes. The retina was successfully flattened in vitrectomy, and the intraocular C3F8 gas filling was performed. In order to prolong the time of intraocular gas filling, the intraocular gas-liquid exchange was performed one or four times after vitrectomy, and the vitreous cavity fluid was obtained at the same time. The contents of MMP-9 and MMP-2 in the samples were determined by gelatinase analysis. Results: 1. The expression of MMP-9 and MMP-2 was detected in vitreous cavity of patients without choroidal detachment and patients with choroidal detachment after vitrectomy. 2. There was a significant difference between MMP-2 in vitreous cavity reformation fluid and retinal detachment without choroidal detachment in patients with complicated retinal detachment before operation. There was no significant difference between MMP-9 and MMP-2. There was a significant positive correlation between the expression of 3.MMP-9 and MMP-2 and the re-formation of PVR after operation. The activity of PVR in Rd patients with PVR recurrence was significantly higher than that in Rd patients without PVR. There was also a significant difference between the two groups. 4. The content of MMP-2 and MMP-9 decreased significantly with the decrease of gas-liquid exchange times, and the ratio of MMP-9 / MMP-2 decreased significantly, which was inversely proportional to the number of liquid extraction. Conclusion: 1. Retinal detachment with PVR and choroidal detachment after vitrectomy is one of the important factors influencing the expression of MMP-9 and MMP-2 after vitrectomy. 2. The content of MMPs in vitreous cavity fluid can be reduced effectively by the free hand gas-liquid exchange after vitrectomy, and it is inversely proportional to the number of times of exchange. 3. The content of MMP-9 and MMP-2 in vitreous cavity fluid after vitrectomy was determined, which provided a simple and feasible method for monitoring the repair of intraocular tissue after vitrectomy.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R774.1

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