本文選題：兔子 + 人工淚液�。� 參考：《浙江大學(xué)》2017年碩士論文

【摘要】：研究背景:人角膜由上皮層、前彈力層、基質(zhì)層、后彈力層及內(nèi)皮層五部分組成,角膜各層結(jié)構(gòu)完整,功能和代謝正常,共同維持著角膜的整體透明性。角膜上皮細(xì)胞層處于角膜的最外層,對(duì)于維持角膜正常形態(tài)結(jié)構(gòu)及功能,抵抗外力侵襲起著十分重要的作用。這歸功于上皮細(xì)胞之間,上皮細(xì)胞與基底膜之間的連接,以及上皮細(xì)胞的持續(xù)自我更新。上皮細(xì)胞受到損害、消亡,進(jìn)而影響細(xì)胞之間,及細(xì)胞與基底膜之間的連接,導(dǎo)致上皮層結(jié)構(gòu)功能的不穩(wěn)定性,使角膜組織容易受到外界致病因子的侵害。世界衛(wèi)生組織聲明,角膜損傷僅次于角膜感染,成為第二大潛在致盲原因。某些藥物長(zhǎng)期全身、局部使用,外傷,感染,手術(shù)等均可引起角膜上皮的損傷。不完全、不及時(shí)的角膜上皮修復(fù)容易引起角膜感染、角膜新生血管長(zhǎng)入、潰瘍、穿孔、角膜白斑、斑翳甚至失明。通常情況下,角膜上皮缺損,特別是小范圍損傷,一般自我修復(fù)較快,但某些損傷,可導(dǎo)致持續(xù)性角膜上皮缺損,而相對(duì)嚴(yán)重的角膜上皮損傷需要盡快得到治療,以促進(jìn)角膜上皮的再生修復(fù)及避免角膜感染及斑翳。角膜上皮細(xì)胞之間緊密連接的形成,在角膜上皮修復(fù)過程中是非常重要的一步,可以促進(jìn)上皮屏障的完整形成,抵御病原微生物的入侵,防止角膜潰瘍甚至穿孔。近幾年,促進(jìn)角膜上皮快速修復(fù)得到臨床越來越多的重視,盡管有很多滴眼液被認(rèn)為可以促進(jìn)角膜上皮修復(fù),但由于角膜上皮細(xì)胞具有較強(qiáng)的自我修復(fù)能力,故很難明確不同眼藥水在角膜上皮修復(fù)中的差別。臨床上,人工淚液被廣泛應(yīng)用于促進(jìn)角膜上皮修復(fù),可是選擇何種人工淚液一直沒有相應(yīng)的共識(shí)。搜索文獻(xiàn)發(fā)現(xiàn),關(guān)于人工淚液對(duì)角膜上皮修復(fù)是否存在促進(jìn)作用的相關(guān)臨床報(bào)道及研究較少。人工淚液能夠緩解眼部干澀,改善淚膜功能,延長(zhǎng)淚膜破裂時(shí)間,學(xué)者們已經(jīng)研究透徹,但是,人工淚液除了能改善淚膜功能,對(duì)于角膜損傷修復(fù),究竟有沒有作用尚不得而知。本研究擬探討不同人工淚液對(duì)角膜上皮修復(fù)的影響,首先建立兔角膜損傷模型,模擬人類角膜損傷,觀察不同人工淚液對(duì)兔角膜上皮再生修復(fù)是否存在促進(jìn)作用,同時(shí)比較不同人工淚液時(shí)間是否存在差異,并在角膜上皮修復(fù)不同階段行病理學(xué)及掃描電鏡檢查,以期增加對(duì)人工淚液影響角膜上皮修復(fù)的認(rèn)識(shí),從而為臨床用藥提供依據(jù)。研究目的:觀察不同人工淚液對(duì)兔角膜上皮的修復(fù)過程,評(píng)估人工淚液是否存在促進(jìn)角膜上皮修復(fù)作用,及不同人工淚液之間是否存在差異。研究方法:選取相同年齡的35只(35眼)新西蘭長(zhǎng)耳兔,建立角膜上皮損傷模型(6mm直徑圓形中央上皮缺損),隨機(jī)將動(dòng)物模型分為7組,分別為實(shí)驗(yàn)組:0.1%玻璃酸鈉滴眼液組,0.3%玻璃酸鈉滴眼液組,羥糖苷滴眼液組,聚乙二醇滴眼液組,0.5%羧甲基纖維素鈉滴眼液組,生理鹽水組及空白對(duì)照組。實(shí)驗(yàn)組均給予相應(yīng)滴眼液,使用頻率為1滴/次,4次/日。并且在損傷模型建立之后0小時(shí),24小時(shí),36小時(shí),48小時(shí),60小時(shí)及72小時(shí),進(jìn)行裂隙燈觀察,拍照,并在不同時(shí)期,進(jìn)行病理學(xué)檢查上皮細(xì)胞與基質(zhì)連接及上皮細(xì)胞排列情況,并掃描電鏡觀察角膜上皮超微結(jié)構(gòu)。比較不同實(shí)驗(yàn)組之間的差異,及實(shí)驗(yàn)組與對(duì)照組之間的差異。所有數(shù)據(jù)均采用SPSS 17.0軟件包進(jìn)行統(tǒng)計(jì)學(xué)處理,采用Tamhane'sT2進(jìn)行實(shí)驗(yàn)組間兩兩對(duì)比分析,運(yùn)用獨(dú)立樣本T檢驗(yàn)進(jìn)行實(shí)驗(yàn)組與對(duì)照組對(duì)比分析。P0.05為差異有統(tǒng)計(jì)學(xué)意義。(以a=0.05為檢驗(yàn)水準(zhǔn))。結(jié)果:1.所有損傷角膜上皮(包括實(shí)驗(yàn)組及對(duì)照組)均在72小時(shí)以內(nèi)修復(fù)完全(形態(tài)學(xué)上),大部分損傷眼角膜上皮在60小時(shí)以內(nèi)修復(fù)完全(形態(tài)學(xué)上),少部分在48小時(shí)左右修復(fù)完全。2.72小時(shí),對(duì)實(shí)驗(yàn)組兔眼角膜做病理組織學(xué)檢查發(fā)現(xiàn):所有再生的角膜上皮細(xì)胞層數(shù)完整,排列整齊,與基底部貼合緊密。掃面電鏡觀察超微結(jié)構(gòu)時(shí)發(fā)現(xiàn),24小時(shí),0.3%玻璃酸鈉滴眼液組角膜上皮缺損區(qū)仍有基底膜暴露,生理鹽水滴眼液組基底膜已被再生角膜上皮覆蓋,72小時(shí),生理鹽水組角膜上皮細(xì)胞基質(zhì)內(nèi)含有大量液泡,而0.3%玻璃酸鈉滴眼液組中幾乎沒有,與正常角膜上皮形態(tài)無異。3.空白對(duì)照組角膜上皮再生修復(fù)所需時(shí)間明顯比實(shí)驗(yàn)組長(zhǎng),對(duì)比有統(tǒng)計(jì)學(xué)意義。實(shí)驗(yàn)組之間兩兩比較,差異無統(tǒng)計(jì)學(xué)意義。玻璃酸鈉對(duì)角膜上皮的修復(fù)作用于濃度有關(guān)。結(jié)論:1.人工淚液對(duì)兔角膜上皮損傷均有修復(fù)作用。2.玻璃酸鈉滴眼液對(duì)兔角膜上皮的修復(fù)能力與其濃度有關(guān)。3.生理鹽水可促進(jìn)兔角膜上皮細(xì)胞較快的再生、移行及定植,但72小時(shí)修復(fù)再生的上皮細(xì)胞與正常角膜上皮細(xì)胞內(nèi)微觀結(jié)構(gòu)有差異。
[Abstract]:Background: human cornea consists of five parts of the epithelium, the front elastic layer, the matrix layer, the posterior elastic layer and the endothelial layer. All the layers of the cornea are intact, function and metabolize normally to maintain the overall transparency of the cornea. The corneal epithelial cell layer is in the outer layer of the cornea, to maintain the normal structure and function of the cornea and resist external force invasion. It is of great importance. This is attributed to the connection between epithelial cells, epithelial cells and the basement membrane, and the continuous self renewal of epithelial cells. The epithelial cells are damaged and disappeared, and the connections between the cells and the basement membrane are affected, which lead to the instability of the structure and function of the epithelium and make the cornea tissue easy to suffer. The WHO declared that corneal injury is the second most potential cause of blindness. Some drugs can cause corneal epithelial damage for long time, local use, trauma, infection, and surgery. Incomplete corneal epithelial repair is easy to cause corneal infection and corneal neoplasma. Canes, perforations, perforations, corneal leukoplakia, pannus and even blindness. Generally, corneal epithelial defects, especially small range injuries, are usually repaired faster, but some injuries can lead to persistent corneal epithelial defect, and a relatively severe corneal epithelial injury needs to be treated as soon as possible to promote regenerative repair and avoidance of corneal epithelium. The formation of close connection between corneal epithelial cells is a very important step in the process of corneal epithelial repair. It can promote the complete formation of the epithelial barrier, resist the invasion of the pathogenic microorganism, prevent corneal ulcer and even perforate. In recent years, the rapid repair of corneal epithelium has gained more and more weight in clinic. Although many eye drops are considered to promote corneal epithelial repair, it is difficult to identify the difference in corneal epithelial repair due to the strong self repair ability of corneal epithelial cells. There is a corresponding consensus. The search literature has found that there are few clinical reports and studies about the effect of artificial tears on the promotion of corneal epithelial repair. Artificial tears can relieve eye dryness, improve tear film function, and prolong tear film rupture time. Scholars have studied thoroughly, but artificial tears can improve tear film function, but This study is to explore the effects of different artificial tears on corneal epithelial repair. First of all, a rabbit corneal injury model is established to simulate human corneal injury, and the effect of different artificial tears on corneal epithelial regeneration and repair in rabbits is observed and the different artificial tears are compared. In order to increase the understanding of the influence of artificial tears on corneal epithelium repair and provide a basis for clinical use, the purpose of this study is to observe the repair process of rabbit corneal epithelium with different artificial tears and to evaluate the existence of the promotion angle of artificial tears. Study methods: 35 New Zealand long ear rabbits (35 eyes) of the same age were selected to establish corneal epithelial injury model (6mm diameter circular central epithelial defect), and the animal models were randomly divided into 7 groups, 0.1% Sodium Hyaluronate Eye Drops group and 0.3% sodium hyaluronate drop. Eye fluid group, hydroxy glucoside eye drop group, Polyethylene Glycol Eye Drops group, 0.5% Carboxymethylcellulose Sodium Eye Drops group, saline group and blank control group. The experimental group was given the corresponding eye drops, using 1 drops / times, 4 times / day. And the slit lamp was carried out at 0 hours, 24 hours, 36 hours, 48 hours, 60 hours and 72 hours after the damage model was established. Observation, photographing, and at different periods, pathological examination of epithelial cells and matrix connection and the arrangement of epithelial cells, scanning electron microscope to observe the ultrastructure of corneal epithelium. Compare the differences between the different experimental groups and the differences between the experimental group and the control group. All the data were statistically treated by SPSS 17 software package. 22 contrast analysis between the experimental groups was carried out, and the experimental group was compared with the control group by the independent sample T test. The difference between the experimental group and the control group was statistically significant. (a=0.05 as the test level). Results: 1. all damaged corneal epithelium (including the experimental group and the control group) were completely repaired within 72 hours (morphological) and most of the injuries were damaged within 72 hours. The corneal epithelium was repaired within 60 hours completely (morphologically), less part of the corneal epithelium was repaired for about 48 hours for complete.2.72 hours. Histopathological examination of the cornea of the rabbits in the experimental group showed that all the regenerated corneal epithelial cells were complete, arranged and fitted closely with the basal part. The ultrastructure of the corneal epithelium was found to be 24 hours, 0.. 3% in the corneal epithelial defect area of the Sodium Hyaluronate Eye Drops group, the basement membrane was still exposed, and the basement membrane of the saline eye drops was covered by the regenerated corneal epithelium. 72 hours, there were a large number of vacuoles in the matrix of the corneal epithelial cells in the saline group, while the 0.3% Sodium Hyaluronate Eye Drops group had almost no one in the normal corneal epithelium, which was no different from the normal corneal epithelium in.3. blank control. The time required for regenerative repair of corneal epithelium was significantly longer than that of the experimental group, and the comparison was statistically significant. There was no significant difference between the 22 experimental groups. The repair effect of sodium hyaluronate on corneal epithelium was related to the concentration. Conclusion: 1. artificial tears have a repair effect on corneal epithelial injury in rabbits with.2. Sodium Hyaluronate Eye Drops on the rabbit cornea The repair ability of skin and its concentration related to.3. physiological saline can promote the rapid regeneration, migration and colonization of rabbit corneal epithelial cells, but the microstructure of the epithelial cells regenerated by 72 hours is different from that in the normal corneal epithelial cells.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R77

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 唐細(xì)蘭,葉成添,黃楚龍;人工淚液的應(yīng)用[J];食品與藥品;2005年08期

2 陳倩;劉東;;2008～2010年武漢地區(qū)24家醫(yī)院人工淚液的應(yīng)用分析[J];藥物流行病學(xué)雜志;2011年11期

3 翟嘉潔;;人工淚液,也養(yǎng)眼[J];家庭藥師;2012年12期

4 吳暉;;自造人工淚液省錢又安全[J];老同志之友;2012年23期

5 李旭東;;使用人工淚液后眼睛發(fā)癢是怎么回事[J];求醫(yī)問藥;2013年10期

6 嚴(yán)凱;人工淚液研究的最新進(jìn)展[J];上海生物醫(yī)學(xué)工程;2001年01期

7 嚴(yán)凱,顧其勝;人工淚液研究的最新進(jìn)展[J];透析與人工器官;2002年04期

8 鐘文賢;人工淚液的研究現(xiàn)狀[J];江西醫(yī)藥;2004年01期

9 唐細(xì)蘭;黃楚龍;葉成添;;人工淚液的藥理及臨床使用情況分析[J];中國(guó)生化藥物雜志;2006年02期

10 張君敏;;人工淚液對(duì)兒童春季卡他性結(jié)膜炎的治療作用[J];廣州醫(yī)藥;2009年04期

相關(guān)會(huì)議論文 前10條

1 ;深圳市瑞霖醫(yī)藥有限公司銷售產(chǎn)品簡(jiǎn)介[A];第十一次全省中、西醫(yī)眼科學(xué)術(shù)交流會(huì)學(xué)術(shù)論文集[C];2012年

2 劉李平;宋徽;范銀波;曹小鵬;;非甾體類抗炎藥聯(lián)合人工淚液治療干眼癥的療效分析[A];第十四屆西北五省眼科學(xué)術(shù)大會(huì)論文集[C];2013年

3 楊艷麗;沃娜;王奇;;人工淚液淚然聯(lián)合口服維生素A治療干眼癥的療效[A];中華醫(yī)學(xué)會(huì)第十二屆全國(guó)眼科學(xué)術(shù)大會(huì)論文匯編[C];2007年

4 戴旭鋒;林冰;李英姿;劉曉玲;;人工淚液用量對(duì)大鼠視網(wǎng)膜電圖的影響[A];中華醫(yī)學(xué)會(huì)第十二屆全國(guó)眼科學(xué)術(shù)大會(huì)論文匯編[C];2007年

5 孫莉;陳蔚;張曉博;;暫時(shí)性淚道栓塞在水液缺乏型干眼中的應(yīng)用[A];2006年浙江省眼科學(xué)術(shù)會(huì)議論文集[C];2006年

6 劉爽;晏曉明;李海麗;;倍然治療眼瞼刷上皮病變的初步觀察[A];中華醫(yī)學(xué)會(huì)第十二屆全國(guó)眼科學(xué)術(shù)大會(huì)論文匯編[C];2007年

7 ;江西禾氏美康藥業(yè)有限公司產(chǎn)品——一夫諾[A];第十一次全省中、西醫(yī)眼科學(xué)術(shù)交流會(huì)學(xué)術(shù)論文集[C];2012年

8 王嫦君;解佳雋;葉娟;;納米載藥淚道栓的設(shè)計(jì)及其性能初步研究[A];2011年浙江省眼科學(xué)術(shù)會(huì)議論文集[C];2011年

9 陳國(guó)孝;胡萌菲;;滋陰養(yǎng)血中藥聯(lián)合人工淚液治療干眼癥60例療效觀察[A];慶祝浙江省中西醫(yī)結(jié)合學(xué)會(huì)成立三十周年論文集粹2011[C];2011年

10 婁增新;;淺談中西醫(yī)結(jié)合治療干眼癥的療效[A];全國(guó)第九次中醫(yī)、中西醫(yī)結(jié)合眼科學(xué)術(shù)年會(huì)論文匯編[C];2010年

相關(guān)重要報(bào)紙文章 前10條

1 健康時(shí)報(bào)特約記者　　謝明霞;眼睛干澀巧用人工淚液[N];健康時(shí)報(bào);2006年

2 馬波;一日用幾次人工淚液合適[N];醫(yī)藥養(yǎng)生保健報(bào);2006年

3 北京中醫(yī)藥大學(xué)副教授 張紅林;人工淚液也分不同劑型[N];健康時(shí)報(bào);2007年

4 寧黎麗;關(guān)注人工淚液研發(fā) 保證眼部用藥安全[N];中國(guó)醫(yī)藥報(bào);2007年

5 健康時(shí)報(bào)實(shí)習(xí)記者　 劉雁;使用人工淚液一天別超過六次[N];健康時(shí)報(bào);2006年

6 陶海;人工淚液幫助眼睛“抗旱”[N];健康時(shí)報(bào);2007年

7 謝立科;如何防治干眼[N];中國(guó)中醫(yī)藥報(bào);2007年

8 采訪專家：中南大學(xué)湘雅醫(yī)院眼科主任醫(yī)師 劉雙珍 采寫：謝明霞;眼干燥癥，，如何選擇人工淚液？[N];大眾衛(wèi)生報(bào);2006年

9 陶海;眼睛有時(shí)也需“抗旱”[N];家庭醫(yī)生報(bào);2007年

10 李枋;對(duì)癥選用潤(rùn)眼淚液[N];醫(yī)藥養(yǎng)生保健報(bào);2008年

相關(guān)碩士學(xué)位論文 前9條

1 仇山波;針刺結(jié)合人工淚液治療干眼近遠(yuǎn)期的療效觀察[D];南京中醫(yī)藥大學(xué);2015年

2 張文見;納米尺度眼膏劑用于干眼癥治療的研究[D];復(fù)旦大學(xué);2013年

3 周麗穎;潤(rùn)明顆粒聯(lián)合人工淚液治療陰陽兩虛型干眼臨床療效評(píng)估[D];遼寧中醫(yī)藥大學(xué);2016年

4 潮羽涵;納氣針法治療干眼癥的臨床療效觀察[D];大連醫(yī)科大學(xué);2016年

5 雷瓊;中藥聯(lián)合人工淚液治療更年期干眼臨床評(píng)估[D];大連醫(yī)科大學(xué);2005年

6 高巍;不同成份人工淚液治療白內(nèi)障超聲乳化吸除聯(lián)合人工晶體植入術(shù)后干眼的臨床觀察[D];吉林大學(xué);2015年

7 周穎;中藥熏蒸聯(lián)合人工淚液滴眼治療干眼癥的臨床療效觀察[D];新疆醫(yī)科大學(xué);2013年

8 南浩萍;眼針聯(lián)合人工淚液治療干眼癥60例臨床觀察[D];湖北中醫(yī)藥大學(xué);2014年

9 章友美;滋陰養(yǎng)目湯加減聯(lián)合人工淚液治療肝腎陰虛型干眼癥的療效觀察[D];福建中醫(yī)藥大學(xué);2011年

本文編號(hào)：1907586