【摘要】：【目的】探索成功建立兔慢性淚囊炎動物模型的方法，分析成功造模的影響因素。 【方法】將55只兔隨機分成A、B、C、D、E五組，每組11只，實驗眼為右眼。A組暫時性淚道阻塞組，采用TDI欖橄油誘導(dǎo)過敏性鼻炎；B組單純細菌接種組，由淚點注入金黃色葡萄球菌細菌懸液（107cells/ml）；C組永久性淚道阻塞組，由淚點注入MMA和PMMA混合物；D組永久性淚道阻塞組聯(lián)合細菌接種組，即在C組基礎(chǔ)上由淚道注入金黃色葡萄球菌細菌懸液（107cells/ml）；E組為正常對照組，由淚點注入注射無菌生理鹽水。觀察五組動物臨床表現(xiàn)，進行淚道沖洗檢查，將出現(xiàn)慢性淚囊炎臨床表現(xiàn)淚道沖洗不通的兔，抽取淚囊分泌物細菌培養(yǎng)和鑒定、淚囊和鼻淚管組織常規(guī)病理學檢查和超微病理學檢查、淚道CT造影檢查。統(tǒng)計慢性淚囊炎的發(fā)生率，分析慢性淚囊炎成功造模的影響因素。 【結(jié)果】A、B、C、D、E五組中，A、B、E組中所有兔均未出現(xiàn)慢性淚囊炎臨床表現(xiàn)，淚道沖洗檢查均通暢。C組和D組出現(xiàn)慢性淚囊炎臨床表現(xiàn)的兔子分別為8只（成功率8/11，72.7%）和9只（9/11，81.8%），淚道沖洗均不通，多為造模后一周內(nèi)開始出現(xiàn)流淚、分泌物增多等類似慢性淚囊炎的臨床癥狀，且兩組間出現(xiàn)慢性淚囊炎的時間上無顯著差異。將出現(xiàn)慢性淚囊炎癥狀的上述兔的淚囊分泌物行細菌培養(yǎng)和鑒定結(jié)果、巴斯德桿菌的檢出率為100%，且D組金黃色葡萄球菌為優(yōu)勢菌；淚囊和鼻淚管組織常規(guī)病理學表現(xiàn)為淚囊和鼻淚管管腔內(nèi)有不同程度的滲出物，粘膜上皮細胞增生，淚囊粘膜上皮可見巢狀的淋巴濾泡，上皮下彈力纖維和膠原纖維等出現(xiàn)變性，纖維結(jié)締組織增生、排列紊亂，漿細胞等炎性細胞浸潤，上皮下毛細血管管腔高度擴張充血；超微病理學表現(xiàn)鼻淚管粘膜柱狀上皮細胞水腫，內(nèi)有線粒體增生和內(nèi)質(zhì)網(wǎng)擴張，并可見細菌，，中性粒細胞浸潤，淚囊粘膜上皮細胞水腫，細胞表面微絨毛減少，胞內(nèi)可見炎性細胞浸潤，鼻淚管粘膜下可見大量纖維結(jié)締組織排列紊亂，纖維增生；淚囊粘膜下大量的炎性細胞浸潤，主要為淋巴細胞、漿細胞和中性粒細胞；淚道CT造影清晰的顯示出鼻淚管的阻塞部位以及阻塞程度。 【結(jié)論】單純細菌接種和暫時性淚道阻塞動物模型不能出現(xiàn)慢性淚囊炎臨床表現(xiàn)。而淚道永久性阻塞聯(lián)合或不聯(lián)合細菌接種動物模型中70%-80%可出現(xiàn)慢性淚囊炎臨床表現(xiàn)，細菌培養(yǎng)陽性，常規(guī)病理學和超微病理學出現(xiàn)細胞結(jié)構(gòu)及形態(tài)等的慢性炎癥的改變，淚道CT造影顯示鼻淚管阻塞，提示成功建立兔慢性淚囊炎動物模型，淚道完全性阻塞是慢性淚囊炎形成的基礎(chǔ)條件。
[Abstract]:Objective: to explore the method of successful establishment of rabbit chronic dacryocystitis animal model and analyze the factors influencing the successful establishment of rabbit chronic dacryocystitis model. [methods] Fifty-five rabbits were randomly divided into five groups (n = 11 in each group) with right eyes, group A with temporary lacrimal duct obstruction and allergic rhinitis induced by TDI olive oil. Group B was inoculated with bacteria, and staphylococcus aureus suspension was injected with lacrimal point (107cells/ml); C group, permanent lacrimal duct obstruction group, MMA and PMMA mixture). Group D (permanent lacrimal passage obstruction) combined with bacterial inoculation group (group C) was injected with staphylococcus aureus bacteria suspension (107cells/ml); E group as normal control group, lacrimal point injection of sterile saline). The clinical manifestations of five groups of animals were observed and lacrimal duct irrigation was performed. The rabbits with chronic dacryocystitis were collected from the lacrimal sac secretion for bacterial culture and identification. Lacrimal sac and nasolacrimal duct histopathology and ultrastructural pathological examination, lacrimal duct CT examination. The incidence of chronic dacryocystitis and the influencing factors of successful modeling of chronic dacryocystitis were analyzed. [results] the clinical manifestations of chronic dacryocystitis were not found in all the rabbits in group A, B, C, D, E. The clinical manifestations of chronic dacryocystitis in group C and D were 8 (8 / 1172.7%) and 9 (9 / 1181.8%), respectively. Most of the clinical symptoms of chronic dacryocystitis appeared within one week after modeling, and there was no significant difference in the time of chronic dacryocystitis between the two groups. The lacrimal sac secretions of the rabbits with chronic dacryocystitis were cultured and identified. The detection rate of Pasteurella was 100, and group D was the dominant strain of Staphylococcus aureus. The histopathological manifestations of lacrimal sac and nasolacrimal duct were as follows: there were exudates in the lacrimal sac and nasolacrimal duct, mucosal epithelial cells proliferated, and nesting lymphoid follicles were found in dacryocyst mucosal epithelium. Degeneration of subepithelial elastic fibers and collagen fibers, proliferation of connective tissue, disorder of arrangement, infiltration of plasma cells and infiltration of inflammatory cells, hyperemia and hyperemia in capillaries. Ultrastructural pathology showed edema of columnar epithelial cells in nasolacrimal duct mucosa, mitochondria proliferation and endoplasmic reticulum dilatation, bacteria, neutrophil infiltration, edema of epithelial cells in dacryocyst mucosa, and decrease of microvilli on the surface of the cells. Inflammatory cell infiltration could be seen in the cells and a large number of fibrous connective tissues were found in the nasolacrimal duct. A large number of inflammatory cells infiltrated in the submucous membrane of the dacryocyst, mainly lymphocytes, plasma cells and neutrophils, and the location of obstruction and the degree of obstruction in the nasolacrimal duct were clearly revealed by lacrimal duct CT. [conclusion] chronic dacryocystitis can not appear in the animal model of bacterial inoculation and temporary lacrimal duct obstruction. In the animal model of permanent obstruction of lacrimal passage with or without bacterial inoculation, 70% to 80% of the patients had chronic dacryocystitis, and the bacteria culture was positive. The changes of chronic inflammation such as cell structure and morphology were observed in routine pathology and ultrapathology. Lacrimal passage CT showed obstruction of nasolacrimal duct, which suggested the successful establishment of animal model of chronic dacryocystitis in rabbits. Complete obstruction of lacrimal passage is the basic condition for the formation of chronic dacryocystitis.
【學位授予單位】：華中科技大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R777.23

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