本文選題：脫細(xì)胞角膜基質(zhì) + 包裹材料　； 參考：《南昌大學(xué)》2014年碩士論文

【摘要】：目的： 利用反復(fù)凍融+電泳法制備脫細(xì)胞角膜基質(zhì),同時(shí)初步觀察豬脫細(xì)胞角膜基質(zhì)(APCS)作為羥基磷灰石(HA)義眼臺(tái)包裹材料的可行性，為其在眼整形方面的臨床應(yīng)用提供理論和實(shí)驗(yàn)基礎(chǔ)。 方法： 1、采用反復(fù)凍融+電泳法去除豬角膜細(xì)胞成分，制備脫細(xì)胞角膜基質(zhì)（APCS），利用病理切片染色方法檢查其細(xì)胞去除和細(xì)胞外基質(zhì)結(jié)構(gòu)保留情況，同時(shí)利用皮下植入法檢測(cè)其生物相容性； 2、將30只新西蘭白兔隨機(jī)分為A、B2組,每組15只，各組均將HA義眼臺(tái)植入兔左眼眶內(nèi)。A組為對(duì)照組，植入自體鞏膜包裹的HA義眼臺(tái)，B組植入APCS包裹的HA義眼臺(tái)。術(shù)后每天肉眼和裂隙燈顯微鏡檢查術(shù)眼，觀測(cè)眼瞼、結(jié)膜囊愈合情況及義眼臺(tái)有無(wú)暴露，并分別于術(shù)后1周、2周、3周、4周、5周對(duì)每組兔均進(jìn)行雙眼增強(qiáng)磁共振掃描，同時(shí)兩組各隨機(jī)取出1只義眼臺(tái)植入物行組織病理學(xué)檢查，比較植入義眼臺(tái)纖維血管化程度的差異。 結(jié)果： 1、新鮮豬角膜經(jīng)過(guò)脫細(xì)胞進(jìn)程處理，基質(zhì)細(xì)胞已全部移除，細(xì)胞外基質(zhì)構(gòu)架保存良好（含前彈力層及前2/3基質(zhì)層），免疫反應(yīng)實(shí)驗(yàn)結(jié)果顯示：皮下植入后第2周，APCS組織周邊炎性細(xì)胞聚集明顯，以中性粒細(xì)胞為主，植入后4周，實(shí)驗(yàn)組與對(duì)照組均未發(fā)現(xiàn)明顯排斥反應(yīng)， APCS組織中未見(jiàn)中性粒細(xì)胞及淋巴細(xì)胞浸潤(rùn)，周?chē)w維結(jié)締組織，，與周邊形成明顯界限。 2、術(shù)后1周，A、 B組均開(kāi)始有不同程度的血管化，B組血管化速度緩慢，兩組磁共振掃描結(jié)果有統(tǒng)計(jì)學(xué)差異（A、B組間p＜0.05）。術(shù)后2周，兩組血管化程度都提高，但均未完全血管化，B組血管化程度稍低于A組，兩組之間血管化差異有統(tǒng)計(jì)學(xué)意義（A、B組間p＜0.05）。術(shù)后3周，兩組植入物血管化程度加深，較前有明顯提高，但未完全血管化，兩組之間的血管化無(wú)統(tǒng)計(jì)學(xué)差異（A、B組間p＞0.05）。術(shù)后4周及以后， A、B兩組均達(dá)到完全血管化，兩組間無(wú)統(tǒng)計(jì)學(xué)差異。 結(jié)論： 1、利用反復(fù)凍融+電泳法能完全去除豬角膜基質(zhì)細(xì)胞,同時(shí)良好保留細(xì)胞外基質(zhì),使其結(jié)構(gòu)不受破壞。 2、APCS對(duì)早期的HA義眼臺(tái)血管化無(wú)顯著影響，并未延緩羥基磷灰石義眼臺(tái)完全血管化進(jìn)程。 3、利用APCS作為HA義眼臺(tái)植入的包裹材料具有一定可行性。
[Abstract]:Objective:Acellular corneal stroma was prepared by repeated freeze-thaw electrophoresis, and the feasibility of APCS as hydroxyapatite (HA) implantation material was preliminarily observed.To provide theoretical and experimental basis for its clinical application in ocular plastic surgery.Methods:1. The acellular corneal stroma (APCS) was prepared by repeated freeze-thaw electrophoresis, and the cell removal and extracellular matrix structure retention were examined by pathological section staining.At the same time, the biocompatibility was detected by subcutaneous implantation.2. Thirty New Zealand white rabbits were randomly divided into two groups: group A (n = 15), group A (n = 15), and group A (n = 15): the HA prosthesis was implanted into the left orbit of rabbits as a control group.The healing of eyelid and conjunctival sac and the exposure of prosthetic ocular platform were observed every day after operation with slit lamp microscope. The enhanced magnetic resonance imaging (enhanced magnetic resonance imaging) was performed in each group at 1 week, 2 weeks, 3 weeks, 4 weeks and 5 weeks, respectively.At the same time, one implant was randomly removed from each group for histopathological examination to compare the degree of fibrous vascularization.Results:1. After the fresh porcine cornea was treated with acellular process, all the stromal cells were removed.The extracellular matrix structure was well preserved (including the anterior elastic layer and the first 2 / 3 matrix layer). The results of immunoreaction showed that the inflammatory cells around the tissue of APCS were mainly neutrophils at 2 weeks after subcutaneous implantation, and were mainly neutrophils at 4 weeks after implantation.No significant rejection was found in the experimental group and control group, no neutrophil and lymphocyte infiltration was found in the APCS tissue, and the surrounding fibrous connective tissue formed a clear boundary with the peripheral tissue.(2) at 1 week after operation, the velocity of vascularization in group B began to be slow with different degrees of vascularization. There was a significant difference between the two groups in the results of magnetic resonance imaging (P < 0.05).Two weeks after operation, the degree of vascularization increased in both groups, but the degree of vascularization in group B was slightly lower than that in group A, and the difference between the two groups was statistically significant (p < 0.05).At 3 weeks after operation, the degree of vascularization of the implants in the two groups was deepened and increased obviously, but not completely vascularized. There was no significant difference in vascularization between the two groups (p > 0.05).After 4 weeks and after operation, the two groups reached complete vascularization, and there was no statistical difference between the two groups.Conclusion:1. The porcine corneal stromal cells can be completely removed by repeated freeze-thaw electrophoresis, and the extracellular matrix can be preserved so that its structure can not be destroyed.(2) APCS had no significant effect on the vascularization of HA prosthesis in early stage, and did not delay the complete vascularization of hydroxyapatite prosthesis.3. It is feasible to use APCS as the encapsulation material for HA implant.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R779.6

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