本文選題：凍干膠聯(lián)羊膜 + 青光眼��； 參考：《華中科技大學(xué)》2011年博士論文

【摘要】：第一部分自制凍干膠聯(lián)羊膜在兔眼濾過術(shù)后抗瘢痕化作用的研究 目的：探討凍干膠聯(lián)羊膜在實(shí)驗動物兔眼抗青光眼手術(shù)中的抗纖維化作用。方法：選擇日本大白兔24只,隨機(jī)分為3組：實(shí)驗組濾過手術(shù)聯(lián)合凍干膠聯(lián)羊膜移植術(shù)組,對照組濾過手術(shù)聯(lián)合膠聯(lián)自然羊膜組,空白組單純?yōu)V過手術(shù)組。分別與手術(shù)后7天,14天,21天,30天進(jìn)行臨床觀察,HE染色,massion染色,a-SMA免疫組化進(jìn)行組織病理學(xué)觀查。應(yīng)用實(shí)時定量逆轉(zhuǎn)錄聚合酶鏈?zhǔn)椒磻?yīng)(RT-PCR)測其濾過區(qū)域的結(jié)締組織生長因子(CTGF) mRNA的表達(dá)水平。結(jié)果：分別與手術(shù)后7天,14天,21天,30天進(jìn)行臨床觀察,結(jié)膜充血及眼壓有統(tǒng)計學(xué)意義；組織病理學(xué)分析(HE染色,massion染色,a-SMA免疫組化)進(jìn)一步證實(shí),濾過手術(shù)聯(lián)合凍干膠聯(lián)羊膜移植術(shù)組傷口愈合良好,有效減少瘢痕形成,有利于長期保證術(shù)后效果。定量逆轉(zhuǎn)錄聚合酶鏈?zhǔn)椒磻?yīng)(RT-PCR)測其濾過區(qū)域的結(jié)締組織生長因子(CTGF) mRNA的表達(dá)水平,各組在術(shù)后14天達(dá)到高峰,在實(shí)驗的各個時間段CTGFmRNA的表達(dá)：實(shí)驗組對照組空白組。結(jié)論：在我們的實(shí)驗中,凍干膠聯(lián)羊膜延長了濾過泡生存時間,減少了結(jié)膜充血程度,抑制了組織纖維化,在手術(shù)后一定程度降低了眼壓。這種新材料可能常規(guī)用在青光眼濾過術(shù)中。 第二部分自制凍干膠聯(lián)羊膜緩釋藥膜在兔眼濾過術(shù)后抗瘢痕化作用的研究 目的：探討自制凍干膠聯(lián)羊膜做為緩釋藥膜應(yīng)用于兔眼濾過術(shù)后結(jié)膜瓣下,起到抗纖維化作用,延長濾過泡生存時間,降低術(shù)后眼內(nèi)壓(IOP),促進(jìn)濾過術(shù)后傷口正常愈合。方法：選擇日本大白兔24只,隨機(jī)分為3組：實(shí)驗組濾過手術(shù)聯(lián)合結(jié)膜瓣下放置5-fu膠聯(lián)凍干羊膜緩釋藥膜,對照組濾過手術(shù)聯(lián)合結(jié)膜瓣下應(yīng)用5-fu組,空白組單純?yōu)V過手術(shù)組。分別與手術(shù)后7天,14天,21天,30天進(jìn)行臨床觀察,HE染色,massion染色,a-SMA免疫組化進(jìn)行組織病理學(xué)觀查。高效液相(HPLC)色譜儀檢測膠聯(lián)羊膜5-Fu緩釋藥膜控釋系統(tǒng)的兔眼內(nèi)藥代動力學(xué)情況。結(jié)果：分別與手術(shù)后7天,14天,21天,30天進(jìn)行臨床觀察,結(jié)膜充血及眼壓有統(tǒng)計學(xué)意義；組織病理學(xué)分析(HE染色,massion染色,a-SMA免疫組化)進(jìn)一步證實(shí),濾過手術(shù)聯(lián)合凍干膠聯(lián)羊膜緩釋藥膜移植術(shù)組傷口愈合良好,有效減少瘢痕形成,有利于長期保證術(shù)后效果。HPLC檢測術(shù)后3天實(shí)驗組組5-Fu釋放量大于B組5-Fu釋放量。5-FU能從緩釋系統(tǒng)中緩慢釋放,體內(nèi)外釋藥平穩(wěn)、高效,無突釋現(xiàn)象。 結(jié)論：在我們的實(shí)驗中,凍干膠聯(lián)聯(lián)羊膜緩釋藥膜延長了濾過泡生存時間,抑制了結(jié)膜下組織瘢痕化程度,長時間的維持術(shù)后療效,這種新材料可能應(yīng)用在以后的青光眼濾過術(shù)中。
[Abstract]:Part one study on anti-scar effect of self-made freeze-dried gelatin-amniotic membrane in rabbit eye filtration surgery Objective: to investigate the anti-fibrosis effect of freeze-dried gelatine-amniotic membrane in rabbit eyes. Methods: Twenty-four Japanese white rabbits were randomly divided into three groups: the experimental group was treated by filtration surgery combined with freeze-dried glue and amniotic membrane transplantation group, the control group was treated with filtration surgery combined with natural amniotic membrane group, and the blank group was treated with pure filtration operation group. Clinical observation was carried out on the 7th day, 14th day, 21st day and 30th day after operation respectively. The histopathological observation was performed by immunohistochemical staining with HE staining massion staining and a-SMA staining. The expression of connective tissue growth factor (CTGF) mRNA in its filtered region was measured by real-time quantitative reverse transcriptase polymerase chain reaction (RT-PCR). Results: the conjunctival hyperemia and intraocular pressure were observed 7 days, 14 days and 21 days and 30 days after operation respectively. In the group of filtration surgery and freeze-dried glue combined with amniotic membrane transplantation, the wound healed well, the scar formation was effectively reduced, and the long-term effect was ensured. Quantitative reverse transcriptase polymerase chain reaction (RT-PCR) was used to detect the expression level of connective tissue growth factor (CTGF) mRNA in the filtered region. The expression of CTGF mRNA in each group reached its peak on the 14th day after operation. The expression of CTGFmRNA in each time period of the experiment was as follows: the control group was blank group. Conclusion: in our experiment, freeze-dried amniotic membrane prolonged the survival time of filtering bleb, reduced the degree of conjunctival hyperemia, inhibited tissue fibrosis, and reduced intraocular pressure to some extent after operation. This new material may be routinely used in glaucoma filtration surgery. The second part: study on anti-scar effect of self-made freeze-dried gelatin-amniotic membrane sustained release drug membrane in rabbit eye filtration surgery Objective: to study the application of freeze-dried gel combined with amniotic membrane as sustained-release drug membrane under conjunctival flap of rabbit eye filtration, which can prevent fibrosis, prolong survival time of filtering bleb, reduce intraocular pressure (IOP), and promote wound healing after filtering operation. Methods: Twenty-four Japanese white rabbits were randomly divided into three groups: the experimental group was treated with filtration surgery and conjunctival flap placed 5-fu gel and freeze-dried amniotic membrane, the control group was treated with 5-fu under the conjunctival flap, and the control group was treated with filtration only. Clinical observation was carried out on the 7th day, 14th day, 21st day and 30th day after operation respectively. The histopathological observation was performed by immunohistochemical staining with HE staining massion staining and a-SMA staining. High performance liquid chromatography (HPLC) was used to detect the pharmacokinetics of 5-Fu sustained-release drug release system in rabbit eyes. Results: the conjunctival hyperemia and intraocular pressure were observed 7 days, 14 days and 21 days and 30 days after operation respectively. Filtration surgery combined with freeze-dried glue and amniotic membrane sustained release drug membrane transplantation group had good wound healing and effectively reduced scar formation. It was helpful to ensure the long-term effect. The 5-Fu release amount in experimental group was higher than that in group B on the 3rd day after operation. 5-FU was released slowly from the sustained release system, and the drug release in vivo and in vitro was stable, high efficiency and no sudden release. Conclusion: in our experiment, freeze-dried gel combined with amniotic membrane prolonged the survival time of filtration bleb, inhibited the degree of scar formation in subconjunctival tissue, and maintained the postoperative efficacy for a long time. This new material may be used in subsequent glaucoma filtration surgery.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2011
【分類號】：R779.6

【共引文獻(xiàn)】

相關(guān)期刊論文 前6條

1 周衛(wèi)為;張慶平;;青光眼濾過手術(shù)抗瘢痕化的藥物治療[J];廣西醫(yī)學(xué);2006年08期

2 王靜;梁曼;王元貴;李旭庭;;Apoptin基因誘導(dǎo)體外培養(yǎng)的人眼球筋膜囊成纖維細(xì)胞凋亡的初步研究[J];江西醫(yī)學(xué)院學(xué)報;2007年01期

3 范蓮;袁志蘭;陳琴;田寅輝;顧洛;;羥基喜樹堿抑制人眼Tenon囊成纖維細(xì)胞增殖的實(shí)驗研究[J];現(xiàn)代生物醫(yī)學(xué)進(jìn)展;2011年16期

4 葉倩;周和政;;VEGF對青光眼術(shù)后濾過泡瘢痕化影響的研究進(jìn)展[J];眼科新進(jìn)展;2011年12期

5 任彥新;衛(wèi)玉彩;;青光眼濾過手術(shù)中抗瘢痕形成藥物的研究進(jìn)展[J];眼外傷職業(yè)眼病雜志.附眼科手術(shù);2005年12期

6 張振華;李超;;鞏膜瓣下羊膜植入對穿透性小梁切除術(shù)預(yù)后的影響[J];中國醫(yī)學(xué)創(chuàng)新;2009年33期

相關(guān)博士學(xué)位論文 前1條

1 劉文;殼聚糖基5-氟尿嘧啶緩釋膜片的制備及其維持青光眼術(shù)后濾過通道的研究[D];中國海洋大學(xué);2009年

相關(guān)碩士學(xué)位論文 前10條

1 范蓮;羥基喜樹堿調(diào)控青光眼術(shù)區(qū)纖維化的實(shí)驗研究[D];南京醫(yī)科大學(xué);2011年

2 任彥新;紫杉醇在青光眼濾過手術(shù)中抗增殖作用的研究[D];河北醫(yī)科大學(xué);2004年

3 周衛(wèi)為;針刺分離聯(lián)合結(jié)膜下注射干擾素治療失敗濾過泡的臨床研究[D];廣西醫(yī)科大學(xué);2006年

4 姚濤;凍干羊膜的制備及其在兔眼小梁切除術(shù)中應(yīng)用的實(shí)驗研究[D];大連醫(yī)科大學(xué);2006年

5 李艷春;GM6001對實(shí)驗性濾過手術(shù)區(qū)組織PCNA和MMP-2表達(dá)的影響[D];山東大學(xué);2006年

6 徐佳;小梁切除手術(shù)中應(yīng)用絲裂霉素C的近期效果與并發(fā)癥分析[D];浙江大學(xué);2007年

7 李琴;晚期青光眼小梁切除術(shù)后視野分析[D];昆明醫(yī)學(xué)院;2007年

8 丁冰杰;白內(nèi)障超聲乳化吸除治療閉角型青光眼的循證評價[D];河北醫(yī)科大學(xué);2008年

9 王震;小梁切除術(shù)聯(lián)合MMC及生物羊膜移植可調(diào)整縫線治療難治性青光眼的臨床觀察[D];山東大學(xué);2010年

10 葉倩;Avastin對兔眼小梁切除術(shù)后濾過泡血管內(nèi)皮生長因子（VEGF）和轉(zhuǎn)化生長因子（TGF-β_2）抑制作用的實(shí)驗研究[D];南方醫(yī)科大學(xué);2012年

，

本文編號：1931144