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

【摘要】：第一部分自制凍干膠聯(lián)羊膜在兔眼濾過術后抗瘢痕化作用的研究 目的：探討凍干膠聯(lián)羊膜在實驗動物兔眼抗青光眼手術中的抗纖維化作用。方法：選擇日本大白兔24只,隨機分為3組：實驗組濾過手術聯(lián)合凍干膠聯(lián)羊膜移植術組,對照組濾過手術聯(lián)合膠聯(lián)自然羊膜組,空白組單純?yōu)V過手術組。分別與手術后7天,14天,21天,30天進行臨床觀察,HE染色,massion染色,a-SMA免疫組化進行組織病理學觀查。應用實時定量逆轉錄聚合酶鏈式反應(RT-PCR)測其濾過區(qū)域的結締組織生長因子(CTGF) mRNA的表達水平。結果：分別與手術后7天,14天,21天,30天進行臨床觀察,結膜充血及眼壓有統(tǒng)計學意義；組織病理學分析(HE染色,massion染色,a-SMA免疫組化)進一步證實,濾過手術聯(lián)合凍干膠聯(lián)羊膜移植術組傷口愈合良好,有效減少瘢痕形成,有利于長期保證術后效果。定量逆轉錄聚合酶鏈式反應(RT-PCR)測其濾過區(qū)域的結締組織生長因子(CTGF) mRNA的表達水平,各組在術后14天達到高峰,在實驗的各個時間段CTGFmRNA的表達：實驗組對照組空白組。結論：在我們的實驗中,凍干膠聯(lián)羊膜延長了濾過泡生存時間,減少了結膜充血程度,抑制了組織纖維化,在手術后一定程度降低了眼壓。這種新材料可能常規(guī)用在青光眼濾過術中。 第二部分自制凍干膠聯(lián)羊膜緩釋藥膜在兔眼濾過術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用于兔眼濾過術后結膜瓣下,起到抗纖維化作用,延長濾過泡生存時間,降低術后眼內壓(IOP),促進濾過術后傷口正常愈合。方法：選擇日本大白兔24只,隨機分為3組：實驗組濾過手術聯(lián)合結膜瓣下放置5-fu膠聯(lián)凍干羊膜緩釋藥膜,對照組濾過手術聯(lián)合結膜瓣下應用5-fu組,空白組單純?yōu)V過手術組。分別與手術后7天,14天,21天,30天進行臨床觀察,HE染色,massion染色,a-SMA免疫組化進行組織病理學觀查。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)的兔眼內藥代動力學情況。結果：分別與手術后7天,14天,21天,30天進行臨床觀察,結膜充血及眼壓有統(tǒng)計學意義；組織病理學分析(HE染色,massion染色,a-SMA免疫組化)進一步證實,濾過手術聯(lián)合凍干膠聯(lián)羊膜緩釋藥膜移植術組傷口愈合良好,有效減少瘢痕形成,有利于長期保證術后效果。HPLC檢測術后3天實驗組組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,體內外釋藥平穩(wěn)、高效,無突釋現(xiàn)象。 結論：在我們的實驗中,凍干膠聯(lián)聯(lián)羊膜緩釋藥膜延長了濾過泡生存時間,抑制了結膜下組織瘢痕化程度,長時間的維持術后療效,這種新材料可能應用在以后的青光眼濾過術中。
[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.
【學位授予單位】：華中科技大學
【學位級別】：博士
【學位授予年份】：2011
【分類號】：R779.6

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