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目的 探讨Ahmed房水引流物植入术后瘢痕形成而导致手术失败的原因。设计 病例对照研究。研究对象 分为植管组和对照组,植管组为难治性青光眼行Ahmed引流物植入术后,Ⅱ期手术切除的植入物周围瘢痕组织石蜡标本10例,对照组为同年龄段青光眼患者滤过术前剪取的球筋膜组织标本10例。方法 植管组和对照组的组织标本采用免疫组织化学技术(SP法)检测转化生长因子β1(transforminggrowthfactorbeta1,TGF β1)和Ⅲ型胶原的表达,采用独立样本t检验比较植管组和对照组TGF β1和Ⅲ型胶原表达是否存在差异。主要指标 TGF β1和Ⅲ型胶原的表达。结果 植管组TGF β1(平均灰度值为12 9 6 9±3 2 2 )和Ⅲ型胶原(平均灰度值为10 7 75±4 5 4 )免疫组织化学染色均呈强阳性表达,与对照组相比均有显著性差异(t=2 12 7,P =0 0 38和t =3 6 74 ,P =0 0 0 2 )。结论 TGF β1促进Ⅲ型胶原的合成是房水引流物植入术后瘢痕形成的原因之一。
Objective To investigate the causes of surgical failure caused by scar formation in Ahmed aqueous humor after implantation. Design a case-control study. The subjects were divided into three groups: vascular graft group and control group. In the group of refractory glaucoma, Ahmed drainage group was implanted. In the second phase, 10 cases of paraffin-embedded scar tissue around the implant were treated with glaucoma Ten patients underwent preoperative filtration of the fascia tissue samples. Methods Tissue samples of the vascular graft group and the control group were used to detect the expression of transforming growth factor β1 (TGF β1) and type Ⅲ collagen by immunohistochemical technique (SP method) β1 and type Ⅲ collagen expression differences. The main indexes of TGFβ1 and type Ⅲ collagen expression. Results Immunohistochemical staining of TGF β1 (average gray value: 12 9 6 9 ± 3 2 2) and type Ⅲ collagen (average gray value 10 7 75 ± 4 5 4) There were significant differences between the control group (t = 2 12 7, P = 0 0 38 and t = 3 6 74, P = 0 0 0 2). Conclusion TGF β1-promoted collagen Ⅲ synthesis is one of the causes of scar formation after aqueous humor implantation.