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目的探讨羊膜移植在治疗早期兔角膜碱烧伤中的疗效及其对组织型纤溶酶原激活剂(tissue-typeplasminogenactivator,t-PA)和1型纤溶酶原激活剂抑制剂(plasminogenactivatorinhibitor1,PAI-1)活性的影响。设计随机对照实验研究。研究对象72只新西兰白兔,随机分为碱烧伤组、新鲜羊膜移植组、保存羊膜移植组及正常对照组,每组18只。右眼为实验眼。方法制作角膜碱烧伤模型,烧伤后30分钟实施手术。术后第14、30、60天,通过计算机图像分析系统分析角膜情况;并用发色底物法检测角膜组织浸液中t-PA和PAI-1的活性。主要指标角膜上皮荧光染色、角膜烧伤斑面积和平均光密度,t-PA及总PAI-1活性,t-PA/PAI-1比值。结果术后第14、30、60天,新鲜羊膜移植组及保存羊膜移植组t-PA活性和t-PA/PAI-1与碱烧伤组相比均显著下降(P<0.01)。术后第14天,新鲜羊膜移植组t-PA活性明显低于保存羊膜移植组(P=0.022),而总PAI-1活性明显高于保存羊膜移植组(P=0.001);术后第14、30天,t-PA/PAI-1明显低于保存羊膜移植组(P=0.000,P=0.030)。结论羊膜移植术后t-PA活性和t-PA/PAI-1显著下降,证实羊膜具有抑制炎症、抑制瘢痕、促进上皮愈合的功能;新鲜羊膜优于保存羊膜。
Objective To investigate the effect of amniotic membrane transplantation in the treatment of early corneal alkali burns in rabbits and its effect on the expression of tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI- 1) the effect of activity. Design Randomized controlled trial. 72 New Zealand white rabbits were randomly divided into alkali burns group, fresh amniotic membrane transplantation group, preserved amniotic membrane transplantation group and normal control group, with 18 rats in each group. The right eye is the experimental eye. Methods The model of corneal alkali burn was made and the operation was performed 30 minutes after the burn. On the 14th, 30th and 60th postoperative day, the corneal condition was analyzed by computerized image analysis system. The activity of t-PA and PAI-1 in corneal tissue immersion was detected by chromogenic substrate method. The main indicators of corneal epithelial fluorescence staining, corneal burn area and average optical density, t-PA and total PAI-1 activity, t-PA / PAI-1 ratio. Results The t-PA activity and t-PA / PAI-1 in fresh amniotic membrane transplantation group and amniotic membrane transplantation group decreased significantly (P <0.01) on the 14th, 30th and 60th day after operation compared with the alkali burn group. On the 14th postoperative day, t-PA activity in fresh amniotic membrane transplantation group was significantly lower than that in preserved amniotic membrane transplantation group (P = 0.022), while total PAI-1 activity was significantly higher than that in preserved amniotic membrane transplantation group (P = 0.001) 30 days, t-PA / PAI-1 was significantly lower than that of the preserved amniotic membrane transplantation group (P = 0.000, P = 0.030). Conclusions The t-PA activity and t-PA / PAI-1 decreased significantly after amniotic membrane transplantation, demonstrating that amniotic membrane has the functions of inhibiting inflammation, inhibiting scarring and promoting epithelial healing. Fresh amniotic membrane is better than preserving amniotic membrane.