异体脱细胞真皮基质后巩膜加固术后组织相容性及bFGF表达的变化

目的　观察异体脱细胞真皮基质后巩膜加固术后不同时期的组织相容性、巩膜碱性成纤维细胞生长因子（ｂａｓｉｃｆｉｂｒｏ-ｂｌａｓｔｇｒｏｗｔｈｆａｃｔｏｒ，ｂＦＧＦ）表达的变化。方法　１８只日本大耳白兔随机分为术后１个月、２个月、３个月组，每组６只，左眼为实验眼，行异体脱细胞真皮后巩膜加固术，右眼为自身对照眼，行与实验组相同手术操作但不放置加固材料。大体观察实验眼与对照眼标本情况，ＨＥ染色病理切片观察其组织形态学变化，免疫组织化学法观察实验眼加固区巩膜与对照眼相应区巩膜ｂＦＧＦ的表达。结果　术后１个月、２个月实验眼受体巩膜无溶解破坏，巩膜胶原纤维有炎症细胞浸润，而对照眼相应区域巩膜内少量炎症细胞浸润；术后３个月实验眼脱细胞真皮条带边界较术后１个月、２个月稍模糊，条带表面有纤维结缔组织膜，而对照眼相应区无充血，筋膜与巩膜连接较紧密。术后３个月实验眼受体巩膜胶原仍无破坏，加固条带与受体巩膜融合区结缔组织增生，而对照眼相应区域巩膜内炎症细胞减少。术后１个月、２个月、３个月实验眼加固区巩膜ｂＦＧＦ的表达高于对照眼相应域区巩膜，差异均有统计学意义（ｔ＝２．５９８、１．９８９、５．０９２，Ｐ＝０．０２７、０．０４８、０．００１）。结论　异体脱细胞真皮基质后巩膜加固术后组织相容性较好，巩膜ｂＦＧＦ的表达增加可能与异体脱细胞真皮基质的加固作用有关。

Histocompatibility and expression of bFGF after posterior scleral reinforcement by using allogeneic acellular dermal matrix in rabbits

Objective To observe the histocompatibility and changes of bFGF after posterior scleral reinforcement by using allogenic acellular dermal matrix in rabbits. Methods Eighteen rabbits were randomly divided int0 3 groups: postoperative I month group ,postoperative 2 months group , postoperative 3 months group , 6 rabbits in each group. The left eyes of 18 rabbits were set as the experimental groups,which were operated the posterior scleral reinforcement surgery by using the allogenic acellular dermal. and the right eyes were set as control group , which were operated the same operation as the experimental group without the allogenic acellular dermal. The two eyeballs of each rabbit were enucleated , the histological pathological changes were observed by HE staining, and the expressions of bFGF in scleral were evaluated by immunohistochemical staining. Results In the postoperative 3 months group , the boundary of acellular dermal strip were more vague than postoperative I month and 2 months groups, the surface had some dense fibrous connective tissue membrane. However ,in the corresponding region of control group , the sclera and fascia were closely connected without congestive reaction. In the postoperative I month and 2 months groups , the sclera were not destructed. And in the sclera collagen fiber , some inflammatory cells were infiltrated. However.in the corresponding region of control group , the inflammatory cells were few. In the postoperative 3 months group,receptor sclera collagen were still not damaged, and the fusion zone of the reinforcement strip and receptor sclera had obvious hyperplasia of connective tissue. And in the corresponding region of control group , the inflammatory cells were few. At the postoperative I month.2 months and 3 months,the expression of bFGF in the reinforced area were higher than that in the corresponding area of control eyes , the differences were statistically significant ( t = 2. 598 . 1. 989 , 5. 092 ; P = 0. 027 .0. 048 .0. 001 ) . Conclusion In the posterior sclera reinforcement applications , allogenic acellular dermal matrix has good biocompatibility. The increased expression of bFGF may be associated with allograft acellular dermal matrix reinforcement effect on the rabbit’scleral.