生物型硬脑膜补片在兔睑板重建中的应用

探讨兔睑板重建中生物型硬脑膜补片植入替代睑板的组织相容性,观察其组织转归。方法 20只新西兰大白兔,随机数字表法分为生物型硬脑膜补片组和异体巩膜组,每组10只。去除兔左下睑8 mm×6 mm全层睑板后,分别植入生物型硬脑膜补片与异体巩膜。术后观察2组实验兔手术部位大体外观和对应结膜面的改变,术后2、4、6、8、12周行植片组织HE染色观察组织学改变;术后4、8周植片组织行CD4+、CD8+免疫组化检查。结果 生物型硬脑膜补片植入后未见明显排斥反应。免疫组化显示,术后4周、8周生物型硬脑膜补片组植片组织CD4+、CD8+细胞计数均少于异体巩膜组术后4周:CD4+:(9±4)个/视野比(30±5)个/视野,CD8+:(8±3)个/视野比(66±10)个/视野;术后8周:CD4+:(9±-4)个/视野比(61±10)个/视野;CD8+:(7±2)个/视野比(27±7)个/视野,均P＜0.01]。组织学检查显示生物型硬脑膜补片引起的炎性反应轻微,植入初期机体新生纤维组织开始从周边融人植片,随后周边纤维组织转化成胶原纤维,外周新生血管长入,最终其纤维走行类似正常睑板纤维束。结论 生物型硬脑膜补片在植入兔眼睑后有较好的组织相容性,可以作为生物支架引导新生血管和胶原纤维长入,起到替代睑板的作用。

Use of biological dural grafts in rabbit tarsus reconstruction

Objective To investigate the histocompatibility and histological outcomes of biological dural grafts in rabbit tarsus reconstruction. Methods Twenty New Zealand rabbits were divided into the biological dural graft group and allogenic sclera group (n=10 each) by random number table. The rabbits were subjected to total tarsus resection of the left lower eyelid (8 mm×6 mm in size) and implantation with biological dural grafts or allogenic sclera. The gross appearance of the surgical site and the corresponding surface of palpebrsl conjunctiva were observed in both two groups after surgery. Furthermore, HE staining of the graft tissues was performed at 2, 4, 6, 8, 12 weeks, and immunohistochemical assessment ofCD4+ and CD8+ at 4 and 8 weeks after surgery. Results There was no obvious rejection after implantation of the biological dural graft. Immunohistochemistry revealed less infiltration of CD4+ and CD8+ cells on biological dural grafts compared with allogenic sclera at 4 and 8 weeks after surgery 4 weeks after surgery: CD4+: (9±4)/vision vs (30±5)/vision, CD8+: (8±3)/vision vs (66±10)/vision; 8 weeks after surgery: CD4+: (9±4)/vision vs (61±10)/vision, CD8+: (7±2)/vision vs (27±7)/vision; all P＜0.01]. Histological study showed milder inflammation in biological dural graft as a host reaction to implantation. Early after surgery, newly developed fibrous tissues grew into the graft from periphery and transformed into collagen fibers. Along with neovascularization, the alignment of fibrous tissue in the graft was similar to the fiber bundles in normal tarsus. Conclusion Biological dural graft shows favorable histocompatibility after implantation into eyelids of rabbits, and therefore can be used as a tarsus-substituting bioscaffold for induced growth of new vessels and collagenous fiber.