中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2012年
5期
414-417
,共4页
王莹%韩风梅%楚艳华%韩泉洪%赵堪兴
王瑩%韓風梅%楚豔華%韓泉洪%趙堪興
왕형%한풍매%초염화%한천홍%조감흥
角膜交联术%圆锥角膜%甘油醛%生物力学%弹性模量
角膜交聯術%圓錐角膜%甘油醛%生物力學%彈性模量
각막교련술%원추각막%감유철%생물역학%탄성모량
Corneal collagen crosslinking%Keratoconus%Glyceraldehyde%Biomechanics%Elastic Modulus
背景 目前已有一些角膜胶原交联的方法可用于圆锥角膜的治疗,但其安全性均存在一定问题.甘油醛是一种效果好、不良反应少的交联剂,但其对角膜生物力学特点的作用尚不清楚. 目的 评估甘油醛点眼对大鼠角膜生物力学特性的影响.方法 将15只SD大鼠按随机数字表法分为3个组,分别为0.005 mol/L甘油醛组、0.050 mol/L甘油醛组和空白对照组,每组5只,均取右眼为实验眼；每日点眼2次,连续7d.实验终点处死大鼠,获取大鼠角膜,采用读字法评估各组大鼠角膜的透明度,然后切取两端附带2 mm巩膜组织的角膜中央2 mm×6 mm的条带进行生物力学检测,比较各组大鼠角膜6％弹性模量E(MPa)、极限应力σmax (MPa)、极限应变εmax(％)等指标变化,并行组织病理学检查. 结果 0.005 mol/L甘油醛组、0.050 mol/L甘油醛组和空白对照组均可透过大鼠角膜清晰显示文字.采用6％应变时,0.005 mol/L甘油醛组角膜的平均应力为(0.463±0.065) MPa,0.050 mol/L甘油醛组为(0.846土0.240)MPa,均较空白对照组的(0.195±0.103)MPa明显升高,差异均有统计学意义(P=0.029、0.000)；0.005 mol/L甘油醛组、0.050 mol/L甘油醛组、空白对照组角膜极限应力分别为(6.043±2.084)、(10.759±3.337)、(5.295±1.313) MPa,其中0.050 moL/L甘油醛组较空白对照组明显升高,差异均有统计学意义(P=0.007),0.005 mol/L甘油醛组与空白对照组间比较差异无统计学意义(P=0.660).0.005 mol/L甘油醛组、0.050 mol/L甘油醛组角膜极限应变分别为(36.57±3.09)％、(28.53±1.89)％,均较空白对照组的(43.87±1.89)％明显降低,差异均有统计学意义( P=0.009、0.000).0.005 mol/L甘油醛组、0.050mol/L甘油醛组6％弹性模量E值是(7.718±1.076) MPa和( 14.102±4.011) MPa,明显高于空白对照组的(3.252±1.717)MPa,差异均有统计学意义(P=0.029、0.000).空白对照组大鼠角膜组织切片显示胶原纤维密度最低,0.050 mol/L甘油醛组较0.005 mol/L甘油醛组大鼠角膜胶原纤维密度致密,角膜上皮层及内皮层完整.结论 甘油醛交联明显改善了角膜的生物力学指标和胶原纤维密度,但如用于对圆锥角膜的治疗仍需进一步研究角膜交联的长期效果及其安全性.
揹景 目前已有一些角膜膠原交聯的方法可用于圓錐角膜的治療,但其安全性均存在一定問題.甘油醛是一種效果好、不良反應少的交聯劑,但其對角膜生物力學特點的作用尚不清楚. 目的 評估甘油醛點眼對大鼠角膜生物力學特性的影響.方法 將15隻SD大鼠按隨機數字錶法分為3箇組,分彆為0.005 mol/L甘油醛組、0.050 mol/L甘油醛組和空白對照組,每組5隻,均取右眼為實驗眼；每日點眼2次,連續7d.實驗終點處死大鼠,穫取大鼠角膜,採用讀字法評估各組大鼠角膜的透明度,然後切取兩耑附帶2 mm鞏膜組織的角膜中央2 mm×6 mm的條帶進行生物力學檢測,比較各組大鼠角膜6％彈性模量E(MPa)、極限應力σmax (MPa)、極限應變εmax(％)等指標變化,併行組織病理學檢查. 結果 0.005 mol/L甘油醛組、0.050 mol/L甘油醛組和空白對照組均可透過大鼠角膜清晰顯示文字.採用6％應變時,0.005 mol/L甘油醛組角膜的平均應力為(0.463±0.065) MPa,0.050 mol/L甘油醛組為(0.846土0.240)MPa,均較空白對照組的(0.195±0.103)MPa明顯升高,差異均有統計學意義(P=0.029、0.000)；0.005 mol/L甘油醛組、0.050 mol/L甘油醛組、空白對照組角膜極限應力分彆為(6.043±2.084)、(10.759±3.337)、(5.295±1.313) MPa,其中0.050 moL/L甘油醛組較空白對照組明顯升高,差異均有統計學意義(P=0.007),0.005 mol/L甘油醛組與空白對照組間比較差異無統計學意義(P=0.660).0.005 mol/L甘油醛組、0.050 mol/L甘油醛組角膜極限應變分彆為(36.57±3.09)％、(28.53±1.89)％,均較空白對照組的(43.87±1.89)％明顯降低,差異均有統計學意義( P=0.009、0.000).0.005 mol/L甘油醛組、0.050mol/L甘油醛組6％彈性模量E值是(7.718±1.076) MPa和( 14.102±4.011) MPa,明顯高于空白對照組的(3.252±1.717)MPa,差異均有統計學意義(P=0.029、0.000).空白對照組大鼠角膜組織切片顯示膠原纖維密度最低,0.050 mol/L甘油醛組較0.005 mol/L甘油醛組大鼠角膜膠原纖維密度緻密,角膜上皮層及內皮層完整.結論 甘油醛交聯明顯改善瞭角膜的生物力學指標和膠原纖維密度,但如用于對圓錐角膜的治療仍需進一步研究角膜交聯的長期效果及其安全性.
배경 목전이유일사각막효원교련적방법가용우원추각막적치료,단기안전성균존재일정문제.감유철시일충효과호、불량반응소적교련제,단기대각막생물역학특점적작용상불청초. 목적 평고감유철점안대대서각막생물역학특성적영향.방법 장15지SD대서안수궤수자표법분위3개조,분별위0.005 mol/L감유철조、0.050 mol/L감유철조화공백대조조,매조5지,균취우안위실험안；매일점안2차,련속7d.실험종점처사대서,획취대서각막,채용독자법평고각조대서각막적투명도,연후절취량단부대2 mm공막조직적각막중앙2 mm×6 mm적조대진행생물역학검측,비교각조대서각막6％탄성모량E(MPa)、겁한응력σmax (MPa)、겁한응변εmax(％)등지표변화,병행조직병이학검사. 결과 0.005 mol/L감유철조、0.050 mol/L감유철조화공백대조조균가투과대서각막청석현시문자.채용6％응변시,0.005 mol/L감유철조각막적평균응력위(0.463±0.065) MPa,0.050 mol/L감유철조위(0.846토0.240)MPa,균교공백대조조적(0.195±0.103)MPa명현승고,차이균유통계학의의(P=0.029、0.000)；0.005 mol/L감유철조、0.050 mol/L감유철조、공백대조조각막겁한응력분별위(6.043±2.084)、(10.759±3.337)、(5.295±1.313) MPa,기중0.050 moL/L감유철조교공백대조조명현승고,차이균유통계학의의(P=0.007),0.005 mol/L감유철조여공백대조조간비교차이무통계학의의(P=0.660).0.005 mol/L감유철조、0.050 mol/L감유철조각막겁한응변분별위(36.57±3.09)％、(28.53±1.89)％,균교공백대조조적(43.87±1.89)％명현강저,차이균유통계학의의( P=0.009、0.000).0.005 mol/L감유철조、0.050mol/L감유철조6％탄성모량E치시(7.718±1.076) MPa화( 14.102±4.011) MPa,명현고우공백대조조적(3.252±1.717)MPa,차이균유통계학의의(P=0.029、0.000).공백대조조대서각막조직절편현시효원섬유밀도최저,0.050 mol/L감유철조교0.005 mol/L감유철조대서각막효원섬유밀도치밀,각막상피층급내피층완정.결론 감유철교련명현개선료각막적생물역학지표화효원섬유밀도,단여용우대원추각막적치료잉수진일보연구각막교련적장기효과급기안전성.
Background Several cornea collagen crosslinking methods have been used to treat keratoconus.However,the safety of these methods is dissatisfactory.Glyceraldehyde is a very potent and highly reactive crosslinking agent,with little toxicity,but its effect on corneal biomechanical property is poorly clear. Objective The aim of this study was to evaluate the biomechanical effects of glyceraldehyde collagen crosslinking on rats cornea. Methods Fifteen clean SD rats were randomly divided into 0.005 mol/L glyceraldhyde group,0.050 mol/L glyceraldhyde group and blank control group.Glyceraldhyde drops was topically administered in the right ryes 2 times per day for consecutive 7 days in the 0.005 mol/L and 0.050 mol/L glyceraldhyde groups,and no any eye drops was used in the blank control group.Seven days later,the rats were sacrificed.Transparency of corneal buttons in these different groups was evaluated.The central corneal strips of 2 mm×6 mm with 2 mm scleral tiasue were obtained for the biomeehanical stress-strain measurement,including ultimate stress ( MPa),ultimate strain (％) and 6％ elastic modulus (MPa).Corneal collagen fibril density was assessed by histological examination under a light microscopy.The use of the animals followed the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission. Results The words could be clearly displayed transcorneally in all the three groups.When strain was 6％,the stress was (0.463±0.065 ) MPa in 0.005 mol/L glyceraldehyde group,(0.846±0.240) MPa in 0.050 mol/L glyceraldehyde group,both showing a significant increase in comparison with (0.195±0.103 ) MPa of the blank control group (P=0.029,0.000 ).Following the crosslinking treatment,the ultimate stress was significant elevated in 0.050 mol/L glyceraldehydes group compared with the blank control group ( ( 10.759 ± 3.337 ) MPa vs.(5.295± 1.313 ) MPa,P =0.007 ),but no significant change between the 0.005 mol/L glyceraldehydes group and the blank control group ( ( 6.043 ±2.084) M Pa vs.(5.295 ± 1.313 ) MPa,P =0.660 ).Corneal ultimate strain was lower in the 0.005 mol/L glyceraldehyde group and 0.050 mol/L glyceraldehyde group than the blank control group (36.57％ ±3.09％ vs.43.87％ ± 1.89％,P =0.009;28.53％ ±1.89％ vs.43.87％ ± 1.89％,P =0.000).However,significantly increased 6％ elastic modulus were seen in the 0.005 mol/L glyceraldehyde group and 0.050 moL/L glyceraldehyde group compared with the blank control group ( ( 7.718 ± 1.076 ) MPa,( 14.102 ± 4.011 ) MPa vs.( 3.252 ± 1.717 ) M Pa),with statistically significant differences ( P =0.029,0.000).Histological examination showed a increase of collagen fiber density in the 0.050 mol/L glyceraldehyde group. Conclusions Corneal collagen crosslinking induced by glyceraldehyde strengthens biomechanical intensity and increases the density of corneal collagen fiber.But the safety of glyceraldehyde crosslinking for keratoconus needs further study.
