CAJ | 학술논문

目的探讨角膜碱烧伤后的角膜新生淋巴管与炎症反应指数间的关联.方法实验研究.制备大鼠角膜碱烧伤模型.采用5'核苷酸酶-碱性磷酸酶(5'-NA-ALP)双重酶组织化学染色及全角膜免疫荧光法分别检测碱烧伤后1、3 d,1、2、3、4、5、6、7及8周的角膜新生淋巴管和血管的动态变化,并进行淋巴管计数(LVC)和血管计数(BVC).同时,于裂隙灯显微镜下观察角膜炎症反应的变化,记录炎症反应指数(IF),并比较LVC和IF之间的关联.11例人角膜取自碱烧伤后行角膜移植的11例患者.淋巴管内皮细胞受体(LYVE-1)免疫组织化学染色法标记人角膜中的新生淋巴管,LVC和IF之间的关联运用Pearson's相关分析,采用配对t检验比较角膜中存在淋巴管和不存在淋巴管的患者之间IF、炎性细胞计数、碱烧伤病史、年龄的差异.结果碱烧伤后,角膜基质层存在着新生淋巴管.碱烧伤后3 d时出现角膜新生淋巴管,2周末达到高峰,5周末消退.新生淋巴管的出现滞后于炎症反应,但先于炎症反应和新生血管而消退.LVC与IF之间呈正相关(r=0.572,P＜0.01).11例患者中3例存在着角膜新生淋巴管.与另8例角膜中无新生淋巴管的患者相比,前者IF显著性升高(t=3.28,P＜0.05)、炎性细胞计数显著性增加(t=2.42,P＜0.05),年龄显著性下降(t=2.62,P＜0.05),而碱烧伤病史无显著性差异(t=1.28,P＞0.05).结论角膜碱烧伤后有淋巴管生成,角膜新生淋巴管和炎症反应指数之间存在着密切的关联.
목적 탐토각막감소상후적각막신생림파관여염증반응지수간적관련.방법 실험연구.제비대서각막감소상모형.채용5'핵감산매-감성린산매(5'-NA-ALP)쌍중매조직화학염색급전각막면역형광법분별검측감소상후1、3 d,1、2、3、4、5、6、7급8주적각막신생림파관화혈관적동태변화,병진행림파관계수(LVC)화혈관계수(BVC).동시,우렬극등현미경하관찰각막염증반응적변화,기록염증반응지수(IF),병비교LVC화IF지간적관련.11례인각막취자감소상후행각막이식적11례환자.림파관내피세포수체(LYVE-1)면역조직화학염색법표기인각막중적신생림파관,LVC화IF지간적관련운용Pearson's상관분석,채용배대t검험비교각막중존재림파관화불존재림파관적환자지간IF、염성세포계수、감소상병사、년령적차이.결과 감소상후,각막기질층존재착신생림파관.감소상후3 d시출현각막신생림파관,2주말체도고봉,5주말소퇴.신생림파관적출현체후우염증반응,단선우염증반응화신생혈관이소퇴.LVC여IF지간정정상관(r=0.572,P＜0.01).11례환자중3례존재착각막신생림파관.여령8례각막중무신생림파관적환자상비,전자IF현저성승고(t=3.28,P＜0.05)、염성세포계수현저성증가(t=2.42,P＜0.05),년령현저성하강(t=2.62,P＜0.05),이감소상병사무현저성차이(t=1.28,P＞0.05).결론 각막감소상후유림파관생성,각막신생림파관화염증반응지수지간존재착밀절적관련.
Objective To discuss the relationship between corneal lymphangiogenesis and inflammation index (IF) in alkali burned corneas. Methods Experimental research. Rat corneal hemangiogenesis and lymphangiogenesis were examined by 5'-nase-alkaline phosphatase (5'-NA-ALP) double enzyme-histochemistry and whole mount immunofluorescence at 1 day, 3 days, and 1, 2, 3, 4, 5,6, 7, 8 weeks after alkaline burns, and the blood vessel counting (BVC) and the lymphatic vessel counting (LVC) were recorded. The state of corneal inflammation was observed under the slit lamp and evaluated by inflammation index (IF) grading at the same time. Then, the association of LVC with IF was examined. In addition, eleven human alkali burned corneas were obtained from 11 patients undergoing corneal transplantation in Zhongshan Ophthalmic Center from January 2005 to June 2008. Corneal lymphangiogenesis was examined by lymphatic vessel endothelial receptor ( LYVE-1 ) immunohistochemistry. The significance of the differences in IF, inflammatory cells counting, burn history, and age between two groups was analyzed by using paired student's t-test. Results New lymphatic vessels were present in rat alkali burned corneas.Corneal lymphangiogenesis developed 3 days after alkaline burns, reached the top 2 weeks after the injury,then decreased gradually, and disappeared at the end of the 5th week. Corneal lymphatics occurred behind corneal inflammation, but disappeared before corneal inflammation and hemangiogenesis. LVC was strongly and positively correlated with IF ( r = 0. 572, P ＜ 0. 01 ) after corneal alkaline burns. Among eleven human alkali burned corneas, corneal lymphatic vessels were present in 3 corneas. Compared with the other 8 cases without corneal lymphangiogenesis, the scores of IF was significantly higher ( t = 3. 28, P ＜ 0. 05 ), the inflammatory cells counting dramatically increased ( t = 2. 42, P ＜ 0. 05 ), but the age decreased significantly ( t =2.62 ,P ＜0. 05 ). However, the difference in burn history between two groups was not significant( t =1.28 ,P ＞ 0. 05 ). Conclusion Corneal lymphagiogenesis develops after alkaline-burns and correlates closely with inflammation index.