CAJ | 학술논문

目的探讨实验性前房积血继发高眼压时角膜组织的病理改变.方法 30只新西兰白兔随机分为3组各10只,每组随机一眼作为实验眼,另一眼作为对照眼;第一、二、三组实验眼前房内注射自血形成高眼压,维持时间分别为3、5、8d,对照眼做同样的操作,注射生理盐水.术后裂隙灯显微镜观察角膜情况,于第3、5、8d分别测量3组实验兔的实验眼及对照眼的角膜厚度:并取3组兔实验眼及对照眼角膜并分别进行光镜检查,观察前房积血形成高眼压的实验跟随着时间延长有无角膜血染发生;角膜基质水肿、弹力纤维变化、新生血管等情况;嗜酸细胞、纤维细胞、淋巴细胞、浆细胞变化情况,以及角膜各层病理变化与对照眼进行比较,结果用两个重复测量因素的方差分析进行角膜厚度的组间比较,采用SPSS13.0进行统计分析.结果动物模型成功建立,术后第三组角膜水肿最重,角膜厚度最大,差异有明显的统计学意义(P＝0.000).光学显微镜下可见角膜基质弹力纤维间隙增大,纤维扭曲变形很重.角膜边缘区可见新生血管长入,可见嗜酸细胞浸润,可见少量淋巴细胞及浆细胞、纤维细胞;三组均显示后半部分水肿较前半部分明显.结论实验性前房积血并发高眼压的角膜组织的病理结果显示:随着时间延长角膜水肿越来越重;前房积血并发高眼压8d角膜未出现血染,此时角膜后弹力纤维可见断裂现象,这预示:此时应积极处理高眼压及前房出血,若不积极治疗,可能会引起不可逆的病理改变.
목적 탐토실험성전방적혈계발고안압시각막조직적병리개변.방법 30지신서란백토수궤분위3조각10지,매조수궤일안작위실험안,령일안작위대조안;제일、이、삼조실험안전방내주사자혈형성고안압,유지시간분별위3、5、8d,대조안주동양적조작,주사생리염수.술후렬극등현미경관찰각막정황,우제3、5、8d분별측량3조실험토적실험안급대조안적각막후도:병취3조토실험안급대조안각막병분별진행광경검사,관찰전방적혈형성고안압적실험근수착시간연장유무각막혈염발생;각막기질수종、탄력섬유변화、신생혈관등정황;기산세포、섬유세포、림파세포、장세포변화정황,이급각막각층병리변화여대조안진행비교,결과 용량개중복측량인소적방차분석진행각막후도적조간비교,채용SPSS13.0진행통계분석.결과 동물모형성공건립,술후제삼조각막수종최중,각막후도최대,차이유명현적통계학의의(P＝0.000).광학현미경하가견각막기질탄력섬유간극증대,섬유뉴곡변형흔중.각막변연구가견신생혈관장입,가견기산세포침윤,가견소량림파세포급장세포、섬유세포;삼조균현시후반부분수종교전반부분명현.결론 실험성전방적혈병발고안압적각막조직적병리결과 현시:수착시간연장각막수종월래월중;전방적혈병발고안압8d각막미출현혈염,차시각막후탄력섬유가견단렬현상,저예시:차시응적겁처리고안압급전방출혈,약불적겁치료,가능회인기불가역적병리개변.
Objective To evaluate the impact of hyphema secondary to high intmocular pressure on corneal pathology in rabbits. Methods Thirty adult New Zealand rabbit were randomized into 3 equal groups, and in each rabbit, one eye served as the experimental eye with the other as the control eye. In the experimental eye, autoblood was injected into the anterior chamber to induce high intraocular pressure maintained for 3, 5, or 8 days. Only saline was injected into the control eye. After the injections, the cornea was observed with slit-lamp microscopy, and at 3, 5, or 8 days, the experimental and control eyes were taken from the 3 groups for microscopic examination of the corneas to detect the occurrence of cornea bloodstain with prolonged high intraocular pressure. Corneal edema, elastic fibers changes, growth of new blood vessels, changes of eosinophils, fibroblasts, lymphocytes and plasma cells, as well as the pathological changes of the corneal layers were observed and compared between the experimental and control eyes. Results Maintenance of high intraocniar pressure for 8 days resulted in the most severe corneal edema and thickening, and histopathologically, the corneal stroma showed widened space between the elastic fibers and obvious fiber distortion. Neovascularization was seen in the marginal cornea where eosinophil infiltration occurred with a small number of lymphocytes, plasma cells and fiber cells. All the three groups showed more obvious edema in the posterior than in the anterior cornea. Conclusion Prolonged hyphema with ocular hypertension results in aggravation of corneal edema, and corneal blood staining does not occur until 8 days of high intraocular pressure but corneal elastic fiber disruption can be seen, suggesting the impending irreversible pathological changes of cornea.