摘要目的 探讨活化的巨噬细胞在视神经损伤修复中的作用.方法 选取112只健康新西兰大耳白兔作为实验动物,按随机数字表法随机分为实验组和对照组,每组各56只,按照不同观察时间点(1、4、7、10、14、21、28 d)每组分为7个亚组,每亚组8只.用液压冲击颅脑损伤仪(FPI)建立外伤性视神经不完全损伤联合晶体损伤模型作为实验组,外伤性视神经不完全损伤模型作为对照组.应用闪光视觉诱发电位(FVEP)分析并比较实验组、对照组建模前及建模后不同时间点视神经功能变化情况,组织病理学方法 观察并比较实验组、对照组建模后视网膜组织中巨噬细胞及神经节细胞变化情况.结果 建模前,实验组FVEP P100波潜伏时为(42.74±5.83)ms,振幅为(7.98±2.15)μV.建模后1 d,实验组FVEP P100波潜伏时为(103.91±10.89)ms,较建模前延长,差异有统计学意义(t=-8.464,P=0.000);振幅(6.39±2.19)μV,较建模前降低,差异有统计学意义(t=-2.094,P=0.000).建模后10 d,实验组P100波潜伏时最长,之后逐渐恢复(F=35.894,P=0.000).建模后7 d,实验组P100波振幅最低,之后逐渐回升(F=6.594,P=0.000).组织病理学检查显示,建模后1 d,实验组视网膜、视神经未见活化的巨噬细胞,之后逐渐增多,10 d时到达高峰(91.25±6.91),之后又逐渐减少,差异有统计学意义(F=21.277,P=0.000);建模后1 d,实验组视网膜未出现神经节细胞轴突再生,7 d时出现,平均值为6.38±1.85,之后逐渐增多,28 d时到达高峰,平均值为49.63±2.50,差异有统计学意义(F=7.711,P=0.000).结论 视神经不完全损伤联合晶状体损伤后,视神经可逐渐修复,活化的巨噬细胞在视神经不完全损伤修复中起着重要的作用.

abstractsObjective To explore the role of activated macrophage in the repair of traumatic optic nerve injury in an animal model of incomplete traumatic optic nerve injury with lens damage. Methods One hundred and twelve healthy New Zealand big ear white rabbits were divided into two groups (experimentaland control groups) randomly. According to the different time points (one, four, seven, ten, 14, 21 and 28 days), each group was further divided into seven subgroups, each subgroup had eight rabbits. Traumatic optic neuropathy and lens damage were induced in one eye of each rabbit by fluid percussion brain injury device (FPI);those eyes were the experimental group. The eyes of control group only had traumatic optic neuropathy. The functional and morphological changes of retina and optic nerve were evaluated by histopathology and flash-visual evoked potential (FVEP). Results FVEP P100 latency was (42.74± 5.83)ms, P100 amplitude was (7.98 ± 2.15) μV before optic nerve injury was induced. One day after the injury,the P100 latency increased and the P100 amplitude reduced significantly. The P100 latency reached the longest at ten days after injury, and then recovered gradually. The P100 amplitude reached the lowest at seven days after injury, and then recovered gradually. The histopathological examination showed activated macrophages were not detected in the retina and optic nerve at day one after the injury, then they increased gradually and reached their peak (91.25 ±-6.91) at day ten, and decreased after that, the difference was statistically significant (F= 21. 277, P= 0. 000);retinal ganglion cell axon regeneration began at day seven after the injury with an average of (6.38± 1.85). The axons increased gradually and reached their peak (49.63±2. 50) at day 28, and the changes were significant (F=7. 711, P=0. 000). Conclusions Incomplete optic nerve injury can recover gradually if there is lens damage at the same time. Activated macrophage may playan important role in this recovery process.