摘要目的 研究Ⅰ型胶原、Ⅲ型胶原在丝素膜移植修复兔眼睑中的表达,探讨应用丝素膜行眼睑重建的愈合机制.方法 将健康新西兰大白兔36只随机分为丝素膜修复组(n=18)和异体巩膜修复组(n=18),均制作右跟上睑板缺损模型,分别植入丝素膜和异体巩膜予以修复.左眼为正常对照.各组于术后第1、2、4周取手术区域上眼睑,苏木精伊红(HE)染色观察组织形态学变化,免疫组织化学法检测眼睑中Ⅰ型胶原、Ⅲ型胶原的表达.结果 所有兔眼睑缺损均Ⅰ期愈合.HE染色结果显示,术后移植区炎性细胞浸润异体巩膜组多于丝素膜组.免疫组化染色结果显示,丝素膜组和异体巩膜组Ⅰ型胶原、Ⅲ型胶原的表达随着术后观察时间的增加而增加.术后各时间点Ⅰ型胶原的表达为异体巩膜组＞丝素膜组＞正常对照组(1周:F=19.586,P＜0.01;2周:F =30.041,P＜0.01;4周:F=32.587,P＜0.01).术后各时间点Ⅲ型胶原的表达为异体巩膜组＞丝素膜组＞正常对照组(1周:F=19.220,P＜0.01;2周:F=39.414,P＜0.01;4周:F=49.680,P＜0.01).结论 丝素膜移植修复兔眼睑缺损Ⅰ型胶原、Ⅲ型胶原表达较异体巩膜少,愈合反应较异体巩膜轻,可用于眼睑重建.

abstractsObjective To study the expression of collagen Ⅰ and collagen Ⅲ in rabbit eyelid with silk fibroin membrane for tarsal repair in eyelid reconstruction and to investigate the healing mechanism of eyelid reconstruction with silk fibroin membrane.Methods Thirty-six healthy New Zealand white rabbits were randomly assigned into group with silk fibroin membrane and group with allogeneic sclera.Tarsal defects were created in all the right upper eyelids in both groups,and repaired by silk fibroin membrane in group with silk fibroin membrane and by allogenic sclera material in group with allogeneic sclera.All the left eyes were as normal controls.Histological examination by HE staining were performed on 1 week,2 weeks and 4 weeks after surgery.The expressions of collagen Ⅰ and collagen Ⅲ in eyelids were detected by immunohistochemical method.Results All the eyelid defects showed a primary healing.There were more inflammatory cells infiltrating in the sclera group than in the silk fibroin group.By immunohistochemical method,the sort order of the expression of collagen Ⅰ in eyelid was the sclera group ＞ the silk fibroin group ＞ the normal control group(1 week:F =19.586,P ＜ 0.01 ; 2 weeks:F =30.04 1,P ＜ 0.01 ; 4 weeks:F =32.587,P ＜ 0.01).The sort order of the expression of collagen Ⅲ in eyelid was the sclera group ＞ the silk fibroin group ＞ the normal control group (1 week:F =19.220,P ＜ 0.01 ; 2 weeks:F =39.414,P ＜ 0.01 ; 4 weeks:F =49.680,P ＜ 0.01).Conclusion The expression of collagen Ⅰ and collagen Ⅲ in rabbit eyelid with silk fibroin membrane for tarsal repair were less than that with allogenic sclera material.Silk fibrobin membran can be used for eyelid reconstruction with less healing response.