維生素C不同頻率及途徑對(duì)兔角膜堿燒傷療效觀察
發(fā)布時(shí)間：2018-10-18 13:24
【摘要】：目的:通過建立兔角膜堿燒傷模型,比較單純白天1次/h維生素C點(diǎn)眼與高頻率維生素C點(diǎn)眼及增加夜間結(jié)膜下注射維生素C治療角膜堿燒傷的療效差異。 方法:24只成年家兔被隨機(jī)分為A、B、C、D四組,每組6只眼,建立右眼角膜堿燒傷模型。A組:單純白天1次/h維生素C點(diǎn)眼;B組:1次/h維生素C點(diǎn)眼加睡前結(jié)下注射維生素C;C組:單純白天高頻率維生素C點(diǎn)眼;D組:高頻率(1次/10min)維生素C點(diǎn)眼加睡前結(jié)下注射維生素C。在堿燒傷后不同時(shí)點(diǎn)(1d、3d、5d、7d、14d),角膜熒光素鈉染色,眼前節(jié)拍照,計(jì)算機(jī)圖像分析,計(jì)算角膜上皮修復(fù)率;制作不同時(shí)點(diǎn)的病理切片,進(jìn)行光、電鏡觀察及早中晚測(cè)定角膜PH值。 結(jié)果: 1、角膜上皮修復(fù)率:角膜堿燒傷后,各組角膜上皮趨于逐漸愈合,1d各組角膜上皮修復(fù)率比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05),D組(0.5635±0.02462)優(yōu)于B組(0.4054±0.01424),B組優(yōu)于C組(0.3965±0.02506),C組優(yōu)于A組(0.3055±0.02066)。3d時(shí)D組(0.8881±0.03664)分別與A組(0.7035±0.02522)、B組(0.8485±0.01444)、C組(0.8443±0.03255)比較,D組優(yōu)于A、B、C組差異均有統(tǒng)計(jì)學(xué)意義(P0.05),B組與C組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。7d、14d、21d時(shí)D組優(yōu)于其它各組,A組與B組、C組比較,A組角膜上皮愈合較B、C組差,B、C組優(yōu)于A組,結(jié)果有統(tǒng)計(jì)學(xué)意義(P0.05),B組與C組比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。 2、角膜PPH值:各組堿燒傷后角膜組織PH下降先快后慢,在堿燒傷后2h、1d、3d、7d、14d,D組角膜PH值小于A、B、C組,B、C組介于A、D組之間。PH值經(jīng)統(tǒng)計(jì)學(xué)分析,B、C組差異無(wú)顯著性(P0.05),其余各組間有顯著性差異(P0.05)。 3、光鏡檢查:堿燒傷后7d,D組角膜上皮基本愈合約3-4層,細(xì)胞形態(tài)規(guī)則,排列整齊,基質(zhì)層膠原纖維排列規(guī)則,炎細(xì)胞浸潤(rùn)少;A組角膜上皮約2-3層,細(xì)胞形態(tài)異常且排列紊亂,角膜上皮部分愈合,基質(zhì)層膠原纖維排列不規(guī)則;B、C組角膜上皮2-4層,部分細(xì)胞排列不規(guī)則。堿燒傷后21d,D組角膜基質(zhì)層膠原纖維排列較A、B、C組整齊,炎胞浸潤(rùn)亦較少;A組與B、C組比較,A組基質(zhì)大量炎癥細(xì)胞浸潤(rùn),PMN、淋巴細(xì)胞均較多,炎癥反應(yīng)強(qiáng)烈,膠原纖維排列紊亂;B、C組形態(tài)改變相似,膠原纖維排列情況及炎細(xì)胞浸潤(rùn)介于A、D組之間。 4、透射電鏡檢查:堿燒傷后21d,D組角膜上皮細(xì)胞形態(tài)接近正常,細(xì)胞間可見較多橋粒連接,細(xì)胞內(nèi)線粒體、粗面內(nèi)質(zhì)網(wǎng)、高爾基復(fù)合體、核糖體較多,染色質(zhì)豐富,基質(zhì)層膠原纖維排列較整齊;A組角膜上皮細(xì)胞形態(tài)不規(guī)則,細(xì)胞間隙大,未見橋粒連接,上皮細(xì)胞核腫脹,線粒體固縮或空泡化,可見大量核旁脂滴,基質(zhì)層膠原纖維排列紊亂;B、C組介于A、D組之間,角膜上皮細(xì)胞形態(tài)大致正常,可見少量橋粒連接及核旁脂滴。 結(jié)論: 1、角膜堿燒傷后,增加睡前結(jié)下注射維生素C對(duì)兔角膜堿燒傷的療效優(yōu)于單純白天維生素C點(diǎn)眼。 2、高頻率維生素C點(diǎn)眼比低頻率維生素C點(diǎn)眼對(duì)兔角膜堿燒傷的療效較好。
[Abstract]:Objective: to establish a rabbit corneal alkali burn model and compare the therapeutic effects of single daily vitamin C spot eye with high frequency vitamin C spot eye and increasing night subconjunctival injection of vitamin C in the treatment of corneal alkali burn. Methods: Twenty-four adult rabbits were randomly divided into four groups with 6 eyes in each group. Establish the right corneal alkali burn model. Group A: vitamin C spot eye once a day alone; group B: vitamin C injection before bedtime; group C: single high frequency vitamin C spot eye during daytime; group D: high frequency vitamin C spot eye; group B: vitamin C injection before bedtime. Group C: single high frequency vitamin C spot eye in daytime; group D: high frequency vitamin C spot eye. (1 / 10min) Vitamin C was injected into the eyes before bedtime. At different time points (1 d ~ 3 d ~ 5 d ~ 7 d ~ 14 d), cornea fluorescein sodium staining, anterior segment photography, computer image analysis, corneal epithelial repair rate were calculated, and pathological sections were made at different time points for light, electron microscope observation and early, middle and late corneal PH measurement. Results: 1. Corneal epithelial repair rate: after alkali burn of cornea, corneal epithelium of each group tended to heal gradually. The difference was statistically significant (P0.05), D group (0.5635 鹵0.02462) vs B group (0.4054 鹵0.01424), B group) vs C group (0.3965 鹵0.02506), C group vs A group (0.3055 鹵0.02066). 3 days after 3 days, group D (0.8881 鹵0.03664) and group A (0.7035 鹵0.02522), B) (0.8485 鹵0.01444), C) (0.8443 鹵0.03255), group D (P 0.05) was better than group C (P 0.05) and group C had no difference. The corneal epithelial healing of group A was worse than that of group B, group A was better than group A than group B, group B was better than group A, and group B was better than group A. Results there was no significant difference between), B group and C group (P0.05). The corneal PPH value: after alkali burn, the PH of corneal tissue in each group decreased quickly first and then slowly. The corneal PH value in group D was lower than that in group A (14 d) after alkali burn. The PH value of group C was between group A and D (P 0.05), but there was no significant difference among other groups (P 0.05). Light microscopy: group D after 7 days of alkali burn, there was no significant difference (P0.05). Light microscopy: group D, 7 days after alkali burn, there was no significant difference in PH value between group B and C (P0.05), but there was no significant difference between group B and C (P0.05). Light microscopy: group D after 7 days of alkali burn had no significant difference (P0.05). The corneal epithelium is basically healed in 3-4 layers. In group A, the corneal epithelium was about 2-3 layers with abnormal morphology and disordered arrangement, and the corneal epithelium was partially healed. The collagenous fibers in stroma layer were irregular, and in group B C, corneal epithelium was 2-4 layers, and some cells were irregularly arranged. On the 21st day after alkali burn, the collagen fibers of corneal stroma layer in group D were neatly arranged and the infiltration of inflammatory cells was less than that in group A, while in group A, a large number of inflammatory cells were infiltrated, PMN, lymphocytes were more in group A than in group A, and the inflammatory reaction was strong. The morphology of corneal epithelial cells in group B and C was similar, and the arrangement of collagen fibers and the infiltration of inflammatory cells were between group A and D. 4. Transmission electron microscopy showed that the morphology of corneal epithelial cells in group D was close to normal at 21 days after alkali burn. There were more desmosome junctions, mitochondria, rough endoplasmic reticulum, Golgi complex, ribosome, chromatin rich and collagen fibers arranged neatly in matrix layer in group A. in group A, corneal epithelial cells had irregular morphology and large intercellular space. There were no desmosome junctions, swelling of epithelial nuclei, pyknosis or vacuolation of mitochondria, large number of lipid droplets and disorder of collagen fibers in stroma layer. A small number of desmosome junctions and parafronucleus lipid droplets can be seen. Conclusion: 1. After alkali burn of cornea, The effect of increasing vitamin C injection before bedtime on alkali burn of rabbit cornea was better than that of simple vitamin C spot in daytime. 2. High frequency vitamin C spot was better than low frequency vitamin C spot on alkali burn of cornea.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R779.1
本文編號(hào)：2279258
[Abstract]:Objective: to establish a rabbit corneal alkali burn model and compare the therapeutic effects of single daily vitamin C spot eye with high frequency vitamin C spot eye and increasing night subconjunctival injection of vitamin C in the treatment of corneal alkali burn. Methods: Twenty-four adult rabbits were randomly divided into four groups with 6 eyes in each group. Establish the right corneal alkali burn model. Group A: vitamin C spot eye once a day alone; group B: vitamin C injection before bedtime; group C: single high frequency vitamin C spot eye during daytime; group D: high frequency vitamin C spot eye; group B: vitamin C injection before bedtime. Group C: single high frequency vitamin C spot eye in daytime; group D: high frequency vitamin C spot eye. (1 / 10min) Vitamin C was injected into the eyes before bedtime. At different time points (1 d ~ 3 d ~ 5 d ~ 7 d ~ 14 d), cornea fluorescein sodium staining, anterior segment photography, computer image analysis, corneal epithelial repair rate were calculated, and pathological sections were made at different time points for light, electron microscope observation and early, middle and late corneal PH measurement. Results: 1. Corneal epithelial repair rate: after alkali burn of cornea, corneal epithelium of each group tended to heal gradually. The difference was statistically significant (P0.05), D group (0.5635 鹵0.02462) vs B group (0.4054 鹵0.01424), B group) vs C group (0.3965 鹵0.02506), C group vs A group (0.3055 鹵0.02066). 3 days after 3 days, group D (0.8881 鹵0.03664) and group A (0.7035 鹵0.02522), B) (0.8485 鹵0.01444), C) (0.8443 鹵0.03255), group D (P 0.05) was better than group C (P 0.05) and group C had no difference. The corneal epithelial healing of group A was worse than that of group B, group A was better than group A than group B, group B was better than group A, and group B was better than group A. Results there was no significant difference between), B group and C group (P0.05). The corneal PPH value: after alkali burn, the PH of corneal tissue in each group decreased quickly first and then slowly. The corneal PH value in group D was lower than that in group A (14 d) after alkali burn. The PH value of group C was between group A and D (P 0.05), but there was no significant difference among other groups (P 0.05). Light microscopy: group D after 7 days of alkali burn, there was no significant difference (P0.05). Light microscopy: group D, 7 days after alkali burn, there was no significant difference in PH value between group B and C (P0.05), but there was no significant difference between group B and C (P0.05). Light microscopy: group D after 7 days of alkali burn had no significant difference (P0.05). The corneal epithelium is basically healed in 3-4 layers. In group A, the corneal epithelium was about 2-3 layers with abnormal morphology and disordered arrangement, and the corneal epithelium was partially healed. The collagenous fibers in stroma layer were irregular, and in group B C, corneal epithelium was 2-4 layers, and some cells were irregularly arranged. On the 21st day after alkali burn, the collagen fibers of corneal stroma layer in group D were neatly arranged and the infiltration of inflammatory cells was less than that in group A, while in group A, a large number of inflammatory cells were infiltrated, PMN, lymphocytes were more in group A than in group A, and the inflammatory reaction was strong. The morphology of corneal epithelial cells in group B and C was similar, and the arrangement of collagen fibers and the infiltration of inflammatory cells were between group A and D. 4. Transmission electron microscopy showed that the morphology of corneal epithelial cells in group D was close to normal at 21 days after alkali burn. There were more desmosome junctions, mitochondria, rough endoplasmic reticulum, Golgi complex, ribosome, chromatin rich and collagen fibers arranged neatly in matrix layer in group A. in group A, corneal epithelial cells had irregular morphology and large intercellular space. There were no desmosome junctions, swelling of epithelial nuclei, pyknosis or vacuolation of mitochondria, large number of lipid droplets and disorder of collagen fibers in stroma layer. A small number of desmosome junctions and parafronucleus lipid droplets can be seen. Conclusion: 1. After alkali burn of cornea, The effect of increasing vitamin C injection before bedtime on alkali burn of rabbit cornea was better than that of simple vitamin C spot in daytime. 2. High frequency vitamin C spot was better than low frequency vitamin C spot on alkali burn of cornea.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R779.1
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