摘要
背景眶内植入珊瑚多孔羟基磷灰石（CHA）义眼台是矫正眼球内容物摘除术后眼窝凹陷的主要方法，但植入物的血管化程度低可造成植入物感染和暴露。研究表明，碱性成纤维细胞生长因子（bFGF）胶原蛋白复合海绵具有促进新生血管生成的作用，但其能否改善CHA植入物的血管化过程有待研究。目的在体研究bFGF胶原蛋白复合海绵对CHA义眼台纤维血管化的促进作用。方法将45只新西兰白兔用随机数字表分为3个组，所有实验兔均行左眼内容物摘除术，然后在各组兔术眼肌圆锥内分别植入无包裹CHA义眼台、胶原蛋白海绵包裹CHA义眼台和bFGF胶原蛋白复合海绵包裹CHA义眼台。分别于术后2、4…6812周经兔耳缘静脉注射”Tc”．亚甲基二磷酸盐（MDP）3mCi，注射后3h观察双侧兔眼眶内核素扫描显影强度，评估植入物的血管化情况，并计算兔CHA义眼台植入眼与对侧非植入眼眶内平均放射性计数的比值（左眼／右眼）。于术后12周摘取CHA义眼台行组织病理学检查，观察植入物中组织的包裹情况。结果术后随着时间延长，眼部组织的炎症反应逐渐消失，未发现义眼台暴露。核素扫描图像显示，术后2周3个组兔术眼与对侧眼核素显影强度相似，术后4～6周，无包裹CHA义眼台植入组和胶原蛋白海绵包裹CHA义眼台植入组术眼核素显影强度逐渐高于对侧眼，术后8周术眼核素显影最强，而bFGF胶原蛋白复合海绵包裹CHA义眼台植入组兔双眼间核素显影强度的差异则在术后6周最大。术后2、4、6周，bFGF胶原蛋白复合海绵包裹CHA义眼台植入组双眼间眼眶内感兴趣区域（ROI）平均放射性计数值明显高于胶原蛋白海绵包裹CHA义眼台植入组和无包裹CHA义眼台植入组，差异均有统计学意义（P〈0．05）；且胶原蛋白海绵包裹CHA义眼台植入组明显高于无包裹CHA义眼台植入组，差异均有统计学意义（P〈0．05）；术后8周和12周，3个组问双眼间平均放射性计数比值的差异均无统计学意义（P〉0．05）。术后12周组织病理学检查显示，植人物可见胶原纤维呈平行排列，新生血管生长至义眼台中心。结论bFGF（20斗g）胶原蛋白复合海绵和胶原蛋白海绵均可促进CHA义眼台纤维血管化，但bFGF胶原蛋白复合海绵的作用强于胶原蛋白海绵。
Background Intraorbital implantation of coralline porous hydroxyapatite （CHA） is a favorable cosmetic method after enucleation. However, the low degree of vaseularization in implant results in implant infection and exposure. Studies showed that a collagen composite sponge treated by basic fibroblast growth factor （bFGF/ collagen composite sponge） can promote angiogenesis. However, whether bFGF/collagen composite sponge improves the vascularization of CHA implants is unclear. Objective This study was to investigate the accelerating effect of bFGF collagen composite sponge on vaseularization of orbital implant made of CHA using 99Tcm-methylene diphosphate （MDP） scan. Methods Forty-five New Zealand rabbits were randomly assigned to 3 groups. Evisceration of eyeball was performed on the left eyes of rabbits,and naked CHA,collagen composite sponge wrappedCHA and bFGF/collagen composite sponge wrapped CHA were implanted into the orbit respectively in 3 groups. 99Tcm-MDP of 3 mCi was injected in the rabbits via ear vein in 2,4,6,8 and 12 weeks,and the vascular enhancement intensity on implants was observed 3 hours after injection. The ratio of average radioactive count from the area of interest with the same size between the left eyes and the right eyes was calculated. The implants were extracted for histopathological examination in the 12 weeks. Results As the lapse of postoperative time, the inflammation response gradually disappeared and no exposure of implants was seen during the 12-week duration. A similar vascular development strength was found in the area of interest among the 3 groups 2 weeks after surgery. However,the vascular development was significantly enhanced in the left eyes compared the right eyes from 4 to 6 weeks,with the highest intensity in the 8th week in the naked CHA group and collagen composite sponge wrapped CHA group. In the bFGF/ collagen composite sponge wrapped CHA group,the strongest image was in the 6th week after operation. The ratios of average radioactive count between the left eyes and the right eyes were significantly higher in the hFGF/collagen somposite sponge wrapped CHA group compared with the naked CHA group and collagen composite sponge wrapped CHA group （ all at P〈0.05） , and ratios of average radioactive count of the collagen composite sponge wrapped CHA group was significantly higher than that of the naked CHA group （ all at P〈0.05 ）. New blood vessels ingrowed toward the center of the implants through the coralline porous under the optical microscope. Conclusions Both bFGF （20 μg）/collagen composite sponge and collagen composite sponge can accelerate the ingrowth of vessel in the CHA, but the promoting effect of bFGF collagen composite sponge is prominent.
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2014年第8期706-711,共6页
Chinese Journal Of Experimental Ophthalmology
基金
江西省科技厅科技支撑计划项目（2008BA05100）
