眼内液金属蛋白酶含量与手术预后的研究

发布时间：2018-05-04 18:30

本文选题：基质金属蛋白酶 + 增殖性玻璃体视网膜病变　；参考：《中南大学》2012年硕士论文

【摘要】：目的：研究复杂性孔源性视网膜脱离患者玻切+C3F8填充术后玻璃体腔再生成液内基质金属蛋白酶的含量,分析其表达与术后PVR形成及视网膜再脱离的关系,并观察术后眼内气—液交换术次数对其的影响。对象及方法：患者为复杂性孔源视网膜脱离玻璃体视网膜术后采取气体充填及再次眼内气液交换者75眼,其中男性42例,女性33例,年龄17～68岁,平均46±19.3岁,术前PVR—B～D2级。孔源性视网膜脱离合并有脉络膜脱离者32例,32眼。术后PVR再形成并视网膜再脱离13眼,成功62眼。玻璃体切割术中均成功平复视网膜,眼内均为C3F8气体充填,为延长眼内气体充填时间,术后行1～4次徒手眼内气—液交换术,同时获取玻璃体腔再形成液。采用明胶酶谱分析法测定所获样本中MMP-9及MMP-2的含量。结果： 1.无脉络膜脱离的患者及合并有脉络膜脱离的患者经玻切术后取得的玻璃体腔再形成液中均检测到MMP-9及MMP-2的表达。 2.术前合并脉络膜脱离的复杂性视网膜脱离患者的玻璃体腔再形成液中MMP-2与无脉络膜脱离的视网膜脱离患者有明显区别,MMP-9无明显区别,MMP-9与MMP-2的比值增加。 3.MMP-9及MMP-2的表达与术后PVR的再形成呈显著正相关(r=0.63,P0.01)。MMP-2的活性在有PVR复发的RD组患者显著高于无PVR组(P0.01)。MMP-9的变化在两组间也有显著差异(P0.05)。 4.MMP-2,MMP-9的含量随着气液交换的次数减少,MMP-9/MMP-2的比值也明显下降,与取液次数呈反比关系. 结论： 1.玻切术后视网膜再脱离并伴有PVR形成及术前合并脉络膜脱离是影响术后MMP-9和MMP-2表达的重要原因之一 2.玻切术后的对患者行徒手气液交换可有效减少玻璃体腔液中MMPs的含量,并且随交换的次数成反比。 3.测定玻璃体切割术后玻璃体腔液中MMP-9和MMP-2的含量,对如何监测玻切术后眼内组织修复情况的提供了一个简便可行的方法。
[Abstract]:Objective: To study the content of matrix metalloproteinases (MMPs) in vitreous cavity regenerative fluid of complex rhegmatogenous retinal detachment patients after vitrectomy with C3F8, and to analyze the relationship between the expression of matrix metalloproteinases and the formation of PVR and retinal detachment after vitrectomy. The influence of the times of intraocular gas-liquid exchange was observed. Objects and methods: After vitreoretinal surgery, 75 eyes were treated with gas filling and re-intraocular gas-liquid exchange after vitreoretinal surgery, including 42 males and 33 females, with a mean age of 46 卤19.3 years, with a mean age of 46 卤19.3 years. 32 cases (32 eyes) of rhegmatogenous retinal detachment complicated with choroidal detachment. Postoperative PVR reformation and retinal detachment in 13 eyes were successful in 62 eyes. The retina was successfully flattened in vitrectomy, and the intraocular C3F8 gas filling was performed. In order to prolong the time of intraocular gas filling, the intraocular gas-liquid exchange was performed one or four times after vitrectomy, and the vitreous cavity fluid was obtained at the same time. The contents of MMP-9 and MMP-2 in the samples were determined by gelatinase analysis. Results: 1. The expression of MMP-9 and MMP-2 was detected in vitreous cavity of patients without choroidal detachment and patients with choroidal detachment after vitrectomy. 2. There was a significant difference between MMP-2 in vitreous cavity reformation fluid and retinal detachment without choroidal detachment in patients with complicated retinal detachment before operation. There was no significant difference between MMP-9 and MMP-2. There was a significant positive correlation between the expression of 3.MMP-9 and MMP-2 and the re-formation of PVR after operation. The activity of PVR in Rd patients with PVR recurrence was significantly higher than that in Rd patients without PVR. There was also a significant difference between the two groups. 4. The content of MMP-2 and MMP-9 decreased significantly with the decrease of gas-liquid exchange times, and the ratio of MMP-9 / MMP-2 decreased significantly, which was inversely proportional to the number of liquid extraction. Conclusion: 1. Retinal detachment with PVR and choroidal detachment after vitrectomy is one of the important factors influencing the expression of MMP-9 and MMP-2 after vitrectomy. 2. The content of MMPs in vitreous cavity fluid can be reduced effectively by the free hand gas-liquid exchange after vitrectomy, and it is inversely proportional to the number of times of exchange. 3. The content of MMP-9 and MMP-2 in vitreous cavity fluid after vitrectomy was determined, which provided a simple and feasible method for monitoring the repair of intraocular tissue after vitrectomy.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R774.1

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