维生素C不同频率及途径对兔角膜碱烧伤疗效观察
发布时间：2018-10-18 13:24
【摘要】：目的:通过建立兔角膜碱烧伤模型,比较单纯白天1次/h维生素C点眼与高频率维生素C点眼及增加夜间结膜下注射维生素C治疗角膜碱烧伤的疗效差异。 方法:24只成年家兔被随机分为A、B、C、D四组,每组6只眼,建立右眼角膜碱烧伤模型。A组:单纯白天1次/h维生素C点眼;B组:1次/h维生素C点眼加睡前结下注射维生素C;C组:单纯白天高频率维生素C点眼;D组:高频率(1次/10min)维生素C点眼加睡前结下注射维生素C。在碱烧伤后不同时点(1d、3d、5d、7d、14d),角膜荧光素钠染色,眼前节拍照,计算机图像分析,计算角膜上皮修复率;制作不同时点的病理切片,进行光、电镜观察及早中晚测定角膜PH值。 结果: 1、角膜上皮修复率:角膜碱烧伤后,各组角膜上皮趋于逐渐愈合,1d各组角膜上皮修复率比较,差异均有统计学意义(P0.05),D组(0.5635±0.02462)优于B组(0.4054±0.01424),B组优于C组(0.3965±0.02506),C组优于A组(0.3055±0.02066)。3d时D组(0.8881±0.03664)分别与A组(0.7035±0.02522)、B组(0.8485±0.01444)、C组(0.8443±0.03255)比较,D组优于A、B、C组差异均有统计学意义(P0.05),B组与C组比较差异无统计学意义(P0.05)。7d、14d、21d时D组优于其它各组,A组与B组、C组比较,A组角膜上皮愈合较B、C组差,B、C组优于A组,结果有统计学意义(P0.05),B组与C组比较,差异无统计学意义(P0.05)。 2、角膜PPH值:各组碱烧伤后角膜组织PH下降先快后慢,在碱烧伤后2h、1d、3d、7d、14d,D组角膜PH值小于A、B、C组,B、C组介于A、D组之间。PH值经统计学分析,B、C组差异无显著性(P0.05),其余各组间有显著性差异(P0.05)。 3、光镜检查:碱烧伤后7d,D组角膜上皮基本愈合约3-4层,细胞形态规则,排列整齐,基质层胶原纤维排列规则,炎细胞浸润少;A组角膜上皮约2-3层,细胞形态异常且排列紊乱,角膜上皮部分愈合,基质层胶原纤维排列不规则;B、C组角膜上皮2-4层,部分细胞排列不规则。碱烧伤后21d,D组角膜基质层胶原纤维排列较A、B、C组整齐,炎胞浸润亦较少;A组与B、C组比较,A组基质大量炎症细胞浸润,PMN、淋巴细胞均较多,炎症反应强烈,胶原纤维排列紊乱;B、C组形态改变相似,胶原纤维排列情况及炎细胞浸润介于A、D组之间。 4、透射电镜检查:碱烧伤后21d,D组角膜上皮细胞形态接近正常,细胞间可见较多桥粒连接,细胞内线粒体、粗面内质网、高尔基复合体、核糖体较多,染色质丰富,基质层胶原纤维排列较整齐;A组角膜上皮细胞形态不规则,细胞间隙大,未见桥粒连接,上皮细胞核肿胀,线粒体固缩或空泡化,可见大量核旁脂滴,基质层胶原纤维排列紊乱;B、C组介于A、D组之间,角膜上皮细胞形态大致正常,可见少量桥粒连接及核旁脂滴。 结论: 1、角膜碱烧伤后,增加睡前结下注射维生素C对兔角膜碱烧伤的疗效优于单纯白天维生素C点眼。 2、高频率维生素C点眼比低频率维生素C点眼对兔角膜碱烧伤的疗效较好。
[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 卤0.02462) vs B group (0.4054 卤0.01424), B group) vs C group (0.3965 卤0.02506), C group vs A group (0.3055 卤0.02066). 3 days after 3 days, group D (0.8881 卤0.03664) and group A (0.7035 卤0.02522), B) (0.8485 卤0.01444), C) (0.8443 卤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.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.1
本文编号：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 卤0.02462) vs B group (0.4054 卤0.01424), B group) vs C group (0.3965 卤0.02506), C group vs A group (0.3055 卤0.02066). 3 days after 3 days, group D (0.8881 卤0.03664) and group A (0.7035 卤0.02522), B) (0.8485 卤0.01444), C) (0.8443 卤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.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.1
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