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牙龈间充质干细胞对兔小梁切除术后滤过泡形态的影响

马遥  张海娟  马科   

  1. 100005 首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科研究所 眼科学与视觉科学北京市重点实验室
  • 收稿日期:2019-03-10 出版日期:2019-05-25 发布日期:2019-06-06
  • 通讯作者: 马科,Email:cdmake@163.com E-mail:cdmake@163.com

Effects of gingival mesenchymal stem cells on the morphology of filtering blebs after trabeculectomy in rabbits

MA Yao, ZHANG Hai-juan, MA Ke   

  1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China
  • Received:2019-03-10 Online:2019-05-25 Published:2019-06-06
  • Contact: MA Ke, Email:cdmake@163.com E-mail:cdmake@163.com

摘要:

目的 观察牙龈间充质干细胞(gingival mesenchymal stem cells,GMSC)对兔实验性抗青光眼术后滤过泡形态的影响,并探索其有效浓度。设计 实验研究。研究对象 新西兰大白兔50只。方法 50只兔随机分为5组,每组10只,分别为Ⅰ组(GMSC 104个/ml)、Ⅱ组(GMSC 105个/ml)、Ⅲ组(GMSC 106个/ml)、Ⅳ组(Healaflow组)和Ⅴ组(生理盐水组)。每只兔行右眼小梁切除术,术毕时将0.3 ml的相应浓度GMSC、Healaflow或生理盐水分别注射至结膜下。术后1、2、4周时测量眼压;术后4、8周行前节OCT扫描,对前节OCT图像中滤过泡进行分型(扁平弥散型、囊型、微小囊泡型、无囊泡型),其中,扁平弥散型和微小囊泡型为功能性滤过泡,囊型和无囊泡型为非功能性滤过泡),计算滤过泡截面积并比较。主要指标 眼压、滤过泡功能分级、滤过泡截面积。结果 术后2周时,Ⅰ~Ⅴ组的平均眼压分别为(5.43±0.76)、(5.20±1.08)、(4.27±0.79)、(5.71±0.84)、(4.71±1.09)mmHg(F=3.998,P=0.008),在两两比较后,Ⅲ组与Ⅴ组比有统计学差异(P=0.006),Ⅰ、Ⅱ、Ⅳ组与Ⅴ组均无统计学差异(P均>0.05);术后1、4周时,Ⅰ~Ⅴ组间的平均眼压无统计学差异(P均>0.05)。术后4周时,Ⅰ~Ⅴ组功能性滤过泡所占比例分别为60%、50%、90%、87.5%、37.5%,Ⅲ组与Ⅴ组比较有统计学意义(χ2=5.513,P=0.043),Ⅰ、Ⅱ、Ⅳ组与Ⅴ组比较无统计学意义(P均>0.05);术后8周时,Ⅰ~Ⅴ组功能性滤过泡所占比例分别为60%、40%、80%、85.7%、25%,Ⅲ、Ⅳ组与Ⅴ组比较有统计学意义(χ2=5.445、5.529,P=0.049、0.041),Ⅰ、Ⅱ组与Ⅴ组比较无统计学意义(P均>0.05)。术后4周时,Ⅰ~Ⅴ组的滤过泡截面积分别为(0.161±0.081)(0.159±0.111)(0.195±0.095)(0.087±0.060)(0.041±0.025)mm2(F=4.998,P=0.002),Ⅰ~Ⅲ组与Ⅴ组比有统计学意义(P=0.004、0.005、0.001),Ⅳ组与Ⅴ组比无统计学意义(P>0.05);术后8周时,Ⅰ~Ⅴ组的滤过泡截面积分别为(0.171±0.087)(0.208±0.130)(0.180±0.099)(0.052±0.018)(0.042±0.029)mm2(F=6.409,P=0.001),Ⅰ~Ⅲ组与Ⅴ组比有统计学意义(P=0.004、0.000、0.002),Ⅳ组与Ⅴ组比无统计学意义(P>0.05);术后4、8周时,Ⅰ~Ⅲ组两两比较,均无显著性差异(P均>0.05)。结论 GMSC可以在一定程度上延长兔小梁切除术后功能性滤过泡的存在时间。

关键词: 牙龈间充质干细胞, 前节OCT, 滤过泡

Abstract:

Objective To observe the effect of gingival mesenchymal stem cells (GMSC) on the morphology of filtering blebs after experimental anti-glaucoma surgery in rabbits and to explore its effective concentration. Design Experimental study. Participants Fifty New Zealand white rabbits. Methods Fifty rabbits were randomly divided into five groups with 10 rabbits in each group: group I (GMSC 104/ml), group II (GMSC 105/ml), group III (GMSC 106/ml), group IV (Healaflow group) and group V (saline group). Each rabbit underwent right trabeculectomy and 0.3 ml of GMSC, Healaflow or saline were injected into the conjunctiva at the end of the operation. Intraocular pressure was measured at 1, 2 and 4 weeks postoperatively; anterior segment OCT scan was performed at 4 and 8 weeks postoperatively to classify the filtering blebs in anterior segment OCT images (flat diffuse type, cystic type, microcystic type, non-vesicular type, in which flat diffuse type and microcystic type as functional, cystic type and non-vesicular type as non-functional). The cross-sectional area of the filtering blebs was calculated and compared. Main Outcome Measures Intraocular pressure, classification of filtering bleb function and cross-sectional area of filtering bleb. Results At 2 weeks after operation, the mean intraocular pressure of group I~V was (5.43±0.76), (5.20±1.08), (4.27±0.79), (5.71±0.84), (4.71±1.09) mmHg (F=3.998, P=0.008). There was significant difference between group III and group V (P=0.006).  There was no significant difference in mean intraocular pressure between group I, II, IV and group V (all P>0.05). At 4 weeks after operation, the proportion of the functional follicles in group I~V was 60%, 50%, 90%, 87.5% and 37.5%, respectively. There was significant difference between group III and group V (χ2=5.513, P=0.043). There was no significant difference between group I, II, IV and group V (all P>0.05). At 8 weeks after operation, the proportion of the functional follicles in group I~Ⅳ was 60%, 40%, 80%, 85.7% respectively, higher than that in group V (25%). There was significant difference between group III, IV and group V (χ2=5.445, 5.529, P=0.049, 0.041). There was no significant difference between group I, II and group V (all P>0.05). At 4 weeks after operation, the cross-sectional area of the follicles in group I~V was (0.161+0.081) , (0.159+0.111) , (0.195+0.095),  (0.087+0.060), (0.041+0.025) mm2 (F=4.998, P=0.002), and there was significant difference between group I~III and group V (P=0.004, 0.005, 0.001), but there was no significant difference between group IV and group V (P>0.05); at 8 weeks after operation, the cross-sectional area of the follicles in group I~V was (0.171+0.087),  (0.208+0.130),  (0.180+0.099),  (0.052+0.018), and  (0.042+0.029) mm2 (F=6.409, P=0.001). There was significant difference between group Ⅰ, Ⅱ, Ⅲ and group V (P=0.004、0.000、0.002). There was no significant difference between group Ⅳ and group V (P>0.05) . There was no significant difference among groupⅠ, Ⅱ, and Ⅲ at 4 and 8 weeks after operation (all P>0.05). Conclusion GMSC can prolong the existence time of functional filtering blebs in rabbits after trabeculectomy to a certain extent.

Key words: gingival mesenchymal stem cells, anterior segment OCT, filtering bleb