【作者】 代应辉；

【导师】 陈逖； 朱美玲； 李寿玲；

【作者基本信息】 安徽医科大学 ， 眼科学， 2003， 硕士

【摘要】 目的：建立新型的大鼠高眼压视网膜缺血再灌注模型，通过光镜及电镜观察不同损伤的组织病理改变，复方丹参对视网膜缺血再灌注(RIR)的防护作用以及视网膜神经节细胞及内、外核层细胞凋亡的存在，并借助于免疫组织化学方法，初步研究p75在RIR损伤中的表达及意义。方法：SD大鼠74只，随机分为对照角膜损伤组，缺血组，缺血再灌注组，复方丹参防护组和生理盐水防护对照组。建立15kPa，90min高眼压视网膜缺血模型，再灌注1，4，12，24，72h后处死，普通光镜，透射电镜观察，免疫组织化学检测。结果：缺血再灌注组出现光镜和电镜下的病理改变，包括视网膜水肿，神经节细胞空泡变性，视网膜外节盘变形，内节线粒体轻度扩张，部分脱嵴，神经节细胞膜皱缩，染色质凝成块状，线粒体空泡化，外节盘溶解等。随着再灌注时间的延长，视网膜组织形态及超微结构损害加重。角膜损伤对照组无改变，复方丹参防护组损伤较生理盐水对照组明显减轻。缺血再灌注损伤后p75阳性表达，且随损伤的加重而增加。结论：高眼压视网膜缺血再灌注可造成视网膜结构严重损害，随再灌注时间延长而加重。复方丹参对缺血再灌注损伤有保护作用；在RIR模型中存在神经节细胞，内、外核层细胞凋亡；缺血再灌注损伤后视网膜内核层及神经节细胞出现p75阳性，表达随损伤的加重而增多，与视网膜细胞凋亡有关联。这些结果有助于视网膜缺血性损伤治疗方法的制定。更多还原

【Abstract】 Objective : To establish a new animal model of ocular hypertension and observe the development process of retinal injury in ischemia - reperfusion state and investigate the protective effect of compound injection salvia in retinal ischemia reperfusion (RIR).To make sure apoptosis occur in retina and detect the expressin of the low-affinity neurotrophin receptor p75 in RIR .Method : 74 Sprague-Dawley rats were devided into five groups at random , containing cornia damaged group, ischemia group,ischemia-reperfusion group, salvia miltiorrhiza protect group and normal saline control group.60 of 60 rats subjected to 90 minutes of pressure-induced ischemia, then fixed for light and electron microscopy with reperfusion after 1,4,12 hours, and 1 or 3 days from the time ocular ischemia was relaxed. p75 was examined in the retina by immunohistochemical at light level, result : Neuroganglion fibrous layer showed vacuolation degeneration when ocular hypertension was maintained to 90 min .the ganglion cells of retina showed that the karyltheca crimpled the karyotin agglomerated.the mitochondrion was vacuocated and the membranous disc of outer segment was damaged .The longer had ischemia-reperfusion continued, the more serious was the reperfusion injury .The histopathologic damage of retina in compound injection salvia group were not severe than that in the control group .The p75 was detected in the retinal ganglion cells , inner and out nuclear layer. During the time after the reperfusion started, especially after more than 12 hours, apoptotic signs became obvious and extended from the inner to the outer retina. These apoptotic findings could be seen with electron microscopy. By 3 days after the reperfusion, necrotic cells in the ganglion cell layer, and the inner and outer nuclear layer became more prominent thanapoptotic cells..Conclusion :RIR can make serious damage to retinal histopathology and ultrastructure. . mainline of compound injection salvia miltiorrhiza may be effected on protection from retinal damage induced by RIR. The low affinity neurotrophin receptor p75 seems to be involved in apoptosis after RIR . These results may provide a baseline for therapeutic strategy and the prognosis of ischemia-reperfusion injury in the retina.更多还原