摘要
背景 视网膜前膜的形成和发展过程有多种细胞、细胞因子和细胞外基质等的调控和参与,结缔组织生长因子（CTGF）和纤维连接蛋白（FN）等参与其中,研究视网膜前膜的形态结构和病理学特征对于防治相关的视网膜病变具有重要意义. 目的 分析不同类型和病程眼底病变所致视网膜前膜的病理特点,研究CTGF和FN在视网膜前膜中的表达.方法 收集玻璃体切割术或硅油取出术中获得的视网膜前膜标本,其中孔源性视网膜脱离（RRD）组24例24眼,包括病程＜90 d者14眼及≥90 d者10眼；伴有玻璃体积血或牵拉性视网膜脱离（RD）的糖尿病视网膜病变（DR）组20例20眼,硅油填充眼组7眼,病程均≥90 d.各眼增生性玻璃体视网膜病变（PVR）分级均为C2级以上.对获取的视网膜标本进行常规组织病理学检查,采用免疫组织化学法检测视网膜前膜标本中CTGF和FN的表达,应用Fisher确切概率法对病程≥90 d不同组间和RRD组不同病程间视网膜前膜标本中CTGF和FN表达阳性率的差异进行比较. 结果 RRD组病程＜90 d的标本中以视网膜色素上皮（RPE）细胞和炎性细胞增多为主,而病程≥90 d的标本中以神经胶质细胞和成纤维细胞增多为主.RRD组和伴有玻璃体积血或牵拉性RD的DR组以炎性细胞浸润为主要表现,而硅油填充眼组以纤维增生为主要表现.病程≥90 d的3个组视网膜前膜中,RRD组CTGF阳性表达者7眼,占70.0％,伴有玻璃体积血或牵拉性RD的DR组18眼,占90.0％,硅油填充眼组2眼,占28.6％,3个组间视网膜前膜中CTGF表达阳性率的总体比较差异有统计学意义（P=0.037）；RRD组FN阳性表达者9眼,占90.0％,伴有玻璃体积血或牵拉性RD的DR组18眼,占90.0％,硅油填充眼组7眼,占100.0％,3个组间FN表达阳性率的总体比较差异无统计学意义（P=0.379）.RRD组中,病程≥90 d者视网膜前膜中CTGF阳性表达者7眼,占70.0％,病程＜90 d者13眼,占92.
Background Many kindof cells,cytokineand extracellulamatrix components,such aconnective tissue growth facto（CTGF） and fibronectin （FN）,can regulate and controll the formation and developmenof epiretinal membrane.Iiimportanto investigate the morphology and pathology of epiretinal membrane fothe prevention of relevanretinopathies.Objective Thistudy wato investigate the expression of CTGF and FN in differentypeand stageof epiretinal membranes.MethodEpiretinal membranewere collected during vitrectomy and silicon oil removal surgery from 24 eyeof 24 casewith rhegmatogenouretinal detachment（RRD） （including 14 eyewith courses〈90 dayand 10 eyewith course≥ 90 days）,20 eyeof 20 casewith diabetiretinopathy （DR）associated with vitreouhemorrhage and tractional RD （course≥ 90 days）and 7 eyeof 7 casewith silicon oil tamponade （course≥ 90 days）.The grading of the proliferative vitroretinopathy （PVR） wa〉C2 in all the eyes.Histopathological examination waperformed to assesthe pathological elemenin the differentypeand stageof epiretinal membrane,and the differential expressionof CTGF and FN in the varioutypeof epiretinal membranewere detected by immunochemistry.The amounof cellpositive foCTGF and FN wacompared using the FisheExacProbability method.ResultHistopathological examination showed thaincrease in the numbeof RPE celland inflammatory cellwaprimary characteristiin the epithelial membrane of RRD with courses〈90 days,buthere were loof neurogliocyteand fibroblastin the RRD group with course≥ 90 days.In addition,the infiltration of inflammatory cellwapredominanin the RRD and Dgroups,bufibroplasiwaobviouin the silicon oil tamponade group.When the course wa≥ 90 days,7 eye（70.0%）in the RRD group wapositive foCTGF,and 18 eyes（90.0%）in the Dgroup and 2 eyes（28.6%）in the silicon oil tamponade group were positive foCTGF,with significandifference among them（P=0.037）.In regardto FN,9 eyeshowed expression in the RRD group（90.0%）,18 eyein the Dgroup（90.0%）and 7 eyein th
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2013年第8期757-762,共6页
Chinese Journal Of Experimental Ophthalmology
