目的：评价经脱细胞处理的同种异体结膜细胞外基质（ECM）是否可以作为一种新兴的结膜替代物用于眼表的修复，并阐述它的优点。方法：实验组10只兔，取其右眼上方的球结膜人为制造15×8mm²的缺损区，保留角膜缘外1mm内及穹隆结膜，行脱细胞的异体结膜ECM移植。对照组5只兔，相同方式制造缺损后行未脱细胞的异体结膜移植。结果：实验组：10例中有8例移植效果满意。大体观察：术后1周时见植片边缘处有血管长入，2周时，血管长入更多，4-6周时植片与周围结膜的界限已难辨认。观察至术后12周，植片始终存活良好。光镜检查：术后1周已有1-2层上皮覆盖在基质表面，2周时细胞层数增多，基质内有毛细血管及成纤维细胞长入， 4-6周后与正常结膜组织基本相同，上皮内可见杯状细胞。始终未见淋巴细胞，巨噬细胞大量聚集的现象。10例中有2例外观欠佳，植片表面不光滑。对照组：5例均在术后4天-10天内植片溶解脱落。光镜下见大量的巨噬细胞及淋巴细胞浸润。结论：异体结膜细胞外基质（ECM）是一种较为理想的结膜替代物，它具有上皮化速度快，排斥反应小，稳定性好等优点。
【关键词】 结膜，细胞外基质，替代物

Purpose: To evaluate whether acellular allogenic conjunctival matrix can be used as an alternative for ocular surface reconstruction. Methods: In 15 New Zealand rabbits, a 15×8mm2²defect was created on the upper bulbal conjunctiva. Acellular conjunctival allograft was transplanted to cover the defect in 10 animals. Whereas, the other 5 animals received a unprocessed conjunctival allograft and served as controls. All animals were photografted every week after operation. In experimental group ,2 animals were sacrificed at 1, 2, 4, 6, 12 weeks, grafted specimens were examined by histology. Results: In experimental group, 8 of 10 grafts looked pretty good, vessal infiltration was first observed at 1week, and progressed at 2 weeks, approximately at 4-6 weeks, they appeared nearly the same as normal conjunctiva. Histological examination show that the conjunctival matrix supported epithelialization, neovascularization and fibroblast infiltration. There was no evidence of inflammatory cells aggregation in 12 weeks. 2 were undesirable for rough surface. In control group, at 4-10 days, all 5 grafts looked grey-white and detachable from original place. Histological analysis revealed numerous lymphocyte and microphage infiltration. Conclusions: Acellular allogenic conjunctival matrix can be a desirable conjunctival substitute, due to its low antigenicity and facilitation of epithelialization.

【Key words】 conjunctival , acellular , matrix