环孢霉素A3种用药方法抗瘢痕化作用的比较  

Anti-scarring effects of cyclosporin A:the comparison of three application methods

作　　者：王继兵[1] 魏厚仁[2] 刘雨清[3] 刘晓方[1] 李坤[1] 

机构地区：[1]潍坊医学院附属医院眼科,山东潍坊261031 [2]华中科技大学同济医学院附属协和医院眼科,湖北武汉430022 [3]潍坊医学院附属医院病理教研室,山东潍坊261031

出　　处：《眼科新进展》2004年第4期266-269,共4页Recent Advances in Ophthalmology

摘　　要：目的　比较不同的用药方法所产生的抗瘢痕化效果的差异 ,为临床推广应用提供依据。方法　新西兰大白兔行双眼全层滤过手术 ,3种用药方法 (A组 ,单纯术后滴药 ;B组 ,术中用药联合术后滴药 ;C组 ,术中一次性用药 )比较 2 0g·L-1环孢霉素A(CsA)对术后眼压下降幅度、滤过泡计分、滤过泡生存期、瘢痕厚度及成纤维细胞密度的影响。结果单纯术后滴药组 (A组 )滤过泡生存期差异无显著性意义 (P >0 .0 5 ) ;术中用药联合术后滴药组 (B组 )术后 6d起 ,用药眼降压幅度大于对照眼 (P <0 .0 5 ) ,术后 3d起 ,滤过泡计分高于对照眼 (P <0 .0 5 ) ,滤过泡生存期长于对照眼 (P <0 .0 0 5 ) ,术后 2 6d ,用药眼瘢痕厚度小于对照眼 (P <0 .0 5 ) ,成纤维细胞密度低于对照眼 (P <0 .0 5 ) ;单纯术中用药组 (C组 )术后 6d起 ,用药眼降压幅度大于对照眼 (P <0 .0 5 ) ,术后 3d起滤过泡计分高于对照眼 (P <0 .0 5 ) ,滤过泡生存期亦长于对照眼 (P <0 .0 0 5 )。结论　环孢霉素A在活体具有抗增殖作用 ,单纯术中用药或联合术后滴药效果明显 ,未发现明显不良反应 ,具有临床推广应用价值。Objective To compare antiscarring effects of cyclosporin A(CsA) in three application methods.Methods Full-thickness filtering operation was performed on both eyes of New Zealand albino rabbits. Three different application methods(group A,CsA used only postoperation;group B,applied intraoperation combined with CsA used postoperation;group C,applied once intraoperation) of 20g·L -1 CsA were employed among three groups respectively. Decreases in intraocular pressure (IOP),filtering bleb score and longevity,scar thickness and fibroblast density between CsA-treated and control eyes were compared postoperatively.Results There were no significant difference in filtering bleb longevity in group A (P>0.05). The value of decreases in IOP in CsA-treated eyes was significantly larger than that in control eyes from 6 postoperative days in group B and group C (P< 0.05),filtering bleb score in CsA-treated eyes was also significantly higher than that in control from 3 postoperative days to the end of studied period (P<0.05),filtering bleb longevity was significantly longer than control eyes (P<0. 005). Scar thickness was significantly thinner than control eyes at 26 postoperative days(P<0.05),and fibroblast density was also significantly lower than control in group B (P<0.05).Conclusion The antiscarring effects of CsA was confirmed in vivo.It is showed that a single intraoperative subconjunctival application of CsA or combined with CsA used postoperatively could significantly increase the filtering bleb longevity after filtration surgery in rabbits with few complication occured.It is worthwhile applying widely in glaucoma filtering surgery.

关 键 词：环孢霉素A 抗瘢痕化作用 用药方法 

分 类 号：R774.1[医药卫生—眼科]