5-氟尿嘧啶聚乳酸微球防治实验性增生性玻璃体视网膜病变的效果观察  

Efficacy of 5-fluorouracil polyactic acid microsphere in prevention of proliferative vitreoretinopathy

作　　者：毕宏生[1] 崔彦[1] 张建华[1] 王兴荣[1] 解孝锋[1] 

机构地区：[1]济南施尔明眼科医院,济南250002

出　　处：《中华眼科杂志》2006年第1期37-41,共5页Chinese Journal of Ophthalmology

摘　　要：目的评价5-氟尿嘧啶(5-Fu)聚乳酸微球防治增生性玻璃体视网膜病变(PVR)的效果。方法分别将5-Fu聚乳酸微球和5-Fu原料粉末注入兔眼玻璃体腔后,测定前房水中5-Fu浓度,观察5-Fu聚乳酸微球体内释放特性。将健康家兔48只随机分为3组:1组为5-Fu聚乳酸微球组;2组为无药物的聚乳酸微球对照组;3组为5-Fu原料粉末对照组。以巨噬细胞注入家兔玻璃体腔建立PVR动物模型后,1、2、3组分别向实验家兔左右两眼玻璃体中后部注入:1组注入5-Fu聚乳酸微球的BSS混悬液0.2ml(相当于25mg微球,含5-Fu2.6mg);2组注入含有25mg无药物聚乳酸微球的BSS混悬液0.2ml;3组注入5-Fu注射液0.2ml(含5-Fu2.6mg)。评价其防治PVR的效果。结果5-Fu聚乳酸微球较5-Fu原料粉末消除半衰期明显延长,半衰期为379.05h,清除率明显降低。1组中有2只眼因晶状体损伤排除试验;3组中有4只眼因发生急性药物毒性反应而排除试验。药效实验表明:21及28d,2组视网膜脱离发生率为62.5%、71.9%;3组为64.3%、78.6%;1组为13.3%和13.3%,其中1组的视网膜脱离发生率降低,与2、3组比较,差异有统计学意义(P<0.01),2、3组视网膜脱离发生率的差异无统计学意义(P>0.05)。结论5-Fu聚乳酸微球具有明显的缓释作用,玻璃体腔植入可有效防治巨噬细胞诱发的实验性PVR。Objective To evaluate the efficacy of 5-fluorouracil polyactic acid microsphere in prevention of proliferative vitreoretinopathy （PVR）. Methods 5-fluorouracil polyactic acid microsphere or 5-fluorouracil were used to implant into rabbits vitreous cavity. 48 healthy rabbits were divided into 3 groups： rabbits in Group 1 received implantation of 5-fluorouracil polyactic acid microsphere; rabbits Group 2 served as polyactic acid microsphere control; rabbits in Group 3 received only 5-fluorouracil powder. Macrophages were injected into vitreous cavity of rabbit to induce PVR. 0.2 ml BSS containing 25 mg microsphere with 2.6 mg 5-fluorouracil was injected into vitreous cavity of two eyes in Group 1. 0.2 ml BSS containing 25 mg microsphere without medicine and 0. 2 ml BSS containing 2.6 mg 5-fluorouracil were injected into rabbits vitreous cavity in Group 2 and 3 respectively, Drug content in aqueous humor was measured regularly. Release feature of 5-fluorouracil polyactic acid microsphere in vivo was observed. The efficacy of the inhibition of PVR was evaluated according to Ryan＇s grade of proliferative vitreoretinopathy. Results The releasing time of 5-fluorouracil polyactic acid microsphere was much longer than 5-fluorouracil powder. Its half life T1/2 was 379.05 h with low clearance rate. The attack rate of retinal detachment in Group 2 was 62.5% and 71.9% on the 21st and 28th day respectively. The attack rate of retinal detachment in Group 3 was 64.3% and 78.6% whereas that of Group 1 was 13.3% and 13.3% on the 21st and 28th day. There was statistical difference in retinal detachment rate in Group 1 and 2 or 3 （ P 〈 0. 01 ）. No differences was found in retinal detachment ration in Group 2 and 3 （P 〉 0. 05 ）. Conclusion Implantation of5-fluorouracil polyactic acid microsphere into vitreous cavity can effectively prevent proliferative vitreoretinopathy induced by macrophages in rabbit model.

关 键 词：氟尿嘧啶 乳酸 聚合物 微球体 玻璃体视网膜病 增生性 

分 类 号：R774.1[医药卫生—眼科] R979.1[医药卫生—临床医学]