眼外超声助溶治疗实验性视网膜静脉阻塞的初步观察  

Preliminary observation of external therapy of ultrasound enhancing thrombolysis on the experimental retinal vein occlusion

作　　者：陈辉[1] 高小明 张黎明[1] 高小伟[1] 沈光宇[3] 施美英[3] 徐建云[1] 

机构地区：[1]南通大学附属医院眼科,226001 [2]宁波光明眼病医院 [3]南通大学附属医院康复科

出　　处：《中华眼底病杂志》2007年第3期166-169,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的探讨眼外超声（ETUS）助溶治疗实验性视网膜静脉阻塞（RVO）的有效性和安全性。方法将51只中华大耳白兔双眼用光动力血栓法建立RVO模型后，分别进行ETUS助溶实验和超声能量及治疗时间选择实验。前者将RVO形成后的27只兔随机分为两组，一组（15只兔）静脉内注射尿激酶（UK）（1700～2200U溶于20m1生理盐水中），一组（12只兔）注射生理盐水（NS）20ml；每只兔一只眼接受ETUS治疗（1．0W／cm^2，20min），另一只眼不施行ETUS作为对照。后者将RVO形成后的24只兔48只眼按超声能量随机分为0．7、1．0w／cm。两组（每组各12只兔），每组再按辐射时间分成8、14、20min 3小组（每小组8只眼）。均采用1MHz超声波100Hz脉冲波，每天1次，连续3d进行ETUS治疗。超声治疗后第4天行荧光素眼底血管造影（FFA）观察血管再通情况，第15天行视网膜光学显微镜和电子显微镜检查。结果ETUS＋UK组血管再通率为66．7％，高于单纯UK组（20．0％）（P=0．025）、单纯NS组（8．3％）（P=0．005）和ETUS＋NS组（8．3％）（P=0．005）；不同超声能量组的血管再通率均随辐射时间延长而明显增加（P=0．006，0．001），但不同辐射时间组超声能量对血管再通率无明显影响（P〉0．05）。接受ETUS治疗均有不同程度的视网膜组织改变和节细胞的超微结构变化，且随辐射时间增加而变得严重。结论ETUS能显著促进尿激酶对兔RVO血栓的溶解，同时可造成视网膜组织的明显损伤和节细胞的超微结构改变。Objective To investigate the efficacy and the safety of external therapy of ultrasound （ETUS） enhancing thrombolysis on the experimental retinal vein occlusion. Methods The effect of ETUS enhanced thrombolysis and the impact of ultrasound energy and exposure were investigated respectively after both eyes of 51 rabbits with retinal branch vein occlusion created by photodynamic initiated thrombosis were divided into 4 groups. The first 2 groups are the ETUS groups, including one group （15 rabbits） underwent intravenous injection with urokinase （UK） （1700-2200 UK dissolved into 20 ml normal saline）, and other group （12 rabbits） underwent intravenous injection with normal saline. In these 2 groups, each rabbit received ETUS treatment （1.0 W/cmz, 20 rain） in one eye and the fellow eye didn＇t which was as the control. The latter 2 groups are the energy and duration of ultrasound groups, and 12 rabbits in each group underwent ETUS with the energy of 0.7 and 1.0 W/cmz respectively. Each of the 2 groups was divided into 3 subgroups （8 rabbits in each） according to the radiated durations （8, 14, and 20 minutes）. All of the eyes except the control ones underwent ETUS with 1 MHz ultrasound and 100 Hz pulsed ultrasound once a day for 3 days. Fundus fluorescein angiography （FFA） was used to detect the vascular condition 4 days after ETUS, and at the 15th day, retinal light microscopy and electron microscopy were performed. Results The vascular recanalization rate in ETUSq-UK treatment group was 66.7%, which is obviously higher than which in single UK group （20.0%, P=0. 025）, normal saline group （8.3%, P=0.005）, and ETUSq- normal saline group （8.3%, P=0.005）. The vascular recanalization rates in groups with different energy of ultrasound increased obviously as the radiated durations increased （P= 0. 006, 0. 001）, while no apparent effect of energy of ultrasound on the vascular recanalization rate was found in the groups with different radiated duration （P〉0.05）. The ey

关 键 词：视网膜静脉闭塞/治疗 超声疗法 血栓溶解疗法 

分 类 号：R686[医药卫生—骨科学]