阿霉素与地塞米松巩膜塞植入体联合防治实验性增生性玻璃体视网膜病变  

Adriamycin and dexamethasone scleral plug in treatment of experimental proliferative vitreoretinopathy

作　　者：程娟[1] 徐国庆[1] 张琦[1] 胡毅倩[1] 王于蓝[1] 祝肇荣[1] 

机构地区：[1]上海交通大学医学院附属新华医院眼科,上海市200092

出　　处：《眼科新进展》2007年第5期349-352,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨可生物降解的阿霉素(adriamycin,ADM)、地塞米松(dexamethasone,DEX)巩膜塞植入体对兔眼实验性增生性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)的防治效果,及其对玻璃体中生长因子浓度的影响和作用机理。方法成年新西兰大白兔25只50眼,随机分为模型组和用药组各10只20眼,另外设空白组5只兔10眼。所有兔眼行玻璃体切割术,并向玻璃体腔注入兔结膜成纤维细胞悬液0.1mL(2×109个/LPBS)。用药组植入ADM、DEX巩膜塞各一枚。连续28d观察眼底PVR分级情况,检测玻璃体中碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)、血小板源性生长因子(platelet-derived growth factor,PDGF)浓度。结果模型组和用药组术后第28天牵引性视网膜脱离发生率分别为75%和30%,模型组与用药组之间有显著差异(χ2=8.120,P=0·004)。用药组中bFGF和PDGF浓度明显低于模型组,有显著性差异(P<0.01)。结论ADM、DEX巩膜塞植入体能够明显降低玻璃体中bFGF和PDGF的浓度,抑制细胞过度增生,降低牵拉性视网膜脱离的发生率,从而防治PVR的形成和发展。Objective To study the curative and preventive effect of biodegradable adriamycin（ADM ） and dexamethasone （DEX） scleral plug on experimental proliferative vitreoretinopathy （PVR） in rabbit,and to examine its effect and mechanism on concentration of growth factors in vitreous body. Methods Twenty-five rabbits（50 eyes） were randomly divided into model group（ 10 cases, 20 eyes）, ADM-DEX group （ 10 cases, 20 eyes ） and control group （ 5 cases, l0 eyes）. Vitrectomy were applied in all eyes,and 0.1 mL rabbit conjunctival flbroblast suspension（2×10^9/L PBS） was injected into vitreous body. The ADM and DEX scleral plugs was implanted into the ADM-DEX group. The ocular fundus of PVR grade was observed for continuous 28 days, and the concentrations of basic flbroblast growth factor （bFGF） and platelet-derived growth factor （PDGF） in vitreous body were detected. Results The incidence rate of tractional retinal detachment in model group and ADM-DEX group on the 28th day was 75% and 30% , respectively, there was significant difference between two groups （χ^2 = 8. 120, P = 0. 004）. The concentrations of bFGF and PDGF in ADM-DEX group were lower than that in model group, there was significant difference（F=36.700,P〈0.01）. Conclusion The ADM and DEX scleral plugs can degrade the concentration of bFGF and PDGF obviously,inhibit excessive proliferation and reduce the incidence rate of tractional retinal detachment, therefore prevent the formation and development of PVR.

关 键 词：增生性玻璃体视网膜病变 阿霉素 地塞米松 巩膜塞植入体 碱性成纤维细胞生长因子 血小板源性生长因子 

分 类 号：R774.1[医药卫生—眼科]