丝裂霉素C缓释系统辅助兔青光眼滤过性手术的研究  

Experimental study of mitomycin-C drug delivery system on glaucoma filtration surgery in rabbit

作　　者：郑晓丽[1] 王广慧[1] 魏淑芳[1] 高建鲁[1] 李镜海[2] 

机构地区：[1]山东聊城市人民医院眼科,252000 [2]山东大学齐鲁医院眼科,济南250014

出　　处：《眼科研究》2007年第7期498-501,共4页Chinese Ophthalmic Research

摘　　要：目的研究丝裂霉素C缓释系统（MMC DDS）对兔眼滤过性手术后抗瘢痕形成的疗效。方法24只大白兔双眼行小梁切除术,所有兔右眼术中植入MMC DDS1粒,为实验组,左眼随机选择12只眼术中植入空白缓释系统1粒,另外12只眼术中应用0.2mg/ml MMC棉片。结果实验组维持了较长时间的低眼压水平,术后全程平均滤过泡得分及持续时间明显高于空白对照组。术后7-14d房水中的MMC保持了一个有效药物质量浓度的平台。组织病理学显示实验组滤过道部位炎性细胞及成纤维细胞明显受到抑制。免疫组织化学显示MMC DDS抑制了滤过手术后手术部位成纤维细胞PCNA（增生细胞核抗原）的表达。结论MMC DDS能有效抑制滤过性手术后的炎症反应及成纤维细胞的增生。Objective Topical application of intraoperative 0. 2 -0.4 mg/ml MMC can effectively inhibit subconjunctival fibroblasts and improve the successful rate of filtration surgery, but its complications produce a new threat to visual function of glaucoma patient. The objective of this study was to investigate the efficacy, feasibility and adverse effects of mitomycin C drug delivery system（MMC DDS ） as a new anti-scarring agent during glaucoma surgery. Methods The drug delivery system was made with polymer polylactioglycolic acid （PLGA）, and 0.02 mg mitomgcin C was incorporated into PLGA with a dissolving duration within 28 days. Filtering surgery model was established in both eyes of 24 white rabbits,and the right eyes received MMC DDS as experimental group,and only MMC was used in 12 left eyes and blank DDS was put in other 12 left eyes（EM DDS group）. Results No evident inflammation was found in the eyes of MMC DDS group, indicating a well tolerance in surgery eyes. The filtering bleb was kept over 28 days in MMC DDS group, showing a longer period in comparison with control group. The IOP remained steady at a level of less than baseline in the MMC DDS group. The implantation of MMC DDS enhanced the MMC concentration in aqueous for 7 - 14 days. The collagen fibers were less 28 days after surgery in MMC DDS group under the microscope. MMC DDS reduced fibroblast activity,displaying a significant reduction in proliferating cell nuclear antigen （PCNA） expression in fibroblast. Conclusion MMC DDS has strong inhibition on inflammatory cells activity and fibroblast activity in surgery sites. MMC DDS can improve filtration surgery outcome. It is of potential as a new anti-scarring agent in glaucoma filtration surgery.

关 键 词：丝裂霉素C 缓释剂 滤过手术 瘢痕形成 增生细胞核抗原 

分 类 号：R779.6[医药卫生—眼科]