壳聚糖药膜植入脉络膜上腔治疗兔眼细菌性眼内炎  

Chitosan drug membrane administrated into perichoroidal space against bacterial endophthalmitis in rabbits

作　　者：李立婕[1] 金中秋[2] 周和政[2] 周雄[2] 阎玉华[3] 高玉香[3] 

机构地区：[1]南方医科大学研究生队,广东省广州市510515 [2]广州军区武汉总医院眼科,湖北省武汉市430070 [3]武汉理工大学生物中心,湖北省武汉市430070

出　　处：《眼科新进展》2007年第12期904-907,911,共5页Recent Advances in Ophthalmology

摘　　要：目的比较玻璃体腔注射万古霉素联合脉络膜上腔植入载有曲安奈德(triamci-nolone,TA)的壳聚糖膜与其玻璃体腔注射TA对兔外源性金黄色葡萄球菌的治疗作用。方法30只健康青紫蓝兔均于右眼内注射ATCC25923标准金黄色葡萄菌0.1×109CFU.L-1混悬液0.1mL。建立眼内炎模型后24h,将实验动物随机分为3组,均对右眼进行干预,每组10眼,A组玻璃体腔注射万古霉素、B组玻璃体腔注射万古霉素+TA混悬剂、C组玻璃体腔注射万古霉素+脉络膜上腔植入壳聚糖缓释药膜(载TA)。干预后每日裂隙灯及间接眼底镜观察;注射细菌后24h及干预后14d行B超检查;干预5d行玻璃体腔细菌培养;干预后14d摘除所有术眼于光镜下观察组织病理学改变。结果C组较A、B组炎症明显减轻。不同时间3组进行临床炎症评分,C组各项评分明显低于其他2个对照组,治疗后不同时间A、B、C3组总的炎症评分有显著性差异均为P=0.000,组间对比C组与A、B2组均有显著性差异P=0.000,A、B2组间无显著性差异(P<0.05)。细菌学培养检出率无统计学意义P=0.830;B超显示A、B、C3组视网膜脱离发生率有显著性差异(P=0.015);光镜下见C组眼部各组织结构完整,角膜、前房、玻璃体、视网膜病理学评分A、B、C3组间有显著性差异(P均为0.000),组间比较除A、B2组间视网膜评分有显著性差异(P=0.011),其余各组间各项病理评分均无显著性差异。结论壳聚糖药膜植入脉络膜上腔安全有效,可以成为治疗细菌性眼内炎的一种新的治疗方法。Objective To compare the therapeutic effects of chitosan drug membrane with triamcinolone （TA） administrated into perichoroidal space combined with intraocular Vancomycin injection and intraocular TA injection for endophthalmitis in rabbits. Methods The right eyes of 30 normal rabbits received an intravitreal injection of ATCC 25923 standard strain Staphylococcus aureus organisms 0.1 × 10^9 CFU · L^-1 ,0.1 mL. Twenty-four hours after inoculation,all rabbits were randomly divided into three groups, 10 eyes in each group. Group A received an intravitreal Vancomycin; Gronp B received an intravitreal Vancomycin plus TA; Group C received an intravitreal Vancomycin combined with implanting TA into perichoroidal space. Clinical observation was taken every day with slit lamp and indirect ophthalmofundoscope. B ultrasound test was arranged at 24 hours after inoculation and the 14th day after therapy. Vitreous cultures were obtained on the 5th day after therapy. Istopathologic grading was carried out with light microscope at the 14th day after therapy. Rosults The inflammation in group C was markedly less than two other groups. When the clinical evaluation was made at the different times,the clinical score of group C notably dropped in comparison with two control groups. There existed significant difference （ P = 0.000） respectively among the three groups and between interblocks with the exception of interclass between group A and B on the total inflammation scores during the different stage. There was significantly difference among three groups on the clinical score（ P 〈0. 05 ）. Culture-positive rates of vitrea samples was no statistical differences among three groups（ P =0.830）. Retinal detachment of the group C occurred less than two other groups via B Scan（P =0.015 ）. The histology structure of group C was intact under the light microscope. Significant difference was seen among three groups in each histopathologic grading about cornea, anterior chamber, vitreous and retina （P = 0. 000）. Ther

关 键 词：壳聚糖药膜 曲安奈德 脉络膜上腔 兔 眼内炎 

分 类 号：R711.2[医药卫生—妇产科学]