维拉帕米和中性蛋白酶联合防治增殖性玻璃体视网膜病变的实验研究  

An Experimental Study on the Prevention and Cure of Proliferative Vitreoretinopathy with the Combination of Verapamil and Dispase

作　　者：贺玮[1] 李志敏[1] 吴珂[1] 

机构地区：[1]贵阳医学院附院眼科

出　　处：《贵阳医学院学报》2007年第6期568-571,共4页Journal of Guiyang Medical College

基　　金：贵州省科学技术基金资助项目[2003NGY050]

摘　　要：目的:研究玻璃体腔内注射钙拮抗剂维拉帕米(Verapamil,Ver)和中性蛋白酶(Dispase)对兔增殖性玻璃体视网膜病变(PVR)的防治作用。方法:20只健康日本大耳白兔随机分为对照组(Ctrl)、维拉帕米组(Ver)、Dispase组及维拉帕米联合中性蛋白酶组(VD)组。制备PVR模型后,治疗组立即玻璃体腔注入相应药物,对照组注入生理盐水,以评析药物防治PVR的效果。结果:3个用药组PVR平均增生级别均低于Ctrl组,差异有统计学意义(P<0.05),VD组的抑制作用增强;Ver组和VD组抑制视网膜前增生细胞较Ctrl组和Dispase组有差异,但Ver组与VD组比较无差异,Ctrl组与Dispase组亦无差异;电镜未发现用药组视网膜有毒性反应。结论:Ver联合Dispase经玻璃体腔注射途径对PVR发生发展有防治作用,两者呈一定协同作用,对视网膜无明显毒性损伤。Objective： To investigate the preventing and curing effects and toxicity of Verapamil （Ver）, a Ca-antngonist, and Dispase （Dis）, solitary or combined, to experimental proliferative vitreoretinopathy （PVR） in rabbits. Methods： Twenty Japanese big ear white rabbits were divided randomly and evenly into four groups as followscontrol （Ctrl） group, Ver treated group （VG）, Dis treated group （DG） and Vet ＋ Dis group （VD）. After the PVR model was established, rabbits in groups ofVG, DG, and VD were intravitreally injected with respective drugs, while rabbits in Ctrl group were injected with saline instead. The inhibition efficacy to PVR was evaluated according to PVR grades happened in rabbits of different groups with light microscopy, electron microscopy and immunocytochemistry methods. Results： Statistical differences were found between the Ctrl group and the three treated groups （ P 〈 0.05）. The inhibition effects markedly increased when combination of Ver and Dis was used. The numbers of proliferative cell in pre-retina of group Ver and group VD were significantly smaller than those in group Ctrl and group DG. There was no statistical significance between those in group VG and group VD, and between those in group Ctrl and group DG. The results of electron microscopy didn＇ t show evidence of toxicity among the treated groups. Conclusion： Injection of Ver combined with Dis into vitreous directly can effectively prevent and cure experimental PVR in rabbits at different stages of the disease. There is a certain synergistic action between the two drugs, which can promote the repair of retina. No obvious toxicity to retina of rabbit occur when used at the tested dosages.

关 键 词：玻璃体视网膜病 增生性 维拉帕米 中性蛋白酶 兔 

分 类 号：R774.1[医药卫生—眼科]