兔眼角膜基质内注射两性霉素B的安全性评价  

Intrastromal injection of amphotericin B in rabbit eyes:corneal toxicity?

作　　者：瞿玲辉[1] 谢汉平[1] 李良毛[2] 任茜[1] 

机构地区：[1]第三军医大学西南医院全军眼科中心,重庆400038 [2]解放军第181医院眼科,广西桂林541002

出　　处：《第三军医大学学报》2009年第6期530-534,共5页Journal of Third Military Medical University

摘　　要：目的探讨兔眼角膜基质内注射两性霉素B的安全性,寻找角膜基质内注射两性霉素B的安全浓度。方法健康家兔20只(40眼)按随机数字表法分为5组(每组8眼)。A组:角膜基质内注射0.1ml平衡盐溶液(BSS);B、C、D、E组角膜基质内分别注射0.1ml浓度为5、10、15、20μg/0.1ml的两性霉素B注射液,每4天注射1次,共注射5次。观察角膜透明性、上皮完整性、角膜新生血管生长情况,测量角膜厚度,第5次注射后30d处死动物,行角膜病理组织学检查、内皮细胞活性率测定及角膜内皮超微结构观察。结果兔角膜基质内注射浓度为5、10μg/0.1ml的两性霉素B注射液后不影响兔角膜正常生理功能,角膜透明、上皮完整,角膜内皮细胞无异常,与BSS组比较,未见明显差异(P>0.05)。15、20μg/0.1ml浓度组,角膜出现明显水肿,角膜上皮脱落,严重的角膜新生血管长入,与BSS组比较,差异显著(P<0.05)。结论角膜基质内注射药物可能是一种可选择的、简单易行的给药途经。两性霉素B的药物浓度在5μg/0.1ml、用量在0.1ml范围内是安全的;两性霉素B的药物浓度在10μg/0.1ml、用量0.1ml可能安全。角膜基质内注射安全浓度的两性霉素B可能是治疗顽固真菌性角膜溃疡的一种较好选择。Objective To investigate the toxicity to cornea of intrastromal injection with amphotericin B in rabbits, and explore a safe range of antibiotic concentration. Methods Totally 20 healthy rabbits （40 eyes） were randomly divided into 5 groups with 8 eyes in each group. The eyes of group A received intrastromal injection of 0.1 ml balanced salt solution, and those of Group B, C, D and E received 0. lml injection containing amphotericin B 5, 10, 15, and 20 μg respectively. Every rabbit received 4 intrastromal injections, once per 4 d. Corneal transparency, epithelial defect and corneal neovascularization were observed with slit lamp biomicroscopy, and corneal thickness was measured with ultrasonic pachymetry. In 30 d after the last injection, all rabbits were sacrificed and their corneas were removed. Pathological observations were carried out for corneal morphology, survival rate of the corneal endothelial cells and uhrastructure of corneal endothelium. Results In the rabbits of Group B and C, they had transparent and intact cornea, normal endothelial cells, and had no any different with those of Group A （ P 〉 0. 05 ）. However, when the concentration of amphotericin B increased to 15 and 20 p.g in the 0.1 ml injection, the rabbits showed edema cornea, exfoliation of corneal epithelium and severe neovascularization, With significant differences compared with Group A （ P 〈 0. 05 ）. Conclusion Intrastromal injection of amphotericin B at the concentration of 5 or 10 μg per 0. 1ml is safe to rabbit cornea.

关 键 词：两性霉素B 角膜基质内注射 角膜新生血管 兔 

分 类 号：R772.205[医药卫生—眼科] R965.3[医药卫生—临床医学]