凉血化瘀中药与曲安奈德抑制脉络膜新生血管的比较  

Comparison of inhibiting choroidal neovascularization utilizing liangxuehuayu decoction and triamcinolone acetonide

作　　者：李学晶[1] 唐由之[1] 

机构地区：[1]中国中医科学院眼科医院,中国北京市100040

出　　处：《国际眼科杂志》2009年第3期428-432,共5页International Eye Science

基　　金：中国国家自然科学基金资助(No.30472229)~~

摘　　要：目的:比较凉血化瘀中药与曲安奈德对氪激光诱导棕色挪威(BN)大鼠脉络膜新生血管(choroidal neovascularization,CNV)形态的影响。方法:BN大鼠48只,双眼行氪激光(659nm)眼底光凝,激光功率360mW,光凝斑直径50μm,曝光时间0.05s。随机分成空白对照组(每日生理盐水灌胃),中药组(每日中药灌胃)和曲安奈德组(术后1d玻璃体腔内注射曲安奈德5μL,0.2mg)各16只。空白对照组,中药组,曲安奈德组,3组分别在光凝后7,14,21,28d随机选取3只行荧光素眼底血管造影(FFA)检查后处死,行HE染色,Ⅷ因子相关抗原免疫组织化学检测;3组在各时间点分别随机选取1只大鼠做脉络膜血管铺片检查。结果:FFA显示,光凝后7～28d,空白对照组CNV渗漏面积逐渐增大,而中药组渗漏面积略增加,曲安奈德组瘢痕着色明显。空白对照组CNV厚度逐渐增加,至21d达高峰,28d略有下降;中药组CNV厚度逐渐增加,至14d达到高峰,21d时明显变薄,28d再次增加;曲安奈德组7～14dCNV逐渐变薄,14d最薄,此后CNV再次增厚。Ⅷ因子相关抗原阳性反应物吸光度,空白对照组7～14d时逐渐增加,至14d达到高峰,此后下降;中药组7d时达到高峰,此后下降;曲安奈德组亦是14d达到高峰,但峰值较空白对照组低,此后下降。脉络膜血管铺片CNV面积,空白对照组7～28d逐渐增大;中药组7～14d达到高峰,14～21d下降,28d时再次增加;曲安奈德组7～14dCNV面积逐渐增加,21,28d时瘢痕明显。结论:曲安奈德玻璃体腔注射可以明显抑制CNV形成,但后期形成瘢痕明显;凉血化瘀中药灌胃可以有效抑制CNV增生,使瘢痕缩小。AIM： To evaluate and compare if taking liangxuehuayu decoction and intravitreal triamcinolone acetonide （TA） inhibit experimental fibrovascular proliferation （FVP） induced by laser trauma in a rat as a model of choroidal neovascular membranes （CNVMs）. METHODS： Both eyes of 48 rats received a series of 20 spots of laser irradiation （659nm,360mW,50μm,0.05s）. The rats were randomly divided into three groups, the control group （16 rats）, traditional Chinese medicine （TCM） group （16 rats）, TA group （16 rats）. The control group received 9g/L physiological saline by gastric gavage, the TCM group were administrated liangxuehuayu decoction drugs by gastric gavage, and TA group underwent an intravitreous injection with 5p L （0.2mg） of TA. Fundus fluorescein angiography（FFA）, histopathologic examination, Ⅷ straining cells by immunohistochemistry and high molecular weight FITC-Dextran （MW 2 × 10^6） for high resolution angiography in RPE-choroid-sclera flat mounts were performed on 7, 14, 21 and 28 days after photocoagulation. Group in all three time points, respectively, were randomly selected to do a rat choroidal vascular ray Shop. RESULTS. FFA showed that in control group the fluorescein leakage in grave sc ne, the fluorescein leakage were less in TCM group than in control group, and in TA group the scar staining were greatly bigger than the control group. Histologically, the CNV membrane was observed beneath the retina and the factor Ⅷ positive cells were seen. CNV thickness was firstly appeared on day 7 after photocoagulation, reaching the peak on day 21 in control group, and decreased on 28 days. In TCM group, CNV thickness was reaching the peak on day 14, and decreased greatly on 21 days, increased again on 28 days. And in TA group, the CNV thickness was getting thinner from 7 to 14 days, get thinnest on 14 days, then the CNV thickness was getting thicker. The staining intensity of Ⅷ in cellular plasma showed that in control group the staining intensity was

关 键 词：凉血化瘀 脉络膜新生血管 曲安奈德 中药 动物 

分 类 号：R774.5[医药卫生—眼科] R619.6[医药卫生—临床医学]