玻璃体腔联合用药治疗眼球穿通伤并发症的实验研究  

Treament of complications of penetrating ocular injury with intravitreal triamcinolone and vancomycin injection in a rabbit model

作　　者：招志毅[1] 彭燕一[1] 

机构地区：[1]桂林医学院附属医院眼科,广西桂林541001

出　　处：《中国现代医学杂志》2009年第5期650-653,共4页China Journal of Modern Medicine

基　　金：广西科学自然基金资助项目(桂科自No:0640191)

摘　　要：目的观察玻璃体腔注射曲安奈德和万古霉素能否降低外伤性增生性玻璃体视网膜病变(prolifer-ative vitreoretinopathy,PVR)程度和减少眼内炎症、感染发生;观察外伤早期玻璃体腔白介素-1β(inter-leukin-1β,IL-1β)浓度与PVR程度相关性。方法建立外伤性出血性眼球穿通伤动物模型。观察眼前节炎症、PVR程度;酶联免疫吸附法(enzyme-liked immunosorbent assay,ELISA)测定外伤早期玻璃体腔IL-1β浓度。结果联合用药组PVR程度、眼前节炎症程度、IL-1β浓度都低于生理盐水组;生理盐水组、曲安奈德组各发生细菌性眼内炎2例;万古霉素组、联合用药组未见细菌性眼内炎发生;外伤早期玻璃体腔IL-1β浓度与PVR程度高度正相关。结论玻璃体腔注射曲安奈德和万古霉素能降低PVR程度和减低眼内炎症、感染发生;外伤早期玻璃体腔IL-1β浓度测定可能可以预测PVR程度。[Objective] To investigate the inhibiting effect of intravitreal triamcinolone and vancomycin injection on proliferative vitreoretinopathy （PVR）, intraocular infection and intraocular inflammation on rabbit model eyes of hemorrhagic penetrating ocular injury. In addition, we viewed the relations between the density of interleukin-1β in vitreous at the early period of trauma and the degree of PVR. [Methods] All right eyes of 40 New Zealand albino rabbits were created as experimental rabbit model eyes of hemorrhagic penetrating ocular injury. The rabbits were divided into phosphate buffered saline group, triamcinolone group, vancomycin group, triamcinolone combination with vancomycin group randomly. The extent of inflammation in anterior segment of eye was estimated by Slit-lamp microscope examination. Microbiology examination in vitreous must be taken upon these eyes that the extent of inflammation lasting over one week in anterior segment had exceeded grade 2. Degree of PVR in vitreous was estimated by direct fundscopy examination. Density of IL-1β in vitreous were detected by ELISA examination at the early period of trauma. [Results] The extent of intraocular inflammation, degree of PVR and density of IL-1β in vitreous in triamcinolone combination with vancomycin group are lower than both phosphate buffered saline group and vancomycin group. There were 2 eyes （occupying 20%） confronted endophthalmitis in both phosphate buffered saline group and triamcinolone group respectively. There were not eyes confronted endophthalmitis in beth vancomycin group and triamcinolone combination with vancomycin group. Positive correlation bewteen the density of IL-1 β in vitreous at the early period of trauma and the degree of PVR was found. [Conclusions] The therapeutics of intravitreal triamcinolone combination with vancomycin injection can decrease both the occurrence of bacterial endophthalmitis and the extent of intraocular inflammation, besides, it can decrease the degree of PVR. Maybe the methods of detecting d

关 键 词：眼球穿通伤 并发症 药物治疗 曲安奈德 万古霉素 

分 类 号：R779.1[医药卫生—眼科]