腺病毒载体介导的单纯疱疹病毒胸苷激酶／丙氧鸟苷系统抑制晶状体后囊膜混浊的研究  

Prevention of posterior capsule opacification by adenovirus-mediated herpes simplex virus thymidine kinase/ ganciclovir system

作　　者：邱海雁[1,2] 翁景宁[1] 

机构地区：[1]福建医科大学附属协和医院眼科,福州350001 [2]湖州市中心医院眼科,湖州313000

出　　处：《中华实验眼科杂志》2011年第6期521-524,共4页Chinese Journal Of Experimental Ophthalmology

摘　　要：背景晶状体后囊膜混浊（PCO）目前尚无有效的防治途径。目的研究腺病毒载体介导的单纯疱疹病毒胸苷激酶（HSV-tk）／丙氧鸟苷（GCV）系统对PCO的抑制作用。方法选取新西兰白兔12只，用电脑随机选号法随机分为BSS＋BSS组、BSS＋GCV组、HSV-tk＋BSS组及HSV-tk＋GCV组，每组3只。兔眼行晶状体超声乳化摘出术，术中依据分组情况分别在晶状体囊袋中注入0．1mlBSS或携带有HSV-tk基因的腺病毒载体，术后12h分别在BSS＋BSS组和HSV-tk＋BSS组兔眼前房注入0．1mlBSS，BSS＋GCV组及HSV-tk＋GCV组以同样的方法注入GCV，每日1次，共3次。术后裂隙灯下观察眼前节情况，PCO分级按照Couderc的方法。术后4周摘除兔眼，采用Miyake-Apple法观察PCO情况，显微镜下取出晶状体囊袋后以电子天平称出整个囊袋湿质量，并行晶状体囊袋的组织学检查。结果术后1～3d各组均可见角膜轻度水肿与房水混浊，2周内基本恢复正常。术后4周，HSV-tk＋GCV组PCO明显轻于其他3组，差异均有统计学意义（H=2．647、H=2．939、H=2．884，P〈O．05），而BSS＋BSS组、BSS＋GCV组、HSV-tk＋BSS组组间的差异均无统计学意义（H=0．631、H=0．924、H=0．589，P〉0．05）。Miyake-Apple法观察显示，HSV-tk＋GCV组PCO面积与密度小于其他3组，晶状体囊袋湿质量也明显轻于其他3组，差异均有统计学意义（q=9．93、q=10．15、q=10．07，P〈O．05），BSS＋BSS组、BSS＋GCV组、HSV-tk＋BSS组组间差异均无统计学意义（q=0．22、q=0．07、q=015，P〉0．05）。囊袋组织学检查提示HSV-tk＋GCV组可见少量赤道部晶状体上皮细胞（LECs）增生并向后囊膜迁移，在囊袋外周形成稀薄的soemmering环，在中央部无细胞和皮质，或仅形成单细胞层纤维膜。BSS＋BSS组、BSS＋GCV组、HSV—tk＋BSS组可见大量赤道部LECs增生和迁移，在囊袋外周部soemmering环稠厚，在中央部形成多细胞Background There is no effective preventing way for the posterior capsular opacification （PCO） after cataract surgery. Objective The aim of this study was to investigate the preventing effeet of adenovirus- mediated herpes simplex virus thymidine kinase/ganciclovir （HSV-tk/GCV） system on PCO. Methods Twelve New Zealand white rabbits were divided into BSS＋BSS group,BSS＋GCV group, HSV-tk＋BSS group and HSV-tk＋GCV group at random. Phacoemulsification was performed in bilateral eyes of rabbits, and 0. 1 ml of BSS or adenoviras vector with HSV-tk gene were injected into lens capsular bag during the operation based on the grouping. In 12 hours after operation,0. 1 ml BSS was injected into the anterior chamber daily for 3 times in BSS＋BSS group and HSV-tk＋ BSS group,and 0. 1 ml GCV was used in the same way in BSS＋GCV group and HSV-tk＋GCV group. The situations of the anterior segment and the posterior capsule were examined under the slit lamp postoperatively. All the wet weight of capsular bags was assessed using electronic balance. The capsular membrane was histopathologically examined in the 4th week after injection. PCO was graded according to the method of Couderc. Results Mild corneal edema and aqueous humor opacity were observed in all the eyes within 3 days and returned to normal level gradually within 2 weeks postoperatively. PCO scores were higher in BSS ＋ BSS group, BSS ＋ GCV group, HSV-tk ＋ BSS group than the HSV-tk＋GCV group, showing the significant differences between them （ H = 2. 647, P = 0. 008 ; H = 2. 939, P = 0. 003 ; H =2. 884,P=0. 004）. No obvious difference was seen in PCO score among BSS＋BSS group,BSS＋GCV group,HSV-tk ＋BSS group（P〉0.05）. The wet weight of the capsular bags in HSV-tk＋GCV group was reduced in comparison with BSS＋BSS group,BSS＋GCV group, HSV-tk＋BSS group with the statistically significant difference between them （q = 9.93 ,q = 10. 15 ,q = 10. 07, P〈0. 05 ）. H istopathological examination revealed that mild proliferation of l

关 键 词：腺病毒载体 胸苷激酶 丙氧鸟苷 晶状体 后囊膜混浊 

分 类 号：R686[医药卫生—骨科学]