环孢霉素A在抗青光眼滤过性手术中抗增殖作用的实验研究  

Experimental study of the antiproliferative effects of cyclosporin A on the glaucoma filtering surgery

作　　者：董桂玲[1] 戴馨[1] 陈进[2] 朱桂玲[2] 李慧萍[3] 

机构地区：[1]山东省菏泽医学专科学校眼科教研室,山东菏泽274030 [2]山东菏泽市立医院眼科 [3]山东省菏泽医学专科学校病理教研室

出　　处：《眼科》2002年第4期232-234,共3页Ophthalmology in China

基　　金：山东省教育委员会 1998年计划内课题;批号 :JOOK0 9

摘　　要：目的 :研究环孢霉素A(cyclosporinA ,CsA)在抗青光眼滤过性手术中的抗增殖作用。方法 :将 30只健康新西兰大白兔随机分成 3组 ,即实验组 (CsA)、对照组 1为 5 氟尿嘧啶 (5 -fluorouracil,5 -Fu)组、对照组 2为丝裂霉素C(mitomycinC ,MMC)组均行小梁切除术 ,术中分别在Tenon囊和巩膜之间放置 2 %CsA、0 5 % 5 Fu、0 0 0 2 %MMC的海绵块 5分钟后 ,用0 9%生理盐水冲洗干净。分别在术后第 7天、30天、6 0天检查眼压、滤过泡、角膜、眼底 ,并进行病理、透射电镜检查。结果 :CsA组眼压多控制理想 ,较对照组 1、2有明显差异 (分别为P <0 0 0 1和P <0 0 0 0 1) ,多数形成功能性滤过泡 ,无任何并发症 ,病理未见结缔组织胶原化。电镜下 ,胞浆内可见空泡 ,线粒体较少 ,纤维细胞异染色质功能不活跃。结论 :CsA在抗青光眼滤过术中抗增殖作用较 5 Fu、MMC效果好 ,副作用小 。Objective:To study the antiproliferative effects of cyclosporin A (CsA) on the glaucoma filtering surgery.Methods:Thirty rabbits (60 eyes) underwent trabeculectomy.All eyes were randomly divided into three groups.In the experimental group,the eye was exposed to cyclosporin A(CsA,2%) intraoperatively for five minutes,then rinsed with normal saline.In the control group,fluorouracil(5-Fu,0.5%)or mitomycin C(MMC,0.002%)was used.The postoperative IOP,bleb,cornea and fundus were observed.Results:In CsA group,functioning blebs were observed in most eyes without complication and connective tissue collagenization.Control of postoperative IOP in CsA group was better than those in the control groups,and the difference was significant statistically ( P < 0.001, P <0.0001).Electron microsopy showed vacuole in the cytoplasm,and heterochromatin in the fibrocytes.Conclusion:The antiproliferative effects of CsA on anti-glaucoma filtering surgery is better than that of 5-Fu or MMC,and its side-effect is less,thus it is worthwhile to use CsA in antiglaucoma filtering surgery.

关 键 词：实验研究 环孢霉素A 5-氟尿嘧啶 丝裂霉素C 青光眼 外科学 

分 类 号：R779.6[医药卫生—眼科]