MMC联合t-PA抑制青光眼滤过手术后增殖的临床分析  

Clinical analysis of MMC combined with t-PA on proliferation after glaucoma filtering operation

作　　者：王红伟 张健 沈洋 

机构地区：[1]河北省新乐市医院,河北新乐050700 [2]河北省新乐市中医医院,河北新乐050700

出　　处：《现代中西医结合杂志》2014年第27期2977-2979,共3页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察丝裂霉素C(MMC)联合应用组织型纤溶酶原激活剂(t-PA)在青光眼滤过手术中的抗增殖作用。方法将行单纯小梁切除术的青光眼患者78例(93眼)分为2组。对照组仅予以浸有0.2 g/L MMC棉片置于巩膜下5 min;实验组在对照组基础上于术毕前房注射t-PA 0.1 mL(200 mg/L),术后1,3 d球结膜下再次注射t-PA 0.3 mL。分别在术前及术后3,7,14,28 d和6个月测定2组患者眼压;分别在术后3,7,14,28 d和6个月取局部病理组织行增殖细胞核抗原(PCNA)染色记录5个高倍视野下阳性细胞数,HE染色观察滤过道开放情况,Masson三色染色观察滤出道新生胶原生成情况,裂隙灯下观察滤过泡形态。结果 2组患者术后3,7,14,28 d和6个月眼压均显著低于术前(P均<0.01);且实验组术后各时间节点眼压均显著低于对照组(P均<0.01)。2组患者术后3,7,14,28 d及6个月滤过道PCNA阳性细胞数均显著低于术前(P均<0.01);且实验组术后各时点滤过道PCNA阳性细胞数均显著低于对照组(P均<0.01)。实验组术后14、28 d滤过道开放率显著高于对照组(P均<0.05)。实验组术后7,14,28 d及6个月滤过道处的胶原较对照组少而疏松,功能性滤过泡比率显著高于对照组(P均<0.05)。结论在青光眼滤过手术中联合应用MMC和t-PA具有较强的抗增殖能力,可用于抗青光眼术后瘢痕形成。Objective It is to observe the effect of mitomycin C（MMC）combined with tissue plasminogen activator（t -PA）in inhibiting the proliferation after glaucoma filtration operation. Methods 78 cases（93 eyes）of glaucoma patients with simple trabeculectomy were divided into two groups. Patients in control group were only received with 0. 2 mg / mL MMC cotton sheet to place under the sclera for 5 min;based on the treatment of control group,patients in experimental group were treated by anterior chamber injection with t - PA 0. 1 mL（200 mg / L）,then subconjunctival injection with t - PA 0. 3 mL again after operation for 1,3 days. Before surgery,and 3,7,14,28 days and 6 months after surgery,IOP was measured in two groups. 3,7,14,28 days and 6 months after surgery,the local pathological proliferating cell nuclear antigen was taken for prolifera-tive cellnucleus antigen（PCNA）staining and recording positive cells under 5 high power field,filtration road open state was observed by HE staining,the generate state of filtration Road new collagen was observed by Masson staining tricolor staining, and the bleb morphology was observed by slit lamp. Results IOP was significantly lower After surgery for 3,7,14,28 days and 6 months than before surgery（all P ﹤ 0. 01）;and IOP in experimental group were significantly lower than that in control group each time（all P ﹤ 0. 01）. Road PCNA - positive cells in two groups after surgery for 3,7,14,28 days and 6 months was significantly lower than before（P ﹤ 0. 01）. The node filtering road PCNA - positive cells in experimental group after each time were significantly lower than that in control group（P ﹤ 0. 01）. The open road filtration rate in experimental group after 14 and 28 days was significantly higher（P ﹤ 0. 05）. After 7,14 days and 6 months,the collagen in filtration road of experimen-tal group was lessened and loose than that of control group,and the percentage of functional blebs was significantly higher than that of control group（all P �

关 键 词：青光眼 滤过手术 组织型纤溶酶原激活剂 

分 类 号：R775[医药卫生—眼科]