吡非尼酮滴眼液在兔眼小梁切除术后抗瘢痕作用研究  

Effects of pirfenidone eye drops for trabeculectomy in rabbit model

作　　者：邵毅[1] 余瑶[2] 裴重刚[1] 胡佩宏 杨璐[1] 黄歆[1] 涂萍[2] 

机构地区：[1]南昌大学第一附属医院眼科,江西南昌330006 [2]南方医科大学附属南昌第三医院内分泌科,江西南昌330009

出　　处：《中国现代医学杂志》2015年第2期13-17,共5页China Journal of Modern Medicine

基　　金：国家自然科学基金(No:81160118;No:81400372);全国临床医药专项基金(No:L2012052);江西省教育厅科技计划项目(No:GJJ14170)

摘　　要：目的探讨吡非尼酮(PFD)滴眼液在兔眼小梁切除术后抑制结膜滤过道瘢痕化的作用。方法选择新西兰白兔24只(24只眼)行小梁切除术,随机分为两组:A组使用PFD滴眼液滴眼,B组使用磷酸盐缓冲液(PBS)滴眼液滴眼。分别于术后1、7、14、21和28 d观察眼压情况、结膜滤过泡和并发症情况;实时定量逆转录-聚合酶链反应(RT-PCR)观察比较两组滤过泡区结缔组织生长因子(CTGF)m RNA表达水平;共焦显微镜观察比较滤过泡微囊泡密度和面积。结果术前及术后1和7 d,两组眼压比较,差异均无统计学意义(P>0.05);术后14、21和28 d,两组眼压比较,差异均有统计学意义(P<0.05)。术后1、7和14 d,两组滤过泡评分比较,差异均无统计学意义(P>0.05);术后21和28 d,两组滤过泡评分比较,差异均有统计学意义(P<0.05)。经过治疗28 d后,两组结膜上皮下平均微囊密度和平均微囊面积比较,差异均有统计学意义(P<0.05)。两组结膜滤过泡区CTGF m RNA表达各时间点比较,差异有统计学意义(P<0.05)。结论 PFD滴眼液应用于兔小梁切除手术后,结膜滤过泡形成良好,有明显的抗瘢痕作用。【Objective】 To investigate the efficacy of pirfenidone eye drops for filtrating pathway after trabeculectomy in rabbit model. 【Methods】 Totally 24 New Zealand rabbits（24 eyes） were randomly divided into 2 groups： group A（ocular trabeculectomy in combination with pirfenidone） and group B（ocular trabeculectomy surgery in combination with PBS）. Clinical observations（including IOP, filtering blebs and complications）,real-time quantitative reverse transcription-polymerase chain reaction（real-time PCR） were performed at different time points（1 d, 7 d, 14 d, 21 d and 28 d） after the surgery. The conjunctiva area of filtering blebs was scanned with Confoscan 4.0. The images of conjunctiva filtering blebs were analyzed. 【Results】 There was no significant difference between the two groups in IOP on 1 d, 7 d before and after operation（P〉0.05）. On 14 d,21 d and 28 d after operation, there were statistically significant differences in IOP between both groups（P〈0.05）. There were statistically differences in filtering bleb scores at postoperative 21 d and 28 d between the two groups（P〈0.05）. On postoperative 28 d, the mean density of microcyst [（112 ± 22） cysts/mm2] and mean microcyst area [（28 589 ± 14 268）μm2] in the group A were significantly higher than those in the group B[mean density of microcyst：（26 ± 19） cysts/mm2 and mean microcyst area：（4 989 ± 2 329）μm2, P〈0.05]. Compared to that in group B, the level of connective tissue growth factor m RNA expression in operation areas was reduced in the group A at all the time points（P〈0.05）. 【Conclusions】 The trabeculectomy with pirfenidone eye drops can sustain the functional filtration bleb, inhibit the proliferation of fibroblasts and open the filtrating pathway in the rabbit glaucoma models.

关 键 词：吡非尼酮 小梁切除术 结缔组织生长因子 瘢痕形成 

分 类 号：R775[医药卫生—眼科] R779.6[医药卫生—临床医学]