吡非尼酮滴眼液在兔眼青光眼手术中应用研究  

Effects of pirfenidone on scar healing in experimental glaucoma surgery

作　　者：李亨辉[1] 李云燕[1] 邵毅[1] 胡佩宏 裴重刚[1] 高桂平[1] 刘秋平 李晶明 

机构地区：[1]南昌大学第一附属医院眼科,江西省330006 [2]江西省视觉科学与眼科研究所,330006

出　　处：《中国实用眼科杂志》2015年第10期1179-1184,共6页Chinese Journal of Practical Ophthalmology

基　　金：国家自然科学基金资助（8116011881400372）;全国临床医药研究专项基金（L2012052）;江西省远航工程（2014022）;江西省青年科学基金（20151BAB215016）;江西省科技支撑计划项目（20151BBG70223）;江西省教育厅科技计划项目（GJJ14170）;江西省卫计委科技计划项目（20155154）

摘　　要：目的探讨毗非尼酮滴眼液在兔青光眼小梁切除手术后的应用效果。方法实验研究。选择新西兰白兔24只（24只眼），制作兔高眼压模型5天后进行小梁切除术，分为两组：实验组使用吡非尼酮滴眼液滴眼，对照组使用PBS眼液滴眼。分别于术后1d（天）、7d、14d、28d观察眼压情况、结膜滤过泡、并发症情况，real—timePCR观察比较两组滤过泡区CTGFmRNA表达水平，共焦显微镜比较观察滤过泡微囊泡密度和面积情况。结果术前及术后1d，7d，比较两组眼压，差异均无统计学意义（P〉0．05）；术后14d，21d和28d，两组间眼压比较，差异均有统计学意义（P〈0．05）。术后1d，7d，14d两组的滤过泡评分比较，差异无统计学意义（P〉0．05）；比较术后21d，28d两组的滤过泡评分，差异有统计学意义（P〈0．05）。经过治疗28d后，实验组结膜上皮下平均微囊密度和平均微囊面积分别为（106±24）cysts／mm2和（29783±13604）um2，而对照组结膜上皮下平均微囊密度和平均微囊面积分别为（23±12）cysts／mm2和（4754±2536）um2，两组比较差异均有统计学意义（P〈0．05）。两组结膜滤过泡区CTGFmRNA表达在各时间点比较差异有统计学意义（P〈0．05）。结论吡非尼酮滴眼液应用于兔青光眼小梁切除手术后，降低眼压持久，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 trabeculectomy in rabbit glaucoma model. Methods Totally 24 rabbits （24 eyes） with high intraocular pressure （lOP） were randomly divided into 2 groups： the experimental group （ocular trabeculectomy in combination with pirfenidone） and the control group （ocular trabeculectomy surgery in combination with PBS）. Clinical observations （including lOP, filtering blebs and complications）, real-time quantitative reverse transcription-polymerase chain reaction （real-time PCR） were performed on different time points （D1, D7, D14, D21 and D28） 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 on lOP before and after ld, 7d preoperation （P 〈0.05）. After PD 21, there were statistically significant differences in the lOP and filtering bleb scores in both group （P 〈0.05）, whereas no statistically difference on that at PD1, 7 and 14 （P 〉0.05）. On postoperative D28, the mean density of microcyst （106±24） cysts/mm2 and mean microcyst area （29783±13604）um2 in the experimental group was significantly higher compared to those in the control group [（23±12） cysts/mm2 and （4754±2536） um2, P 〈0.05, respectively]. Compared to that in control group, the level of CTGF expression in operation areas was reduced in the experimental on mRNA level （P 〈0.05）. Conclusions The trabeculectory surgery with pirfenidone eye drops can control lOP, sustain the functional filtration bleb, inhibit the proliferation of fibroblasts and open the filtrating pathway on the rabbit glaucoma models.

关 键 词：吡非尼酮 小梁切除术 CTGFmRNA 瘢痕形成 

分 类 号：R777.1[医药卫生—眼科]