曲安奈德／聚乳酸己内酯载药静电纺丝膜的抗兔眼滤过泡瘢痕化作用  

Anti-scarring effects of triamcinolone acetonide/polylactic acid caprolactone drug-loaded electrospinning film with trabeculectomy in rabbits

作　　者：郑玉强[1] 王卓实[1] 徐玲[1] 吴建国[1] 赵军[1] 何伟[1] 

机构地区：[1]辽宁何氏医学院沈阳何氏眼科医院,沈阳110034

出　　处：《中华实验眼科杂志》2016年第7期585-590,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：辽宁省自然科学基金项目（2014020153）

摘　　要：背景青光眼滤过术后滤过道的瘢痕形成是手术失败的主要原因，近年来多采用小梁切除术中局部使用抗瘢痕形成药物的方法来保持滤过道的开放，但药物可引起并发症。研究证实，聚乳酸己内酯（PLCA）材料制作的静电纺丝膜可作为负药载体以达到药物缓释的目的，但其在青光眼滤过术中的作用尚未证实。目的探讨小梁切除术联合巩膜层间填充负载曲安奈德（TA）静电纺丝膜在兔眼穿透性小梁切除术中抗瘢痕化的作用及可行性。方法利用静电纺丝技术制备TA／PLCA载药静电纺丝膜，扫描电子显微镜下检测其表面超微结构，采用高效液相色谱仪检测体外药物缓释性能。采用前房注射卡波姆法制备单眼青光眼动物模型，将造模成功的40只新西兰白兔均行穿透性小梁切除术并采用随机数字表法分为5个组，每组8只眼。TA／PLCA载药静电纺丝膜组、PLCA静电纺丝膜组和羊膜组在术中于巩膜瓣下分别植入TA／PLCA载药静电纺丝膜、PLCA静电纺丝膜或羊膜。TA组术眼术毕在结膜下注射40mg／mlTA溶液而术中不植入任何植片，单纯小梁切除术组仅行小梁切除术。分别于术后1…248和12周测量术眼眼压，并采用裂隙灯显微镜观察滤过泡的形态变化；于术后12周制备术眼滤过泡组织切片，采用苏木精一伊红染色法检查各组术眼滤过泡的组织病理学变化。结果制备的PLCA静电纺丝纤维直径为0．5～1．5p,m，呈空间立体网状结构，而TA／PLCA静电纺丝膜结构与PLCA静电纺丝膜相近，可体外缓释药物14d。单纯小梁切除组术眼滤过泡于术后8周前全部消失，术后12周TA／PLCA载药静电纺丝膜组8只眼均存在功能性滤过泡，PLCA静电纺丝膜组中维持功能性滤过泡者5只眼，羊膜组和TA组中分别为4只眼。术后12周各组术眼的眼压明显不同，TA／PLCA载药静电纺丝膜组术眼眼压最低，而单纯小梁切Background Scarring of filter bleb is a main cause of failure after trabeeulectomy. Administration of anti-proliferation dugs during filtering surgery can maintain the opening of filtering pathway, but some serious complications oecure after the drug use. Researches showed that polylaetie acid caprolactone （PLCA） drug-loaded eleetrospinning film can release drug slowly, but its application in glaucoma is seldom. Objective The aim of this study was to evaluate the anti-scarring effects of non-penetrating trabeeuleetomy combined with sclera interlayer implantation of triamcinolone aeetonide （TA）/PLCA drug-loaded electrospinning film in rabbit. Methods TA/PLCA drug-loaded electospinning film was prepared by electrospinning and its surface ultrastructure was observed under the scanning electron microscope. The drug release properties were detected by high performance liquid chromatograph. Ocular hypertensive models were established in New Zealand white rabbits by injecting carbomer into the anterior chamber of the right eyes,and the 40 models were randomized into 5 groups,8 eyes for each group. TA/PLCA drug- loaded electrospun membrane,PLCA electrospun membrane or amniotic membrane was implanted beneath the seleral flap during trabeculectomy respectively in the TA/PLCA group, PLCA group or amniotic group, and 40 mg/ml TA was subconjunctivally injected in the TA group. Only trabeculectomy was performed in the simple trabeculectomy group. Intraocular pressure （IOP） was measured, and the shape of filtering bleb was examined under the slit lamp 1 week,2, 4,8 and 12 weeks after surgery. The section of filtering bleb was prepared 12 weeks after surgery for the histopathological examination. The use and management of experimental animals was in line with animal ethics. Results The similar three-dimensional reticular structure was seen between TA/PLCA and electrospun membrane with the fiber diameter 0.5-1.5 ij, m. TA was released stably for 14 days. All the filtering blebs were disappeared in the simple trabecule

关 键 词：青光眼/治疗 小梁切除术 聚乳酸己内酯/化学 曲安奈德/药物 增生 药物缓释系统 TA/PLCA载药静电纺丝膜 兔 

分 类 号：R779.6[医药卫生—眼科]