丝裂霉素C在难治性青光眼手术中抗瘢痕作用的实验研究  

Experiment study of anti-scarring effects of MMC in refractory glaucoma

作　　者：丁碧青[1] 陶黎明[1] 

机构地区：[1]安徽医科大学第二附属医院眼科,合肥230601

出　　处：《临床眼科杂志》2017年第6期551-554,共4页Journal of Clinical Ophthalmology

摘　　要：目的观察丝裂霉素C在兔眼硅胶垫植入术后的抗瘢痕作用以间接评估丝裂霉素C(MMC)在Ahmed引流阀植入术治疗难治性青光眼术后的抗瘢痕作用。方法健康成年獭兔21只(42只眼),右眼为实验眼,左眼为对照眼,双眼均于颞上方行硅胶垫植入术,分别于术后10、30、90 d取标本,进行HE染色、Masson染色观察组织形态及纤维化程度,免疫组化测定转化生长因子β1(TGFβ1)及α-平滑肌肌动蛋白(αSMA)的表达情况以评估组织的纤维化程度。结果实验组术后10、30、90 d的一个高倍镜视野下TGFβ1阳性细胞数的平均值分别为15.80±2.39、28.20±1.48、41.60±2.70,对照组术后平均值分别为27.80±1.64、50.80±3.35、114.80±4.15,实验组与对照组对比均具有统计学意义(P<0.01)。实验组术后10、30、90 d的一个高倍镜视野下αSMA阳性细胞的平均光密度的平均值分别为0.169±0.010、0.519±0.031、0.877±0.033,对照组术后平均值分别为0.252±0.021、0.519±0.031、0.877±0.033,实验组与对照组在术后对比均具有统计学意义(P<0.01)。结论 MMC在兔眼硅胶垫植入术中具有显著的抗瘢痕作用,可用于临床Ahmed引流阀植入术中,以抵抗瘢痕组织形成。Objective To examine the roles of MMC on anti-scarring after implantation silicone mat in rabbit eyes. Indirect assessment the function of MMC on anti-scarring after Ahmed glaucoma valve（ AGV） implantation in refractory glaucoma. Methods 42 eyes of 21 rabbits underwent silicone insole implantation,and were divided into two groups（ MMC group and blank control group）. The rabbits were sacrificed at 10,30 and 90 days after surgery. Histopathological changes were examined by H. E. staining. Masson stain was used to assess the degree of fibroblast proliferation. The expression of TGFβ1 and α-SMA was identified by immunohistochemistry study. Results Average number of TGFβ1 positive cells in experimental group were 15. 80 ± 2. 39,28. 20 ± 1. 48,and 41. 60 ± 2. 70 at 10,30 and 90 days（ 400 x magnification）. The number of positive cells in control group were 27. 80 ± 1. 64,50. 80 ± 3. 35,114. 80 ± 4. 1,respectively. There were significant differences between the experimental group and the control group at 10,30 and 90 days after surgery（ P〈0. 01）. Average number of αSMA positive cells in experimental group were 0. 169 ± 0. 010,0. 519 ± 0. 031,and 0. 877 ±0. 033 at 10,30 and 90 days（ 400 xmagnification）. The number of positive cells in control group were 0. 252 ± 0. 021,0. 519 ± 0. 031,and 0. 877 ± 0. 033,respectively. There were significant differences between the experimental group and the control group at 10,30 and 90 days after surgery（ P〈0. 01）. Conclusions MMC could effectively and safely inhibit the fibrous proliferating. MMC can be used for preventing the formation of fibrous tissues in clinical Ahmed drainage valve implantation.

关 键 词：丝裂霉素C Ahmed引流阀 难治性青光眼 转化生长因子Β1 Α-平滑肌肌动蛋白 

分 类 号：R779.6[医药卫生—眼科]