吉西他滨对兔眼晶状体后囊膜混浊的抑制作用  

Inhibitory effect of gemcitabine on posterior capsule opacification in rabbit eye lens

作　　者：马强[1] 潘士印[1] 李曦冉 郑博[1] 曲晓瑜 

机构地区：[1]西安市第一医院眼科陕西省眼科研究所陕西省眼科学重点实验室,陕西西安710002 [2]西安交通大学公卫学院流行病与卫生统计学科,陕西西安710049

出　　处：《海南医学》2018年第4期445-448,共4页Hainan Medical Journal

摘　　要：目的研究眼内应用不同浓度的吉西他滨对兔眼晶状体后囊膜混浊(PCO)的抑制作用,初步探讨吉西他滨在眼内应用的安全性及有效性。方法 36只3个月龄新西兰白兔采用随机单位组设计分组法分为A、B、C三组,每组12只。A组为吉西他滨5 mg/m L治疗组,B组为吉西他滨10 mg/m L治疗组,C组为空白对照组;所有的实验动物均进行白内障囊外摘除+人工晶体植入术;术后监测角膜水肿,对后囊膜混浊程度及角膜内皮细胞数量进行分析。结果术后第1天、第3天,三组兔角膜均出现水肿,组间比较水肿差异无统计学意义(P>0.05),而术后第5天三组兔角膜水肿均吸收;后囊膜混浊术后第2周出现,术后30 d后囊膜混浊程度分级,A、B组后囊膜混浊分布于1级和2级,而C组多分布于2级和3级,A组与B组间比较差异无统计学意义(P>0.05),而A组和B组分别与C组比较,差异均有统计学意义(P<0.05);A、B和C三组术后角膜内皮细胞数量低于术前,角膜内皮损失量分别为(182.0±65.6)个/mm^2、(195.2±60.4)个/mm^2和(158.8±58.6)个/mm^2,三组手术前后角膜内皮细胞损失量组间两两比较,差异均无统计学意义(P>0.05)。结论与空白对照组比较,吉西他滨治疗组可以有效抑制后囊膜混浊的发生;5 mg/m L吉西他滨溶液可作为预防后发性白内障的药物。Objective To determine the inhibitory effect of gemcitabine on posterior capsule opacification in rabbit eye lens, and to analyze the safety and effectiveness of intraocular application of gemcitabine. Methods Thirtysix 3-month-old New Zealand rabbits（36 eyes） were randomized into three groups（each of 12 rabbits） to receive gemcitabine 5 mg/m L（group A）, gemcitabine 10 mg/m L（group B）, no gemcitabine（group C）. All the rabbits underwent extracapsular cataract extraction（ECCE） and intraocular lens（IOL） implantation. After operation, the corneal edema, posterior capsule opacification and the number of corneal endothelial cells were observed and compared among the three groups. Results Corneal edema was detected on the first and third day after operation in all the three groups, showing no significant difference（P0.05）, and the edema disappeared on the fifth day after operation. The posterior capsule opacification appeared at the second week after operation. On postoperative day 30, group A and group B showed posterior capsule opacification of grade 1 and grade 2（P0.05 for group A vs group B）, and group C showed posterior capsule opacification of grade 2 and grade 3（P0.05 for group C vs group A or B）. The postoperative numbers of corneal endothelial cells in three groups were smaller than those before operation. The loss of corneal endothelial cells in group A, B and C were respectively（182 ± 65.6）/mm2,（195.2 ± 60.4）/mm2 and（158.8 ± 58.6）/mm2, with no significant difference among the three groups（P0.05）. Conclusion Application of gemcitabine in ECCE and IOL implantation can effectively reduce posterior capsule opacification, and 5 mg/m L gemcitabine is recommended.

关 键 词：后囊膜混浊 吉西他滨 兔 角膜水肿 角膜内皮细胞 

分 类 号：R332[医药卫生—人体生理学]