大蒜素对青光眼滤过术后兔眼滤过泡瘢痕化的抑制作用  

Effects of allicin on anti-scarring of filtering bleb after glaucoma filtering surgery in rabbit eyes

作　　者：吕玉娟 车慧欣 于利 LV Yu-Juan;CHE Hui-Xin;YU Li(Department of Ophthalmology,the Third Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000,Liaoning Province,China)

机构地区：[1]锦州医科大学附属三院眼科,辽宁省锦州市121000

出　　处：《眼科新进展》2018年第7期625-629,共5页Recent Advances in Ophthalmology

基　　金：辽宁省自然科学基金资助(编号:2014022022);辽宁省自然科学基金重点资助(编号:20170540399);2015年辽宁省大学生创新训练计划项目(编号:201510160000042);辽宁省卫计委临床能力建设项目(编号:LNCCCD31-2015)~~

摘　　要：目的探讨大蒜素对青光眼滤过术后兔眼滤过泡瘢痕化的抑制作用。方法取健康同品系大白兔36只72眼,随机分成大蒜素组、丝裂霉素组、生理盐水组,每组24眼,均行小梁切除术。各组分别将浸有大蒜素(1.112 kg·L^(-1))、丝裂霉素(0.3 g·L^(-1))、生理盐水的棉片放置于结膜囊-巩膜瓣-巩膜床层间,5 min后完全取出棉片,充分冲洗。术后各组分别测眼压,观察滤过泡的形态,计算滤过泡面积并行眼前节照相。术后28 d处死各组兔,行HE染色及Masson染色对比观察各组结膜下瘢痕增生情况。结果术后第1天3组眼压较术前降低,随后眼压逐渐回升。各组不同时间内的眼压差异均有统计学意义(均为P<0.05)。术前及术后1 d、4 d、7 d、14 d两两比较中除术后4 d丝裂霉素组眼压比生理盐水组低(P=0.025)外,其余各时间眼压两两比较,差异均无统计学意义(均为P>0.05)。术后28 d生理盐水组眼压高于大蒜素组和丝裂霉素组(均为P<0.05),大蒜素组和丝裂霉素组相比差异无统计学意义(P>0.05)。术后1～4 d 3组滤过泡面积分别达到最大值,之后滤过泡面积逐渐减小。统计学分析结果示3组滤过泡面积减小量在不同的时间点上是不同的(P<0.05)。不同分组之间的滤过泡面积减小量有明显差异(P<0.05)。术后大蒜素组与丝裂霉素组滤过泡面积减小幅度相同,差异无统计学意义(P>0.05),生理盐水组比大蒜素组和丝裂霉素组的滤过泡面积减小速度更快,差异均有统计学意义(均为P<0.05)。术后28 d各组结膜上皮均完整无破损及增厚。HE染色显示大蒜素组和丝裂霉素组兔眼瘢痕组织较少,滤过通道较宽;生理盐水组兔眼瘢痕组织较多,滤过通道狭窄。Masson染色显示大蒜素组和丝裂霉素组可见少量炎性细胞浸润,滤过区成纤维细胞及胶原纤维疏松,结膜及巩膜间隙较宽;生理盐水组可见大量炎性细胞浸润,滤过区成纤维细胞及胶原纤�Objective To investigate the effect of allicin on the inhibition of subconjunctivalscar formation after trabeculectomy in rabbits.Methods Together 36 healthy rabbits of the same strain were randomly divided into three groups:allicingroup,mitomycin group and saline group.Trabeculectomy was performed on all 24 eyes of each group.During the operation,the cotton slices soaked respectively in allicin(1.112 kg·L-1),mitomycin(0.3 g·L-1)and saline were placed between conjunctival sac and scleral flap for 5 minutes,then the cotton was removed completely and the eye was rinsed thoroughly.After the operation,the intraocular pressure of each group was measured and the filter bleb was observed and measured to calculate the filter bleb area and anterior segment photography was used.Each group of rabbits was sacrificed on day 28 after surgery,and HE staining and Masson staining were used to observe the degree of scar hyperplasia under the conjunctiva.Results On the first day after the operation,the eye pressure of each group was lower than before operation,and then gradually rose again.The intraocular pressure of each group at different time points was statistically significant(all P<0.05).On the 4th day after the operation,the intraocular pressure of the mitomycin group was lower than that of the saline group(P=0.025).As for the rest time-point of the preoperative and postoperative 1 day,4 days,7days,14 days,there were no significant differences in pairwise comparison(all P>0.05)in terms of intraocular pressure.On the 28th day after the operation,the intraocular pressure of the saline group was higher than that of the allicin and mitomycin groups(all P<0.05)and there was no significant difference between the allicin group and the mitomycin group(P>0.05).From the first day to the fourth day after the operation,the area of the filter bleb reached its maximum,and then the area of the filtered bubbles gradually decreased.Statistical analysis showed that the reduction filtered bubbles area of three groups at different times was d

关 键 词：大蒜素 小梁滤过术 瘢痕形成 青光眼 结膜 兔 

分 类 号：R775[医药卫生—眼科]