10 g·L-1聚维酮碘对大鼠眼表结构和泪膜稳定性的影响  

Effects of topical povidone iodine 10 g·L-1 on ocular surface structure and tear film stability in rats

作　　者：陈冬燕 王贺 张灿 郭建新 李明新 CHEN Dongyan;WANG He;ZHANG Can;GUO Jianxin;LI Mingxin(Department of Ophthalmology,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu Province,China)

机构地区：[1]徐州医科大学附属医院眼科,江苏省徐州市221000

出　　处：《眼科新进展》2021年第1期48-52,共5页Recent Advances in Ophthalmology

基　　金：徐州市科技计划项目基金资助(编号KC20107)。

摘　　要：目的评估聚维酮碘对大鼠眼表结构和泪膜稳定性的影响。方法30只SD大鼠左眼使用生理盐水滴眼为A组,右眼使用10 g·L-1聚维酮碘滴眼为B组,均为每天2次,分别在干预前和干预后2 d、4 d、6 d、8 d、10 d、12 d、14 d用裂隙灯观察角膜形态,并计算泪膜破裂时间(BUT)、泪液分泌量、角膜荧光素染色评分和炎症指数以评估干眼的临床指标改变,使用共聚焦显微镜观察两组角膜组织结构,干预后14 d完成临床指标记录后,取眼球组织行病理学检查,HE染色观察角膜各层结构,PAS染色观察结膜杯状细胞情况,PMN/ED1双重免疫组织化学染色观察中性粒细胞/巨噬细胞在角膜组织层间的浸润情况。结果裂隙灯检查结果显示,干预后14 d B组大鼠角膜上皮粗糙,荧光素染色阳性,呈点片状着染。干预后6 d、8 d、10 d、12 d、14 d,与A组相比,B组BUT均明显缩短、泪液分泌量均明显下降,角膜荧光素染色评分及炎症指数均明显升高,差异均有统计学意义(均为P<0.05)。角膜共聚焦显微镜检查结果显示,B组角膜上皮层及基质层可见炎症细胞浸润。HE染色结果显示,B组角膜上皮细胞层数增多,上皮厚度增加,基底细胞呈现“空泡样”结构。PAS染色结果显示,B组结膜PAS染色阳性细胞数量显著降低,结膜上皮增厚,细胞层次增加。PMN/ED1双重免疫组织化学染色结果显示,B组角膜上皮层及基质层可见炎症细胞聚集。结论10 g·L-1聚维酮碘局部滴眼可引起实验大鼠眼表结构损伤和泪膜稳定性下降,聚维酮碘的眼表毒性有必要引起临床医师的高度重视。Objective To evaluate the effect of povidone-iodine disinfectant on ocular surface structure and tear film stability.Methods A model of ocular surface injury in rats was established by local instillation of povidone-iodine at a concentration of 10 g·L-1 in 30 SD rats,which were randomly divided into A group and B group.The A group used physiological saline for left eyes,and the B group used 10 g·L-1 povidone iodine for right eyes,twice a day.The general morphology was observed by slit lamp before and after intervention 2 days,4 days,6 days,8 days,10 days,12 days,14 days,and the tear film break time(BUT),tear secretion,corneal fluorescein staining score and inflammation index score were calculated to evaluate the clinical changes of dry eye.The tissue structure was observed using a corneal confocal microscope.The rat eyeball tissues were taken for fixation,embedding and sectioning,and the cell morphology of each layer was observed by HE staining,and the number of conjunctival goblet cells was observed by PAS staining,and the neutrophils/macrophages were observed between tissue layers by immunohistochemical staining infiltration 14 days after intervention.Results The slit lamp showed that the corneal epithelium of the B group was rough,and the fluorescein staining was positive and patchy on day 14 after intervention.On day 6,8,10,12,14 after the intervention,compared with the A group,BUT was significantly shortened,tear secretion decreased significantly,corneal fluorescein staining score and inflammation index were significantly increased in B group,and the differences were statistically significant(all P<0.05).The results of corneal confocal microscopy showed that there was inflammation in the corneal epithelial and stromal layers of B group.HE staining results showed that the number of corneal epithelial cells increased,the epithelial thickness increased,and the basal cells showed a“vacuum-like”structure in the B group.The PAS staining results showed that the number of PAS staining positive cells in the con

关 键 词：干眼 眼表 聚维酮碘 动物模型 

分 类 号：R772[医药卫生—眼科] R777[医药卫生—临床医学]