康柏西普结膜下注射对兔小梁切除术后滤过通道内瘢痕形成的影响  

Effect of Conbercept on scar formation in rabbit filter channel after trabeculectomy

作　　者：孙中华 刘翠娟[1] 张艳 纪珍 刘伟[1] 王建荣[1] 孙嬿[1] 刘明坤 张苗苗[1] SUN Zhonghua;LIU Cuijuan;ZHANG Yan;JI Zhen;LIU Wei;WANG Jianrong;SUN Yan;LIU Mingkun;ZHANG Miaomiao(Department of Ophthalmology,Jinan Second People's Hospital,Jinan 250000,China;不详)

机构地区：[1]济南市第二人民医院眼科,济南250000 [2]曹县人民医院药剂科 [3]山东第一医科大学临床与基础医学院

出　　处：《山东医药》2023年第34期38-42,共5页Shandong Medical Journal

基　　金：济南市科技计划临床医学科技创新项目(202019067)。

摘　　要：目的探讨康柏西普结膜下注射对兔小梁切除术后滤过通道内瘢痕形成的影响。方法选择健康新西兰大白兔40只,按随机数字表法随机分成4组:小梁切除术中联合应用丝裂霉素组(A组)、小梁切除术毕注射康柏西普组(B组)、小梁切除术中联合应用丝裂霉素并术毕注射康柏西普组(C组)、小梁切除术毕注射生理盐水组(D组),每组10只。于兔右眼行标准小梁切除术,手术前后测量眼压,用裂隙灯显微镜观察术眼滤过泡形态和并发症情况;术后第28天,摘取术眼,剪取滤过泡区域组织,HE染色观察滤过通道组织病理变化,Masson染色观察滤过通道组织胶原蛋白沉积和纤维化程度,免疫组织化学染色观察滤过通道组织CD31表达。结果各组眼压于术后第3天降至最低,术后第7天逐渐回升,术后第28天几乎完全恢复至术前水平。术后第7天,A、B、C组术区均形成功能性滤过泡,D组滤泡表面结膜血管密集,血管化明显,滤过泡区域扁平。其中,A组滤泡高度升高,表面血管稀疏;B组滤泡弥漫性升高,滤泡表面未见明显充血;C组滤泡弥漫性升高,滤泡表面及结膜表面未见明显充血。随着时间延长,至术后28天,各组术区结膜均逐渐充血减轻消退,滤过泡局限、扁平。术后第28天,A、B组术眼组织病理学特征相似,均可见疏松的胶原纤维排列及局部增厚的上皮组织,伴有淋巴细胞点状浸润;A、C组均可见到虹膜中较多上皮细胞变性,细胞肿胀,胞质空泡化,而B组未见到此类病理改变。术后第28天,A、B、C组滤过通道胶原纤维占比均低于D组(P均<0.05),并且B组滤过通道胶原纤维占比低于A、C组(P均<0.05);B组滤过通道组织中微血管数目明显低于A、C、D组(P均<0.05)。结论康柏西普能够抑制兔小梁切除术后滤过通道新生血管形成和瘢痕化,辅助维持滤过泡形态,从而有效提高青光眼小梁切除术成功率。Objective To investigate the effect of Conbercept on fiber scar formation in rabbit filter channel after tra⁃beculectomy.Methods Forty healthy New Zealand white rabbits were randomly divided into four groups:trabeculecto⁃my combined with mitomycin group(group A),trabeculectomy combined with Conbercept injection group(group B),trab⁃eculectomy combined with mitomycin and Conbercept injection group(group C),trabeculectomy combined with normal sa⁃line injection group(group D),with 10 rabbits in each group.Standard trabeculectomy was performed on the right eyes of rabbits.The intraocular pressure(IOP)was measured before and after the operation,and the morphology and complications were observed by slit-lamp microscope.At 28 days after surgery,the operative eye was removed and the tissues of the follicle area were clipped.HE staining was used to observe the histopathologic changes of the filter pas⁃sage,Masson staining was used to observe the collagen deposition and fibrosis degree of the filter passage tissues,and immunohistochemical staining was used to observe the expression of CD31 in the filter passage tissues.Results The IOP in each group decreased to the lowest on the 3rd day after surgery,gradually increased on the 7th day after surgery,and almost completely recovered to the preoperative level on the 28th day after surgery.At 7 days after surgery,functional follicles were formed in the operative area of groups A,B and C,while conjunctival vessels on the follicle surface of group D were dense,with obvious vascularization and flat follicle area.Among them,the height of follicles in the group A in⁃creased and the surface blood vessels were sparse.In the group B,the diffusion of follicles increased,and there was no ob⁃vious congestion on the follicle surface.In the group C,the diffusion of follicles increased,and there was no obvious con⁃gestion on the surface of follicles and conjunctiva.As time went on,to 28 days after surgery,the conjunctival congestion gradually decreased and faded away,and the f

关 键 词：青光眼 小梁切除术 康柏西普 瘢痕 新生血管 大白兔 

分 类 号：R775[医药卫生—眼科]