Lucentis对兔眼青光眼滤过术后滤过通道抗瘢痕化的实验研究  

EXPERIMENTAL STUDY OF LUCENTIS ON ANTI-SCARRING OF FILTERING CHANNRL AFTER GLAUCOMA IN RABBIT EYES

作　　者：张俊芳[1] 陈启 刘嘉方 牛越 史桂桃[3] ZHANG Junfang;CHEN Qi;LIU Jiafang;NIU Yue;SHI Guitao(Inner Mongolia Medical Universily,Hohhot 010059,China;Ningxia Medical University,Yinchuan 750004,China;Depantment of Ophthalmology,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学,内蒙古呼和浩特010059 [2]宁夏医科大学,宁夏银川750004 [3]内蒙古医科大学附属医院眼科,内蒙古呼和浩特010050

出　　处：《内蒙古医科大学学报》2024年第5期453-458,476,共7页Journal of Inner Mongolia Medical University

基　　金：内蒙古自治区自然科学基金项目(2020LH08020)。

摘　　要：目的探讨青光眼滤过手术(glaucoma filtration surgery,GFS)术后滤过泡下注射不同剂量Lucentis,对滤过道纤维瘢痕化的疗效。方法将40只大耳兔随机分为5组,每组8只,所有实验兔均右眼手术,左眼不处理。评估术后眼压、滤过泡、眼前节反应及并发症。采用ELISA法测定各组术后1、7、14、28 d房水及14、28 d滤过泡组织匀浆中VEGF、TGF-β2的浓度。采用HE、Masson、CD31、TUNEL染色观察滤过区组织病理情况。结果D、E组功能滤过泡可以持续至术后28 d,出现较少的并发症,同一时间点组间眼压比较差异无统计学意义(P>0.05);术后1、7、14、28 d房水及14、28 d组织匀浆中VEGF、TGF-β2浓度D、E组较A、B、C组低,差异有统计学意义(P<0.05);术后1、7、14 d房水及14 d的组织匀浆中VEGF浓度C组均较A、B组低,差异有统计学意义(P<0.05);术后14、28 d,D、E组较A组可以观察到明显的炎症细胞、胶原纤维,较少的滤过道组织微血管,较B组有较低的细胞凋亡率。结论Lucentis能有效抑制GFS术后滤过道瘢痕化,对眼部组织无明显不良反应;0.5 mg Lucentis与0.75 mg Lucentis抗瘢痕作用无明显差异。Objective To investigate the effect of different doses of Lucentis injected under the filtering bleb after glaucoma filtration surgery(GFS)on fibrous scarring of the filtering tract.Methods Forty rabbits were randomly divided into 5 groups with 8 rabbits in each group.All the rabbits were operated on their right eyes and left eyes were not treated.The postoperative intraocular pressure,filtering bleb,anterior segment reaction and complications were evaluated.The concentrations of VEGF and TGF-β2 in aqueous humor at 1,7,14 and 28 days after operation and in tissue homogenate of filtering bleb at 14 and 28 days after operation were determined by ELISA.Histopathological changes were observed by HE,Masson,CD31 and TUNEL staining.Results The functional filtering blebs in group D and E could last for 28 days after operation with fewer complications,there was no significant difference in IOP between the two groups at the same time point(P>0.05),The concentrations of VEGF and TGF-β2 in aqueous humor and tissue homogenate on the 1,7,14 and 28 day after operation in group D and E were lower than those in group A,B and C,and the difference was statistically significant(P<0.05),and the concentrations of VEGF in aqueous humor and tissue homogenate on the 1st,the 7 and 14 day after operation in group C were lower than those in group A and B,and the difference was statistically significant(P<0.05).On the 14 and 28 day after operation,obvious inflammatory cells and collagen fibers were observed in group D and E compared with group A,and less microvessels were observed in the filtering passage tissue,and the apoptosis rate was lower than that in group B.Conclusions Lucentis can effectively inhibit the scarring of the filtering tract after GFS,and has no obvious toxic and side effects on the ocular tissue.There was no significant difference in anti-scarring effect between 0.5 mg Lucentis and 0.75 mg Lucentis.

关 键 词：青光眼 滤过性手术 LUCENTIS VEGF TGF-Β2 抗瘢痕 

分 类 号：R367.6[医药卫生—病理学]