摘要
目的探讨替奈普酶(tenecteplase,TNK-TPA)在兔眼玻璃体腔注射诱导玻璃体后脱离(posterior vitreous detachment,PVD)的有效性和安全性。方法选取30只成年有色兔,排除内外眼病。按随机的原则分为A、B、C3组,每组10只。分别将浓度为100mg.L-1、500mg.L-1、1000mg.L-1的TNK-TPA溶液(各0.1mL)注入A、B、C3组兔的左眼玻璃体内,作为实验眼;右眼为对照眼,玻璃体内注入0.1mLBSS溶液。注药后1h、1d、3d,检查眼底、扫描电镜、B超观察PVD情况,光镜、透射电镜和视网膜电图判断药物安全性。结果注药后3d,眼底检查发现A、B、C组实验眼PVD发生率分别为20.0%、80.0%、90.0%,实验眼总PVD发生率为63.3%,对照眼无PVD发生,二者比较差异有显著统计学意义(P<0.01)。扫描电镜显示A、B、C3组实验眼发生完全性PVD各2眼、8眼、9眼。B超检查,注药后3d,B组、C组实验眼中发生PVD的眼数分别是8眼、9眼,与对照眼比较,差异均有统计学意义(均为P<0.05)。光镜和透射电镜检查发现,A、B组实验眼的视网膜组织细胞未见异常;C组实验眼中3眼视网膜神经纤维层水肿,神经节细胞中线粒体肿胀、空泡样变性。扫描电镜观察,A、B、C3组实验眼分别有8眼、2眼、1眼视网膜表面残留大量玻璃体胶原纤维。注药前后的视网膜电图b波平均振幅比较差异均无统计学意义(均为P>0.05)。结论在破坏血眼屏障后,玻璃体内注射500mg.L-1TNK-TPA可以诱导玻璃体后脱离的发生,无明显毒性作用,可以辅助玻璃体视网膜手术。
Objective To investigate the efficacy and safety of intravitreal injection of tenecteplase（TNK-TPA） inducing posterior vitreous detachment（PVD） in rabbit eyes.Methods Thirty adult colored-rabbits without any eye disease were used as experimental animals,and randomly divided into three groups（group A,B,C）,ten rabbits in each group.The left eyes in group A,B,C respectively were intravitreal injected 100 mg·L^-1,500 mg·L^-1,1 000 mg·L^-1 TNK-TPA （0.1 mL）as experimental eyes,the right eyes with 0.1 mL BSS as control eyes.One hour,1 day and 3 days after injection,PVD was evaluated by biomicroscope,B-mode ultrasonography,scanning electron microscope,and the drug safety was judged by light microscope,transmission electron microscope,electroretinogram.Results Three days after injection,under biomicroscopy and ultrasonography the incidence of PVD in experimental eyes were 20.0%,80.0%,90.0% in group A,B,C respectively,total incidence of PVD in experimental eyes was 63.3%,and PVD didn＇t occur in control eyes,there was significant difference between experimental eyes and control eyes（P〈0.01）.Under the scanning electron microscopy,there were 2 eyes,8 eyes,9 eyes with complete PVD in experimental eyes of group A,B,C.The results of B-mode ultrasonography showed there were 8 eyes and 9 eyes with PVD in group B and group C 3 days after injection,there was statistical difference compared with control eyes（P〈0.05）.Under the light microscope and transmission electron microscope,the retinal tissues in experimental eyes of group A,B were normal,but in group C edema retinal nerve fibre layer edema and swelling mitochondria with vacuolar degeneration in retinal ganglion cells were observed in 3 eyes.Under the scanning electron microscope,there were 8 eyes,2 eyes and 1 eye with more glass collagen fiber remaining on the retinal surface in group A,B,C respectively.There was no statistical difference in mean amplitude of b wave in electroretinogram before and after injection（P〉0.05）.Conclusion After destroying the blood-ocular barrier,intravitreal injection of 500 mg·L^-1 TNK-TPA can induce PVD in rabbits with no obvious toxicity,which can assist vitrectomy.
出处
《眼科新进展》
CAS
北大核心
2010年第3期218-221,共4页
Recent Advances in Ophthalmology
关键词
玻璃体后脱离
玻璃体内注药
替奈普酶
兔
posterior vitreous detachment
intravitreal injection
tenecteplase
rabbit
作者简介
姚一民，男，1972年10月出生，河北无极人，硕士，主治医师。主要从事玻璃体视网膜病和眼外伤的研究。联系电话：0311—86919622（O）；E—mail：yaoyimin666@sohu．
