羊膜提取液治疗兔干眼症的实验研究

摘要

目的：研究羊膜提取液对苯扎氯铵诱导的兔干眼的治疗作用。　　方法：选择新西兰大白兔26只(26眼,均为右眼),使用0.2%的苯扎氯铵制作兔干眼症模型,随机分为两组：对照组(A 组,13眼)使用磷酸盐缓冲液(phosphate buffered saline,PBS)滴眼,实验组(B 组,13眼)使用1%羊膜提取液(amniotic extraction)滴眼,4次/ d。另选取2只兔作为正常对照。分别于治疗前和治疗1、2、4、8wk 行 Schirmer I 试验(Schirmer Ⅰ test,SⅠt)、角膜荧光素染色(corneal fluorescein staining,FL)、泪液总蛋白含量、淀粉酶活性、乳铁蛋白、溶菌酶含量检测,并进行结膜印迹细胞检查。结果：不同组间、不同时间点间 SⅠt、FL、溶菌酶活性及结膜杯状细胞密度相比,差异有统计学意义(P<0.05)。治疗前两组 SⅠt、FL、溶菌酶活性及结膜杯状细胞密度相比,差异无统计学意义(P>0.05)；治疗1、2、4、8wk 后,B组 SⅠt、FL、溶菌酶活性较治疗前均有不同程度改善,差异有统计学意义(P<0.05),B 组结膜杯状细胞密度与治疗前相比有所增加,但差异无统计学意义(P>0.05)；治疗1、2、4、8wk 后,A 组 SⅠt、溶菌酶活性及结膜杯状细胞密度均有不同程度下降,差异有统计学意义(P<0.05),A组 FL 评分与治疗前相比有不同程度增加,但差异均无统计学意义(P>0.05)。 A、B 两组各时间点 SⅠt、FL、溶菌酶活性及结膜杯状细胞密度相比,差异均有统计学意义(P<0.05)。同一组内不同时间点,泪液中总蛋白量、乳铁蛋白、淀粉酶活性差异无统计学意义(P>0.05)。治疗前 A、B 两组泪液中总蛋白量、乳铁蛋白、淀粉酶的活性相比,差异无统计学意义(P>0.05)；治疗4、8wk 后两组泪液中总蛋白量、乳铁蛋白、淀粉酶的活性相比,其差异有统计学意义(P<0.05)。　　结论：羊膜提取液能有效治疗兔干眼症,具有良好的临床应用前景。%AIM: To investigate therapeutic efficiency of amniotic extraction on dry eye in rabbit model induced by topical benzalkonium chloride (BAC). METHODS: Totally 26 rabbits (26 right eyes) with dry eye model were studied and divided into two groups:group A (control group with PBS eye drops, n = 13) and group B ( amniotic extraction group, n = 13). Another two rabbits were chosen as normal control. The SchirmerⅠ tests ( S Ⅰ t) and corneal fluorescein staining ( FL) were made, and the tear total protein content, amylase activity, lactoferrin, lysozyme contents, goblet cell density were performed in two groups before treatment and 1, 2, 4 and 8 wk after treatment. RESULTS: There were significant differences in SIT, FL scores, lysozyme activity and goblet cell density among different groups at different time points (P<0. 05). But, there was no significant differences in SⅠt, FL scores, lysozyme activity and goblet cell density between two groups before treatment (P>0. 05). After 8wks' treatment with PBS, the mean differences of the group A showed great changes in SⅠt, lysozyme and goblet cell density compared with those before treatment ( P < 0. 05); but there was no significant differences in FL scores compared with those before treatment (P>0. 05). As for group B, 8wks after treatment, there were statistical changes in SⅠt, FL, lysozyme (P<0. 05); but there was no significant differences in goblet cell density compared with those before treatment ( P > 0. 05). It was evident that statistical differences were observed in S Ⅰ t, FL scores, lysozyme activity and goblet cell density between two groups at each time point (P<0. 05). However, there were no significant differences in total protein, lactoferrin, amylase activity at different time points (P>0. 05). Meanwhile there was no significant differences in total protein, lactoferrin, amylase activity between two groups before treatment ( P > 0. 05 ). But there were significant differences in total protein, lactoferrin, amylase activity between two groups after 4 and 8 wks'treatment (P<0. 05). CONCLUSION: Amniotic extraction has significant therapeutic effect on the dry eye in rabbit model.