苦参碱对兔眼小梁切除术后滤过泡瘢痕的影响

摘要

目的 研究苦参碱对青光眼滤过泡瘢痕形成是否有抑制作用.方法 选取40只新西兰大白兔,随机分为A、B、C、D四组,均行小梁切除术,巩膜瓣下分别放置1.0g·L-1苦参碱棉片、0.4g·L-1苦参碱棉片、0.2 mg · L-1丝裂霉素棉片、生理盐水棉片.于术前,术后1、3、7、14、28 d观察各组眼压、滤过泡、前房反应、并发症等,于术后1、3、7、14、28 d各组随机处死2只兔,摘出眼球分别做病理切片、免疫组织化学染色及Masson三色染色观察炎症细胞、成纤维细胞增殖情况及新生胶原纤维情况,选取术后7d的角膜行透射电镜,观察药物的毒性反应.结果 术后7、14、28 dA、B、C组与D组两两对比眼压值有明显差异(P＜0.05),A组与B组术后7、14、28 d两组眼压有明显差异(P＜0.05).术后7、14、28 dA、B、C三组成纤维细胞计数与D组比较有显著差异(P＜0.01),A、B组成纤维细胞计数比较差异有显著性(P＜0.05).结论 苦参碱能减少成纤维细胞的增殖,减少滤过泡瘢痕形成,对眼部组织无明显毒副作用.%Objective To study the inhibitive effects of matrine on the formation of glaucoma filtration bleb scar.Methods A total of 40 New Zealand white rabbit were chosen and randomly divided into four groups(group A,B,C and D).Both eyes in four groups were treated with glaucoma filtration surgery.The cotton pieces under the sclera flap were made:1.0 g · L-1 matrine cotton piece in group A,0.4 g · L-1 matrine cotton piece in group B,0.2 mg · L-1 mitomycin cotton piece in group C and PBS cotton piece in group D.The intraocular pressure,filtering bleb,anterior chamber reaction and complications were observed at preoperative and postoperative 1 day,3 days,7 days,14 days,28 days in all groups.Two rabbits selected randomly from every group were killed at 1 day,3 days,7 days,14 days and 28 days after surgery.Tissue was harvested from the bleb area and made into pathological section,immunestaining and Masson trichromatic dyeing were used to observe the inflammatory cells,collagen,fibroblasts,the change of muscle fibroblasts and new collagen fibers under light microscope.The cornea was observed at 7 days under transmission electron microscope for drug toxic reaction,Results At postoperative 7 days,14 days,28 days,there were statistical difference in IOP between group A,B,C and group D group (P ＜ 0.05),and there were statistical difference between group A and group B (P ＜ 0.05).At postoperative 7 days,14 days,28 days,there were statistical difference in fibroblasts counting between group A,B,C and group D group (P ＜0.01),and there were statistical differences between group A and group B (P ＜ 0.05).Conclusion Matrine can inhibit fibroblasts hyperplasia,reduce the scar of filtration area and has no side effects on eye tissues.