预防性应用抗菌素对视网膜影响的研究

发布时间：2018-01-22 12:57

本文关键词： 玻璃体腔注射视网膜毒性头孢他啶万古霉素　出处：《山东大学》2012年硕士论文　论文类型：学位论文

【摘要】：第一部分眼内注入抗菌素对视网膜组织结构影响目的：观察眼内注入不同抗菌素对视网膜组织结构影响。方法：选用健康普通级雌性Wistar大鼠78只,随机分为12个实验组和1个对照组,每组6只,均以右眼作为实验眼。对照组动物右眼玻璃体腔注入0.02ml生理盐水,其余各实验组动物右眼玻璃体腔分别注入浓度为10g/l的头孢呋辛、妥布霉素、庆大霉素、盐酸左氧氟沙星、头孢他啶、万古霉素注射液各0.02ml,以及浓度为5g/1的上述溶液各0.02ml。3天后,脱颈处死动物,立即摘取眼球,用lml注射器将固定液自角巩膜缘处注入约0.02ml,将眼球浸入固定液中固定24小时后,取出标本,切除角膜,摘除晶体,将剩余眼球壁再次浸入固定液中,用于HE染色切片的制备。结果：对照组切片显示为正常组织结构,头孢呋辛组神经纤维层水肿,神经节细胞层及内核层空泡样变性；妥布霉素组神经纤维层结构不清,神经节细胞层及内核层部分核固缩,空泡样变性明显；庆大霉素组内界膜不完整,神经纤维层结构不清,神经节细胞层核固缩,内核层变薄,空泡样变性明显,内、外丛状层出现囊样间隙,色素上皮层不完整；左氧氟沙星组神经纤维层结构不清,神经节细胞层及内核层部分核固缩,空泡样变性明显；万古霉素组及头孢他啶组神部分经纤维层及神经节细胞轻度水肿,内核层细胞排列欠规则,少量空泡样变性。结论：头孢呋辛、妥布霉素、庆大霉素和左氧氟沙星有明显的视网膜毒性,万古霉素、头孢他啶视网膜毒性不明显。第二部分眼内注入抗菌素对视网膜超微结构影响目的：观察眼内注入不同抗菌素对视网膜超微结构影响。方法：选用健康普通级雌性Wistar大鼠24只,随机分为3个实验组和1个对照组,每组6只,均以右眼作为实验眼。对照组动物右眼玻璃体腔注入0.02ml生理盐水,各实验组动物右眼玻璃体腔分别注入浓度为5g/l的庆大霉素、头孢他啶、万古霉素注射液各0.02ml。3天后,脱颈处死动物,立即摘取眼球,用lml注射器将3%的戊二醛固定液自角巩膜缘处注入约0.02ml,将眼球浸入固定液中固定24小时之后,取出标本,切除角膜,摘除晶体,将视网膜自眼球壁剥离出置于3%的戊二醛固定液中,用于制备透射电镜标本。结果：对照组显示为正常组织结构,头孢他啶组及万古霉素组部分神经纤维层消失,神经节细胞及内核层部分核膜凹陷,染色质加深,内质网扩张,线粒体肿胀,空泡样变性,内外丛状层轻度水肿；庆大霉素组神经纤维层溶解消失,神经节细胞核膜消失,结构不完整,内外丛状层不规则扩张,囊样间隙明显,内核层及外核层部分细胞核固缩,大部分细胞核膜凹陷,染色质加深,排列不规则,线粒体肿胀明显,内质网扩张,大空泡样变性。结论：虽然万古霉素、头孢他啶在光镜下显示无明显视网膜毒性,但在电镜下其视网膜各层的超微结构显示出了较明显的病理改变。
[Abstract]:Part I effects of intraocular injection of antibiotics on retinal tissue structure Objective: to observe the effect of intraocular injection of different antibiotics on retinal tissue structure. Methods: 78 normal female Wistar rats were randomly divided into 12 experimental groups and a control group. In each group, 6 eyes were used as experimental eyes, and 0.02ml saline was injected into the vitreous cavity of the control group. In other experimental groups, 10 g / l of cefuroxime, tobramycin, gentamicin, levofloxacin hydrochloride, ceftazidime and vancomycin injection were injected into the vitreous cavity of the right eye, respectively. After 0. 2 ml / 1 of 5 g / 1 solution, the animals were killed and eyeballs were removed immediately. The fixative was injected with lml syringe at the edge of the horn and sclera about 0. 02 ml. After the eyeball was immersed in the fixative solution for 24 hours, the specimen was removed, the cornea was excised, the lens was removed, and the remaining eyeball wall was immersed again in the fixative solution. Results: control group showed normal tissue structure, cefuroxime group showed edema of nerve fiber layer, vacuolar degeneration of ganglion cell layer and nuclear layer. In tobramycin group, the structure of nerve fiber layer was unclear, the ganglion cell layer and kernel layer were pyknotic, and vacuolar degeneration was obvious. In gentamicin group, the inner boundary membrane was incomplete, the structure of nerve fiber layer was not clear, the ganglion cell layer was pyknosis, the inner and outer plexiform layer appeared cystic space, and the pigment epithelium was incomplete. In levofloxacin group, the structure of nerve fiber layer was unclear, the ganglion cell layer and inner layer were pyknotic and vacuolar degeneration was obvious. Vancomycin group and ceftazidime group had mild edema in the fibrolayer and ganglion cells, irregular arrangement in the nuclear layer and a small amount of vacuolar degeneration. Conclusion: cefuroxime, tobramycin. Gentamicin and levofloxacin had obvious retinal toxicity, but vancomycin and ceftazidime were not. Part two effects of intraocular injection of antibiotics on retinal ultrastructure Objective: to observe the effect of intraocular injection of different antibiotics on retinal ultrastructure. Methods: 24 normal female Wistar rats were randomly divided into 3 experimental groups and 1 control group. In each group, 6 eyes were used as experimental eyes. In control group, 0.02ml saline was injected into the vitreous cavity of the right eye, and gentamicin (5 g / l) was injected into the vitreous cavity of each experimental group. After ceftazidime and vancomycin injection 0.02ml.3 days, the animals were killed and eyeballs were removed immediately. 3% glutaraldehyde fixative was injected into the keroscleral edge with lml syringe. After the eyeball was immersed in the fixative solution for 24 hours, the specimen was removed, cornea was removed and lens was removed. The retina was removed from the eyeball wall and placed in glutaraldehyde (3%) fixed solution for the preparation of transmission electron microscope (TEM) specimens. Results: the control group showed normal tissue structure. In ceftazidime group and vancomycin group, part of the nerve fiber layer disappeared, the ganglion cells and the nuclear membrane of the inner layer were depressed, chromatin deepened, endoplasmic reticulum dilated, mitochondria swelling and vacuolar degeneration. Mild edema of the inner and outer plexiform layer; In the gentamicin group, the nerve fiber layer dissolved and disappeared, the ganglion nuclear membrane disappeared, the structure was incomplete, the inner and outer plexiform layers were dilated irregularly, the cystic space was obvious, and some nuclei of the inner and outer nuclear layers were pyknosis. Most of the nuclear membrane is hollow, chromatin is deep, irregular arrangement, mitochondria swelling is obvious, endoplasmic reticulum dilatation, large vacuolar degeneration. Conclusion: although vancomycin. Ceftazidime showed no obvious retinal toxicity under light microscope, but the ultrastructure of each layer of the retina showed obvious pathological changes under electron microscope.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R779.6

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