加替沙星胶联羊膜药膜治疗细菌感染性角膜炎模型兔的疗效

发布时间：2018-03-04 19:27

  本文选题：加替沙星胶联羊膜药膜　切入点：细菌性角膜炎　出处：《中国老年学杂志》2017年15期 　论文类型：期刊论文

【摘要】：目的探讨加替沙星胶联羊膜药膜治疗细菌性角膜炎兔模型的效果。方法参照常规方法制作加替沙星胶联羊膜药膜。新西兰大白兔25只中随机取5只,左眼为对照眼,右为实验眼。待动物完全麻醉后,将制成的药膜片覆盖于眼球表面后揭去表层的硝酸滤纸,并用尼龙缝线间断缝合固定于角膜缘浅层巩膜。对照眼结膜囊内滴入配制的3 mg/ml加替沙星溶液50μl,并于12 h后重复滴眼一次。分别于术后和首次滴眼后1 d、2 d、3 d、4 d、5 d双眼同时抽取房水。利用高效液相色谱法检测实验眼和对照眼房水中加替沙星浓度。制作金葡球菌性角膜溃疡动物模型,将溃疡形成后的动物分为4组,每组4只,分别为A组:生理盐水组,B组:加替沙星滴眼液组,C组:加替沙星胶联羊膜药膜组,D组:单层羊膜组。取各组溃疡愈合的兔眼作细菌培养,检查各组金葡球菌性角膜溃疡的细菌阴转情况。取溃疡组织石蜡包埋、切片,HE染色。同时对各组角膜溃疡动物的疗效进行判定。结果实验眼各时间点房水中均可测出加替沙星,浓度0.036~0.274μg/ml,实验组第1、2、3天房水中加替沙星浓度与第4、5天相比明显较高;对照眼仅在第1天和第2天检测出加替沙星,且浓度显著低于实验眼(P0.05)。角膜溃疡,加替沙星滴眼液和药膜均疗效显著,且药膜在干预3 d和7 d后评分均显著低于加替沙星滴眼液干预(P0.05);加替沙星滴眼液和药膜在干预后细菌培养情况均出现一定程度的阴转,而另外两组仅生理盐水干预7 d后出现1例阴转。角膜切片HE染色观察加替沙星滴眼液和药膜干预角膜上皮及基质有轻微水肿,炎症细胞浸润大量减少;加替沙星滴眼液和药膜均疗效显著,痊愈率及好转率分别为(75.00%vs 87.50%)和(100.00%vs 100.00%)。结论加替沙星胶联羊膜药膜对金葡球菌性角膜溃疡具有良好的治疗作用,开辟了治疗细菌性角膜溃疡的另一途径。
[Abstract]:Objective to investigate the effect of gatifloxacin gel combined with amniotic membrane on the treatment of rabbit model of bacterial keratitis. Methods Gatifloxacin gel combined with amniotic membrane was made in 25 New Zealand white rabbits. When the animal is completely anesthetized, the film is coated on the surface of the eyeball and removed from the surface of the surface of the eye with nitric acid filter paper. Nylon suture was used to fix the superficial limbal sclera. The conjunctival sac of control eyes was treated with 50 渭 l of 3 mg/ml gatifloxacin solution and repeated drops 12 hours later. D simultaneous extraction of aqueous humor with both eyes. The concentrations of gatifloxacin in aqueous humor of experimental eyes and control eyes were determined by HPLC. The animal model of Staphylococcus aureus corneal ulcer was established. The animals with ulcers were divided into 4 groups, 4 animals in each group. Group A: normal saline group: group B: gatifloxacin eye drops group (group C): gatifloxacin gel combined amniotic membrane group (group D): monolayer amniotic membrane group. The bacterial negativity of Staphylococcus aureus corneal ulcer in each group was examined. The ulcer tissue was embedded in paraffin and stained with HE. The curative effect of each group was determined. Results gatifloxacin could be detected in aqueous humor at every time point in experimental eyes. The concentration of gatifloxacin in aqueous humor of the experimental group was significantly higher on the 1st and 2nd day than on the 4th and 5th day, and the concentration of gatifloxacin was significantly lower than that of the experimental eye on the 1st and 2nd day, and the concentration of gatifloxacin in the experimental group was significantly lower than that in the experimental eye on the first day and the second day, and the concentration of gatifloxacin in the experimental group was significantly lower than that in the experimental eye. The efficacy of gatifloxacin eye drops and gatifloxacin eye drops was significant, and the scores of gatifloxacin eye drops and gatifloxacin eye drops were significantly lower than those of gatifloxacin eye drops after 3 and 7 days of intervention (P 0.05). In the other two groups, there was only one negative change after 7 days of intervention with normal saline. The corneal sections were stained with HE to observe the slight edema of corneal epithelium and stroma treated with gatifloxacin eye drops and membrane, and the decrease of inflammatory cell infiltration. The curative effect of gatifloxacin eye drops and gatifloxacin eye drops was significant, the cure rate and improvement rate were 75.00 vs 87.50 and 100.00000 vs 100.000.Conclusion Gatifloxacin gel combined amniotic membrane has a good therapeutic effect on Staphylococcus aureus corneal ulcer. It opens up another way to treat bacterial corneal ulcer.
【作者单位】： 重庆医科大学附属第一医院;
【基金】：重庆市卫生局科研资助项目(渝卫科教2008-2-114)
【分类号】：R-332;R772.21
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