干扰素联合氟尿嘧啶抑制兔增殖性玻璃体视网膜病变的疗效观察

发布时间：2018-03-10 11:37

本文选题：增生性玻璃体视网膜病变　切入点：氟尿嘧啶注射液　出处：《山西医科大学》2011年硕士论文　论文类型：学位论文

【摘要】：目的：观察干扰素-r和氟尿嘧啶单独及联合应用对兔眼增殖性玻璃体视网膜病变(Proliferative Vitreoretinopathy, PVR)的疗效。方法：将24只有色家兔随机分为A、B、C、D四组。每组以左眼为实验眼，玻璃体腔注射富含血小板的血浆，建立PVR动物模型。建模后第2天，A组玻璃体腔注射0.2ml平衡盐溶液；B组玻璃体腔注射0.2ml104干扰素-r, C组玻璃体腔注射0.1ml 0.5mg的氟尿嘧啶注射液和0.1ml104的干扰素-r注射液[28],D组玻璃体腔注射0.2ml 0.5mg的氟尿嘧啶注射液。每日常规对实验眼行裂隙灯、眼底检查，并分别于7、14、30天[14]行闪光视网膜电图（F-ERG）、眼B超及视网膜组织病理学检查。结果：⑴裂隙灯检查：不同检查时间点，四组实验眼眼前节均未发现明显异常。注药后1天，A组玻璃体内未见混浊。其余各组玻璃体内均可见轻度混浊，但随时间延长混浊均逐渐减轻。 ⑵眼底检查：随时间的推移，各实验组PVR级别均有所进展，以C组发展较慢。注药后7d、14d、21d，各组间在同一时间点比较差别无统计学意义（P0.05）；30d时，C组PVR级别明显低于其他各组，且差别有统计学意义（P0.05），B、D与A组间比较有统计学意义（P0.05）,B、D组间比较无统计学差别（P0.05）。 ⑶F-ERG检查：各组建模前F-ERG检查结果显示：b波波幅平均值为148.00±6.89μV。建模后，各组b波波幅均比造模前低。注药后14、30d，B、C、D组与A组间差别有统计学意义（p0.05）。其余各检查点组间比较无统计学差别（p0.05）。 ⑷眼B超检查：14d时，A组玻璃体混浊，视网膜前出现纤维增殖膜，有2眼出现视网膜脱离；B、D组出现不同程度的玻璃体增殖条索，但无视网膜脱离。C组未见明显异常。30d时A组视网膜增厚明显，有5眼出现视网膜脱离；B、D组均有不同程度的玻璃体混浊、视网膜增厚，B组2眼、D组3眼出现视网膜脱离。C组玻璃体稍混浊，少许增殖条索，未见视网膜脱离。 ⑸视网膜组织病理学检查：正常兔眼的视网膜各层结构排列整齐、清晰，内界膜连续且光滑。注药后14d，A组视网膜表面出现增殖膜，且各层结构排列紊乱；B、D组视网膜增厚，但各层结构基本正常；C组视网膜未见明显异常，各层结构基本正常。注药后30d，，A组脱离的视网膜形成皱襞，表面纤维血管膜增生；C组视网膜表面轻度纤维增殖；B和D组视网膜纤维增殖膜较C组明显。结论：0.1ml 0.5mg氟尿嘧啶联合0.1ml 104干扰素-r玻璃体腔注射对兔眼增生性玻璃体视网膜病变有一定治疗作用，其疗效优于单独应用0.2ml 0.5mg氟尿嘧啶或0.2ml104干扰素-r。
[Abstract]:Aim: to observe the efficacy of interferon-r and fluorouracil in the treatment of proliferative vitreoretinopathy (PVR) in rabbits with proliferative vitreoretinopathy (PVR). Methods: Twenty-four colored rabbits were randomly divided into four groups: the left eyes were used as experimental eyes and platelet-rich plasma was injected into the vitreous body. PVR animal model was established on the second day after modeling, 0.2 ml of equilibrium salt solution was injected into vitreous body cavity of group A and 0.2 ml of interferon -r was injected into vitreous of group B, 0.1 ml 0.5 mg fluorouracil injection and 0.1 ml interferon-r injection of 0.1 ml 104 were injected into vitreous cavity of group C. Group A was injected with 0.2ml 0.5 mg fluorouracil into the vitreous cavity. Fundus examination was performed on 1430 days (14 days) with flash electroretinogram (ERG), B-ultrasound and histopathology. Results: at different time points, there was no obvious abnormality in the anterior segment of the experimental eyes in the four groups, but no turbidity was found in the vitreous body of group A one day after injection, and slight opacification was found in the other groups. However, the turbidity gradually decreased with the prolongation of time. 2 fundus examination: with the passage of time, the progress of PVR grade in each experimental group was relatively slow, especially in group C. the PVR grade of group C was significantly lower than that of other groups at the same time point at the same time point at the same time point (P 0.05) and the level of PVR in group C was significantly lower than that in other groups. The difference was statistically significant (P 0.05). There was no significant difference between group A and group A (P 0.05). 3F-ERG examination: before modeling, the average value of the ratio b wave amplitude was 148.00 卤6.89 渭 V. after modeling, the B wave amplitude in each group was lower than that before modeling. There was a significant difference between group A and group D at 1430d after injection, and there was no significant difference between the other check point groups (p 0.05). In 4 eyes, vitreous opacification and fibroproliferative membrane appeared before retina in group A, and proliferative bands of vitreous body in group B were found in group B: 2 eyes. However, no obvious abnormality was found in group C. 30 days after retinal detachment, retinal thickening was observed in group A, and vitreous opacification was found in 5 eyes of group B (retinal detachment), and vitreous opacity was found in group B (n = 5). Retinal thickening group B (2 eyes) and D group (3 eyes) had retinal detachment. Group C had a little vitreous opacity, a little proliferative line, and no retinal detachment. 5Retinal histopathological examination: the retinal layers of normal rabbit eyes were arranged neatly and clearly, the inner boundary membrane was continuous and smooth, the proliferative membrane appeared on the surface of retina of group A 14 days after injection, and the retinal thickening of group B _ (D) with the disorder of the structure of each layer was observed. However, no obvious abnormality was found in the retina of group C, and the structure of each layer was basically normal in group C. the retinal folds were formed in group A 30 days after injection. The proliferative membrane of retinal fibers in group B and D was significantly higher than that in group C. Conclusion 0.1 ml 0.5 mg fluorouracil combined with 0.1 ml 10 4 interferon-r intravitreal injection has a certain therapeutic effect on proliferative vitreoretinopathy in rabbits. The therapeutic effect is better than that of 0.2 ml 0.5 mg fluorouracil or 0.2 ml interferon-r.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R774.1

【参考文献】