兔眼复合小梁切除术后丝裂霉素C的残存浓度分析

发布时间：2018-03-21 02:14

本文选题：丝裂霉素C浓度　切入点：房水　出处：《天津医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的 1.应用高效液相色谱分析仪测量丝裂霉素C在兔眼复合式小梁切除联合应用丝裂霉素C术后不同时间段中房水、玻璃体、静脉血液中的浓度。 2.比较兔眼复合式小梁切除联合应用丝裂霉素C术中,丝裂霉素C放置部位不同造成房水、玻璃体、静脉血液中药物浓度的差异。 3.探讨兔眼复合式小梁切除联合应用丝裂霉素C术中应用丝裂霉素C的安全有效浓度。方法新西兰大白兔90只,常规行复合式小梁切除术,术中应用浓度为0.2mg/ml的丝裂霉素C,药物应用的持续时间为120秒。依据体重由小至大依次编序,采用随机数据表法随机分A、B两个实验组。A组：随机选取45只白兔45只眼行复合式小梁切除术,术中将浸有药液的止血海绵片放置于结膜瓣下；B组：随机选取45只白兔45只眼行复合式小梁切除术,术中将浸有药液的海绵片放置于巩膜瓣下。A、B两组中45只兔子均选择一眼为实验组,对该组内所有兔眼在手术过程中按照设计不同,区别应用MMC,另一眼不做处理做为对照组；各实验组均常规行复合式小梁切除术,按要求放置药物后立即应用乳酸林格液80ml灌洗手术区,每组分别于灌洗后5分钟、30分钟以及60分钟各选择5只兔子,分别抽取房水0.12ml,抽取玻璃体0.12ml,抽取静脉血液3ml,将提取物迅速行高效液相色谱分析,分析送检标本内药物浓度；随机选取6只对照组兔眼,在实验组手术操作进行之前分别抽取房水、玻璃体、静脉血液各两份,送检,测得结果做为基础对照。结果 1.5分钟、30分钟、60分钟测得房水中丝裂霉素C浓度依次为：14.95±4.26ng/ml,27.26±6.33ng/ml,2.99±0.79ng/ml(A组);44.81±8.42ng/ml,74.52±6.27ng/ml,17.89±6.85ng/ml(B组)。2.5分钟、30分钟、60分钟测得玻璃体中丝裂霉素C浓度依次为：2.30±0.76ng/ml,0.16±0.12ng/ml,0.13±0.09ng/ml(A组);3.57±0.93ng/ml,1.21±0.81ng/ml,0.20±0.18ng/ml(B组)。 3.5分钟、30分钟、60分钟测得静脉血液中丝裂霉素C浓度依次为：35.32±17.26ng/ml,13.69±4.27ng/ml,0.33±0.55ng/ml(A组),43.31±12.96ng/ml,25.32±5.86ng/ml,4.53±3.06ng/ml(B组)。4.房水、玻璃体、静脉血液中丝裂霉素C最高的药物浓度分别为27.26±6.33ng/ml、2.30±0.76ng/ml、35.32±17.26ng/ml(A组),74.52±6.27ng/ml、3.57±0.93ng/ml、43.31±12.96ng/ml(B组)。 5.房水中药物浓度高峰时间点出现在30分钟,玻璃体与静脉血液中药物浓度高峰时间点均出现在5分钟。 6.对照组测得房水、玻璃体、静脉血液内丝裂霉素C的药物浓度为0。结论 1.兔眼复合式小梁切除联合应用丝裂霉素C术中,房水中丝裂霉素C于应用药物后的30分钟达到峰值。 2.兔眼复合式小梁切除联合应用丝裂霉素C术中,兔眼玻璃体、静脉血液中丝裂霉素C于应用药物后5分钟达到峰值。 3.兔眼复合式小梁切除联合应用丝裂霉素C术中,巩膜瓣下应用丝裂霉素C造成药物在房水、玻璃体、静脉血液内存留的量明显高于结膜瓣下应用。 4.青光眼小梁切除术联合应用低剂量丝裂霉素C,兔眼房水、玻璃体及静脉血液中高峰时期药物浓度均低于造成组织损害的临界值。
[Abstract]:objective
1. high performance liquid chromatography (HPLC) was used to measure mitomycin C concentration in aqueous humor, vitreous body and venous blood at different time periods after combined trabeculectomy and mitomycin C in rabbit eyes.
2. to compare the difference of drug concentration in aqueous humor, vitreous body and venous blood between mitomycin C and mitomycin C during different trabeculectomy combined with mitomycin C.
3. to explore the safe and effective concentration of mitomycin C in the combined use of mitomycin C for combined trabeculectomy in rabbit eyes.
Method
90 New Zealand rabbits were underwent compound trabeculectomy, intraoperative application of mitomycin C concentration is 0.2mg/ml, the duration of drug application for 120 seconds. According to weight from small to large in ordering, using random data table method were randomly divided into A, B two groups. Group.A: 45 rats were randomly selected rabbits 45 eyes underwent combined trabeculectomy in operation hemostatic sponge leaching liquid is placed in the conjunctival flap; group B: randomly selected 45 rabbits 45 eyes underwent combined trabeculectomy in operation, soaked sponge liquid placed under the scleral flap.A, B two groups in 45 rabbit eye were selected as the experimental group, the group in the eyes of all rabbits during the operation according to different design, different application of MMC, the other eye not treated as the control group; the experimental group was treated with compound trabeculectomy, according to the requirements placed immediately after the drug application of lactated Ringer's solution 80 Ml lavage operation area, each group in the lavage after 5 minutes, 30 minutes and 60 minutes each select 5 rabbits respectively, 0.12ml water extraction, extraction of vitreous body 0.12ml, venous blood 3ml, will quickly extract for HPLC analysis, analysis of the drug concentration within the specimen; randomly selected 6 rabbits in control group rabbits in the experimental group, before the operation were extracted from aqueous, vitreous body, two copies of the venous blood inspection, measurement results as a basis for comparison.
Result
1.5 minutes, 30 minutes, 60 minutes measured real water concentration of mitomycin C is as follows: 14.95 + 4.26ng/ml, 27.26 + 6.33ng/ml, 2.99 + 0.79ng/ml (group A); 44.81 + 8.42ng/ml, 74.52 + 6.27ng/ml, 17.89 + 6.85ng/ml (group B).2.5 minutes, 30 minutes, 60 minutes measured mitomycin C concentration in vitreous body as follows: 2.30 + 0.76ng/ml, 0.16 + 0.12ng/ml, 0.13 + 0.09ng/ml (group A); 3.57 + 0.93ng/ml, 1.21 + 0.81ng/ml, 0.20 + 0.18ng/ml (group B).
3.5 minutes, 30 minutes, 60 minutes measured intravenous mitomycin C concentration in blood is as follows: 35.32 + 17.26ng/ml, 13.69 + 4.27ng/ml, 0.33 + 0.55ng/ml (group A), 43.31 + 12.96ng/ml, 25.32 + 5.86ng/ml, 4.53 + 3.06ng/ml (group B).4. aqueous, vitreous body, the highest concentration of mitomycin C venous blood were 27.26 + 6.33ng/ml, 2.30 + 0.76ng/ml, 35.32 + 17.26ng/ml (group A), 74.52 + 6.27ng/ml, 3.57 + 0.93ng/ml, 43.31 + 12.96ng/ml (group B).
The peak time of drug concentration in 5. aqueous humor occurred at 30 minutes, and the peak time of drug concentration in the vitreous and venous blood appeared in 5 minutes.
The drug concentration of mitomycin C in the blood, vitreous body and venous blood was 0. in the 6. control group.
conclusion
In 1. rabbit eye compound trabeculectomy combined with mitomycin C, mitomycin C in aqueous humor reached its peak at 30 minutes after the application of the drug.
2. rabbit eye compound trabeculectomy combined with mitomycin C, the vitreous body of the rabbit eye, and mitomycin C in the venous blood reached the peak at 5 minutes after the application of the drug.
3. rabbit trabeculectomy combined with mitomycin C, the amount of drug stored in the aqueous humor, vitreous and venous blood was significantly higher than that under conjunctival flap when the mitomycin C was applied under scleral flap.
4. glaucoma trabeculectomy combined with Low Dose Mitomycin C, the peak concentration of rabbit eye aqueous humor, vitreous and venous blood is lower than the critical value of tissue damage.

【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R779.6

【引证文献】