囊袋内注入5-氟尿嘧啶抑制后囊膜混浊的临床研究
发布时间：2019-01-24 12:12
【摘要】： 背景和目的在抑制后发性白内障方面,抗代谢药物发挥了重要的作用。其中,5-氟尿嘧啶因其特异性高,抑制作用强,对眼内组织毒性小而倍受重视。本实验在国内外大量翔实的动物实验和临床实验的基础上,利用自制的微量进样器将5-氟尿嘧啶注入到囊袋内,观察其对后发性白内障的抑制作用,为进一步探讨后囊膜混浊的机理打下基础,为临床防治后发性白内障的提供快捷、有效的给药途径。 材料和方法本次实验的研究对象为2009年3月-2009年9月期间在我科就诊的白内障患者。纳入标准为老年性白内障患者,无其他潜在的干扰实验结果的眼部疾病以及全身疾病。将符合上述标准的来自97名患者的107只眼编号,利用随机数字表随机分到四组,分别为实验组A1,A2,A3和对照组B。实验组A1,A2,A3在术中利用自制的微量进样器在囊袋内注入浓度为分别为0.25mg/ml,0.3mg/ml,0.35mg/ml的5-氟尿嘧啶50μl,存留时间约3分钟。对照组则不进行此步骤。实验的观察指标包括术后1月,3月和7月的后囊膜浑浊的Odrich评分,术前术后的眼压值,术前术后的角膜内皮细胞密度以及《受试对象主观感觉调查问卷》。统计学处理：对上述观察指标的结果采用t检验和F检验,全部资料应用SPSS15.0统计软件包进行统计学处理。 结果1.在术后第三个月和第六个月,实验组和对照组之间的Odrich评分之间的差异具有统计学意义；同时,每组都出现了Odrich评分的阳性评分,即5-氟尿嘧啶对晶状体上皮细胞的增殖和移行仅限于抑制作用。2.实验组和对照组的术前和术后眼压值之间的差异无统计学意义3.实验组和对照组术前和术后的角膜内皮细胞密度之间的差异无统计学意义4.实验组和对照组之间患者术后的不适感的阳性率和术后视力满意率的差异具有统计学差异。 结论1,白内障超声乳化术中,在囊袋内直接利用微量计量器注入5-氟尿嘧啶是简单方便,行之有效的给药方式。2,5-氟尿嘧啶对晶状体上皮细胞的抑制作用具有浓度依赖性,同时5-氟尿嘧啶的眼毒性也是具有浓度依赖性；0.35mg/ml是在二者之间达到平衡的浓度。3,5-氟尿嘧啶对晶状体上皮细胞仅存在抑制作用,并不能完全阻止晶状体上皮细胞的增殖和移行。
[Abstract]:Background and objective antimetabolic drugs play an important role in the suppression of post-cataract. Among them, 5-fluorouracil has attracted much attention because of its high specificity, strong inhibitory effect and low toxicity to intraocular tissue. Based on a large number of animal and clinical experiments at home and abroad, 5-fluorouracil (5-FU) was injected into the capsule by using a self-made micro sampler to observe the inhibitory effect of 5-fluorouracil on post-cataract. In order to further explore the mechanism of posterior capsule opacification, and provide a quick and effective way for clinical prevention and treatment of posterior cataract. Materials and methods Cataract patients in our department from March 2009 to September 2009 were studied. Inclusion criteria for senile cataract patients, no other potential interference with experimental results of eye disease, as well as systemic disease. 107 eyes from 97 patients who met the above criteria were randomly divided into four groups by random number table: experimental group A1A2A3 and control group B3. In the experimental group, the concentration of 5-fluorouracil was 0.25 mg / ml 0.35 mg / ml, 0.35 mg / ml, respectively, and the retention time was about 3 minutes. The control group did not take this step. The experimental parameters included the Odrich score of posterior capsule opacification, intraocular pressure (IOP), corneal endothelial cell density (ECC) and subjective perception questionnaire of the subjects at 1 month, 3 months and 7 months after operation. Statistical processing: t test and F test were used for the results of the above observation indexes. All the data were statistically processed by SPSS15.0 statistical software package. Result 1. At the third month and the sixth month after operation, the difference of Odrich score between the experimental group and the control group was statistically significant. At the same time, each group showed a positive score of Odrich score, that is, 5-fluorouracil on the proliferation and migration of lens epithelial cells was limited to the inhibitory effect of 2. 2. There was no significant difference in IOP between the experimental group and the control group before and after operation. There was no significant difference in corneal endothelial cell density between experimental group and control group before and after operation. There were significant differences in the positive rate of postoperative discomfort and the rate of visual acuity satisfaction between the experimental group and the control group. Conclusion 1. During phacoemulsification of cataract, it is simple and convenient to inject 5-fluorouracil directly into the capsule by micrometer. The inhibitory effect of 2-fluorouracil on lens epithelial cells was concentration-dependent, and the eye toxicity of 5-fluorouracil was also concentration-dependent. The concentration of 0.35mg/ml reached a balance between them. 3FU had only inhibitory effect on lens epithelial cells and could not completely prevent the proliferation and migration of lens epithelial cells.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.66
本文编号：2414465
[Abstract]:Background and objective antimetabolic drugs play an important role in the suppression of post-cataract. Among them, 5-fluorouracil has attracted much attention because of its high specificity, strong inhibitory effect and low toxicity to intraocular tissue. Based on a large number of animal and clinical experiments at home and abroad, 5-fluorouracil (5-FU) was injected into the capsule by using a self-made micro sampler to observe the inhibitory effect of 5-fluorouracil on post-cataract. In order to further explore the mechanism of posterior capsule opacification, and provide a quick and effective way for clinical prevention and treatment of posterior cataract. Materials and methods Cataract patients in our department from March 2009 to September 2009 were studied. Inclusion criteria for senile cataract patients, no other potential interference with experimental results of eye disease, as well as systemic disease. 107 eyes from 97 patients who met the above criteria were randomly divided into four groups by random number table: experimental group A1A2A3 and control group B3. In the experimental group, the concentration of 5-fluorouracil was 0.25 mg / ml 0.35 mg / ml, 0.35 mg / ml, respectively, and the retention time was about 3 minutes. The control group did not take this step. The experimental parameters included the Odrich score of posterior capsule opacification, intraocular pressure (IOP), corneal endothelial cell density (ECC) and subjective perception questionnaire of the subjects at 1 month, 3 months and 7 months after operation. Statistical processing: t test and F test were used for the results of the above observation indexes. All the data were statistically processed by SPSS15.0 statistical software package. Result 1. At the third month and the sixth month after operation, the difference of Odrich score between the experimental group and the control group was statistically significant. At the same time, each group showed a positive score of Odrich score, that is, 5-fluorouracil on the proliferation and migration of lens epithelial cells was limited to the inhibitory effect of 2. 2. There was no significant difference in IOP between the experimental group and the control group before and after operation. There was no significant difference in corneal endothelial cell density between experimental group and control group before and after operation. There were significant differences in the positive rate of postoperative discomfort and the rate of visual acuity satisfaction between the experimental group and the control group. Conclusion 1. During phacoemulsification of cataract, it is simple and convenient to inject 5-fluorouracil directly into the capsule by micrometer. The inhibitory effect of 2-fluorouracil on lens epithelial cells was concentration-dependent, and the eye toxicity of 5-fluorouracil was also concentration-dependent. The concentration of 0.35mg/ml reached a balance between them. 3FU had only inhibitory effect on lens epithelial cells and could not completely prevent the proliferation and migration of lens epithelial cells.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R779.66
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