不同药物对硅油乳化影响的体外研究

发布时间：2019-06-08 11:13

【摘要】：眼科用硅油的材料为聚二甲基硅氧烷(Polydimethylsiloxane, PDMS).在常温下,其屈光指数为1.404,与玻璃体屈光指数相近,与晶状体的屈光率基本相同。硅油具有光学透明性好、物理性能稳定、生理惰性、生物相容性好、作用时间持久等优点,作为玻璃体替代物现已广泛应用于临床,用于各种复杂的眼外伤手术及玻璃体视网膜手术中。但是硅油长时间的眼内填充会引起许多并发症,如角膜变性、并发性白内障、继发性青光眼、硅油乳化等,其中硅油乳化的发生率约为0.7%-40%。硅油乳化的发生受许多因素的影响,其发生的原因目前尚无明确的定论,成为国内外众多学者研究的热门课题。本实验通过体外研究分析不同药物：葡萄糖、玻璃酸酶、透明质酸钠、维生素B12及维拉帕米对硅油乳化的影响,为今后硅油乳化防治的深入研究及眼内填充物的性状改善提供依据,以指导临床用药尤其是眼内用药。第一部分不同药物对硅油乳化的影响材料与方法使用特制5ml容量瓶建立体外眼模型,于其中加入硅油(法国ARCAD公司Arciolane 5500cs) 4.0ml和不同药物：平衡盐溶液(balanced salt solution, BSS)0.5ml作为对照组,葡萄糖、玻璃酸酶、透明质酸钠、维生素B12、维拉帕米的BSS溶液各0.5ml作为实验组,在37℃恒温气浴摇床中振荡,速度120转／分。分别于1w,2w,4w,8w观察各组硅油乳化情况并计数乳化硅油颗粒数目。结果 1.不同药物不同时间硅油乳化颗粒数目比较,差异均有统计学意义(P0.05),表示药物不同,硅油乳化颗粒数目不同；随着时间的延长,硅油乳化颗粒数目逐渐增加。 2.高渗葡萄糖组与BSS组各个时间硅油乳化颗粒数目比较,差异均无统计学意义(P0.05),高渗葡萄糖组硅油乳化颗粒数目与BSS组无明显差别。 3.玻璃酸酶组与BSS组1W、2W、4w时比较,差异均无统计学意义(P0.05),硅油乳化颗粒数目与BSS组无差别；8w时差异有统计学意义(P0.05),玻璃酸酶组硅油乳化颗粒数目多于BSS组。 4.透明质酸钠组与BSS组1W、2W、4w时比较,差异均有统计学意义(P0.05),硅油乳化颗粒数目少于BSS组；8w时差异有统计学意义(P0.05),硅油乳化颗粒数目多于BSS组。 5.维生素B12组与BSS组1w时比较,差异无统计学意义(P0.05),硅油乳化颗粒数目与BSS组无明显差别；2W、4W、8w时比较,差异均有统计学意义(P0.05),硅油乳化颗粒数目多于BSS组。 6.维拉帕米组与BSS组各个时间硅油乳化颗粒数目比较,差异均有统计学意义(P0.05),硅油乳化颗粒数目明显多于BSS组。结论 1.体外研究虽然不能模拟活体的代谢,但是可以统一众多繁杂因素,有利于实验研究,分析单纯药物作用下对硅油乳化的影响。 2.随着时间的延长,硅油乳化颗粒数目逐渐增加。高渗葡萄糖溶液对硅油乳化无明显影响；玻璃酸酶随着作用时间的延长,可以增加硅油乳化；透明质酸钠可以影响远期硅油乳化量；维生素B12注射液和维拉帕米注射液可以促进硅油乳化。第二部分不同药物对乳化硅油的影响材料与方法使用特制5ml容量瓶建立体外眼模型,于其中加入硅油(法国ARCAD公司Arciolane 5500cs)4.0ml口BSS液0.3ml重复配置5管,置于37℃恒温气浴摇床中振荡,速度120转/分。2周后显微镜下观察出现乳化硅油颗粒,且数目相近。在乳化的硅油中分别加入不同药物(具体同第一部分),配足0.5ml的液体和乳化硅油4.0ml。在37℃恒温气浴摇床中振荡,速度120转/分。分别于1w,2w,4w,8w观察各组硅油乳化情况并计数乳化硅油颗粒数目。结果 1.不同药物不同时间硅油乳化颗粒数目比较,差异均有统计学意义(P0.05),表示药物不同,硅油乳化颗粒数目不同；随着时间的延长,硅油乳化颗粒数目逐渐增加。 2.高渗葡萄糖组、玻璃酸酶组、透明质酸钠组分别与BSS组不同时间两两比较,差异均无统计学意义(P0.05),各组硅油乳化颗粒数目与BSS组无明显差别；维生素B12组与BSS组不同时间两两比较,在8w时,差异有统计学意义(P0.05),硅油乳化颗粒数目多于BSS组；维拉帕米组与BSS组不同时间两两比较,4W、8w时,差异有统计学意义(P0.05),硅油乳化颗粒数目多于BSS组。结论随着时间的延长,硅油乳化颗粒数目逐渐增加。高渗葡萄糖溶液、玻璃酸酶、透明质酸钠对已乳化硅油的进一步乳化无明显影响。维生素B12注射液和维拉帕米注射液具有促进乳化硅油进一步乳化的作用。
[Abstract]:The material of the silicone oil for ophthalmic use is polydimethylsilicone (pdms). The refractive index of the lens is 1.404 at normal temperature, and the refractive index of the lens is similar to the refractive index of the lens, and the refractive index of the lens is basically the same. The silicone oil has the advantages of good optical transparency, stable physical property, physiological inertia, good biocompatibility, lasting effect, and the like. However, long-time intraocular filling of the silicone oil can cause many complications, such as corneal degeneration, concurrent cataract, secondary glaucoma, silicone oil emulsification, and the like, in which the incidence of silicone oil emulsification is about 0.7% to 40%. The occurrence of silicone oil emulsification is affected by many factors. The reason for the occurrence of silicone oil is not clear and has become a hot topic for many scholars at home and abroad. The effects of different drugs, such as glucose, hyaluronidase, sodium hyaluronate, vitamin B12 and verapamil on the emulsification of silicone oil, were analyzed in vitro. to direct clinical use, especially in the eye Medicine. The first part of the drug is different to the silicone oil emulsion The effect of the process Materials and Methods A special 5-ml volumetric flask was used to establish an in vitro eye model in which silicone oil (Arciolane 5500 cs, French ARCAD) and 4.0 ml of different drugs were added: balanced salt solution (BSS) 0.5 ml. 0.5 ml of the BSS solution of the control group, the glucose, the glass acid enzyme, the sodium hyaluronate, the vitamin B12 and the verapamil is used as the experimental group, The emulsification of silicone oil in each group was observed at 1w, 2w, 4w and 8w, and the milk was counted. to make a difference Results 1. The number of silicone oil emulsion particles in different time was statistically significant (P0.05). The number of oil emulsion particles increased gradually.2. The number of emulsified particles of silicone oil in hypertonic glucose group and BSS group was not significant (P0.05), and the silicone oil of hypertonic glucose group was emulsified. 3. There was no significant difference between the number of particles and the group of BSS.3. There was no significant difference between the group of glass acid and the group of BSS (1 W,2 W, and 4 w (P0.05). The number of the emulsified particles of the silicone oil was not different from that of the BSS group (P0.05). The number of emulsified particles of silicone oil in group was more than that of BSS group.4. The difference between the group of sodium hyaluronate and the group of BSS was 1 W,2 W and 4 w (P0.05). The number of emulsified particles of silicone oil was less than that of BSS group. 5) The number of emulsified particles of silicone oil was more than that of BSS group. .05) The number of silicone oil emulsion particles is more than that of the BSS group. .0 Conclusion 1. In vitro, the number of emulsified particles of silicone oil is much more than that of BSS. Conclusion 1. The in vitro study can not simulate the metabolism of living body, but it can unify many complicated factors. It is beneficial to the experimental study, and the emulsification of the silicone oil under the action of pure drugs is analyzed. 2. With the extension of time, the number of emulsified particles of silicone oil gradually increases. The high-permeability glucose solution has no obvious effect on the emulsification of the silicone oil. The glass-acid enzyme can increase the emulsification of the silicone oil with the extension of the action time, and the sodium hyaluronate can influence the emulsification of the long-term silicone oil. Amount; Vitamin B12 injection and verapamil the injection may To promote the emulsification of silicone oil. The influence materials and methods of the second part of different drugs on the emulsified silicone oil were made using a special 5-ml volumetric flask to establish an in-vitro eye model, in which silicone oil was added (Arciolane 5500 cs of the French ARCAD Company) 4.0 The solution of the BSS solution is 0.3 ml, and the 5 tubes are repeatedly arranged, and the solution is placed in a constant-temperature gas-bath shaking table at the temperature of 37 DEG C for shaking At a speed of 120 r/ min. the emulsified silicone oil particles were observed under a microscope after 2 weeks and the number was similar. Same as the drug (in particular with the first part), with 0.5 ml of liquid. And the speed is 120 revolutions per minute. at 1 The results were as follows:1. The number of silicone oil emulsion particles in different time was statistically significant (P0.05). The number of emulsified particles of silicone oil was different, and the number of emulsified particles of silicone oil gradually increased with the increase of time.2. There was no significant difference between the group of hypertonic glucose, the group of glass acid and the group of sodium hyaluronate (P0.05). There was no significant difference between the number of the particles and the group of BSS, and the difference was statistically significant at 8w (P0.05). The number of emulsified particles of the silicone oil was more than that of the BSS group. The different time between the verapamil group and the BSS group was two or two times. more, The difference was significant when 4W and 8w (P0.05). And the number of the silicone oil emulsion particles is more than that of the BSS group. The number of particles is gradually increased, and the high-permeability glucose solution, the glass acid enzyme and the sodium hyaluronate are used for the preparation of the emulsified silicone oil.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.6

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