谷氨酸与缺血缺氧性视网膜病变研究现状

Present studies on the glutamate and the ischemic-hypoxic retinopathy

目的:谷氨酸兴奋毒性是触发青光眼、糖尿病性视网膜病变、眼创伤等引起的缺血缺氧性神经细胞损伤级联反应的重要因素,它会引起视力丧失,拮抗谷氨酸兴奋毒性可以保护视网膜神经节细胞,减少缺血性损伤和神经节细胞凋亡。对其机制及治疗等方面进行综述。资料来源:应用计算机检索Medline1989-01/2004-08和Elsevier全文数据库1997-01/2004-08的谷氨酸及凋亡方面的文章,检索词为“glutamate,apoptosis,retinaldisease,retinalischemia,exitotoxicity”,并限定文章语言种类为English。计算机检索中国期刊网专题全文数据库2002-01/2004-10的谷氨酸及凋亡方面相关文章,限定文章语言种类为中文,检索词为“谷氨酸,视网膜病变,青光眼,凋亡,眼损伤等”。资料选择:对资料进行初审,筛除明显非随机临床试验的研究,对剩余的文献开始查找全文,进一步判断是否为随机对照临床试验。资料提炼:共收集到23篇关于谷氨酸及凋亡的随机和非随机试验,18个试验符合纳入标准。排除的5篇试验中,系重复的同一研究。资料综合:18篇中包括试验动物模型及各类视网膜疾病患者。结论:寻求有效的拮抗谷氨酸兴奋毒性的药物已是缺血缺氧性视网膜疾病关注的焦点。

OBJECTIVE:The exitotoxicity of glutamate is the important factor to trigger the cascade reaction of the hypoxic/ischemic nerve cell damage that caused by the glaucoma,diabetic retinopathy and ocular injury,and it will cause the visual loss.Antagonizing the glutamate exitotoxicity can safeguard the retinal ganglial cells and reduce ischemic damage and the apoptosis of the retinal ganglial cells.The article will give a review on the mechanism and the treatment of glutamate exitotoxicity.DATA SOURCES:The articles about glutamate and apoptosis were retrieved in Medline between January 1989 and August 2004 and Elsevier Full text Database between January 1997 and August 2004 by using the computer with the key words of “ glutamate,apoptosis,retinal disease,retinal ischemia,exitotoxicity' and the language was limited in English.Meanwhile,the relevant articles to glutamate and apoptosis were retrieved in Special Journal Full text Database of China Journal Net between January 2002 and October 2004 by using the key words of “ glutamate,retinal disease,glaucoma,apoptosis,ocular trauma' and the language was limited in Chinese.STUDY SELECTION:After the first trial to the data,the studies on non randomized clinical trial were excluded.The full text of the rest literatures was looked up to get the further judgment whether they were about randomized controlled clinical trial.DATA EXTRACTION:A total of 23 articles were collected about the randomized and non randomized trial on glutamate and apoptosis.As a result,18 were accorded with the inclusion criteria and the other 5 were excluded because of its duplication.DATA SYNTHESIS:The animal models for trials and the patients with the various retinal diseases were involved in the 18 articles.CONCLUSION:Looking for the operative drugs for antagonizing the glutamate exitotoxicity is the focus of the ischemic hypoxic retinal diseases.