汉防己甲素滴眼液抑制角膜移植术后排斥反应及植片细胞学改变

Experimental study on cytological alterations of corneal allograft and inhibition of typical tetrandrine eye drops on rejection

目的探讨0·5%汉防己甲素(Tet)滴眼液抑制角膜移植排斥反应及植片病理细胞学变化。方法建立大鼠角膜移植排斥反应模型,随机分2组,A组为对照组、B组为0·5%Tet滴眼液组。术后比较各组植片排斥指数(RI)及植片排斥发生时间,并对植片内细胞进行分类并记数、分析。结果术后各组RI及植片排斥时间,A组与B组相比差异均有显著统计学意义(P<0·01)。A组和B组炎性细胞数比较差异均有显著统计学意义(P<0·01)。结论0·5%Tet滴眼液可有效抑制角膜移植排斥反应。

Objective To explore a new anti-corneal rejection drug with low toxicity is a challenge for graft rejection after corneal transplantation surgery. Tetrandrine （Tet） has a extensive pharmacological action in alleviating inflammation and ache, reducing intraocular pressure and anti-fibroplastic proliferation. We investigated the cytological alterations of corneal graft after topical administration of Tet and evaluate its inhibitory effect on experimental corneal allograft rejection. Methods Rat model of heterograft-heterotopic graft transplantation was created in the right eyes of 32 SD rats. 0.5% Tet was topically administrated after operation in 0. 5% Tet-treated group（ 16 rats） and methyl cellulose was used in the control group（ 16 rats）. Slit-lamp microscope, HE staining,light microscope and micro-photography analyses technique were used to observe the rejection index and cytological alterations at different time points in post-operation. Results The edema and vascularization of corneal were seen in rejected graft,and rejection index in the Tet-treated group were 1.43 ±0. 53 and 2. 29 ±0.49 and those of untreated group were 2. 29 ±0.49 and 3.43 ± 0.79 with a significantly difference （P = 0. 001 ）. The cells in the surgical area included mainly lymphocytes,trophilic granulocytes and mononuclear-macrophage. The inflammatory cells were significantly inhibited and the lymphocyte numbers were significantly decreased in 0, 5% Tet-treated group （38, 89 ± 10.78,51.33 ± 10.31,95.57 ± 10.03, 64.78 ± 13.42） in comparison with control group（ 105.56 ± 10.00,152.74 ± 14.93,195.44 ± 10.71,144.56 ± 13.88 ） at 7, 14,21 and 28 days in post-operation （P 〈 0. 01 ）. There was no significant difference in the mononuclearmacrophage infiltration between these two groups（P 〉 0. 05）. Conclusion 0. 5% Tet eye drops significantly inhibit the corneal rejection in SD rats by inhibiting lymphocytes and trophilic granulocytes in the transplanted corneas.