维生素K_3、Dispase联合防治兔增生性玻璃体视网膜病变的实验研究

Experimental study of the preventing effect of VitK_3 and Dispase on traumatic proliferative vitreoretinopathy

目的研究Dispase和维生素K3分别单独和联合用药对实验性兔增生性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)的防治作用与毒性。方法40只兔眼,分为对照组、Dispase组、维生素K3组和联合用药组(每组10只眼)。采用眼球穿通伤及玻璃体内注入富含血小板血浆的方法制备外伤性PVR模型后,经睫状体玻璃体腔注入药物,观察比较Dispase、维生素K3及两者联合应用对实验性兔增生性玻璃体视网膜病变的影响。结果用药组平均增生级别均低于对照组,差异有统计学意义(P<0.05);联合用药组平均增生级别低于单独用药组,两者比较,差异有统计学意义(P<0.05);其中,视网膜前的平均增生总细胞数及平均增生成纤维细胞数,维生素K3组和联合用药组少于对照组及Dispase组,比较差异有统计学意义(P<0.05);但前两组比较无差异,后两组亦无差异。视网膜前的平均增生色素上皮细胞数及平均增生神经胶质细胞数,对照组与各用药组两两比较,差异无统计学意义(P>0.05)。电镜结果显示各用药组视网膜超微结构无明显异常。结论维生素K3与Dispase可在一定程度上抑制外伤性PVR的发生、发展,且两者有一定协同作用,对视网膜无毒性损害。

Objective To investigate the inhibiting effects of VitK3 and Dispase on traumatic proliferative vitreoretinopathy and their toxicity on retina. Methods 20 healthy Japan big ear rabbits （40 eyes） were randomly divided into four groups as follows., the contol group, the Dispase group, the VitK3 group and the VitK3 ＋ Dispase group. Experimental model of traumatic PVR was induced by penetrating injury on the eyeball and injecting platelet-rich plasma into vitreous carvity. To investigate and contol the trerapeutic effects of the Dispase,the VitK3 and the VitK3＋ Dispase on an experimental model of traumatic proliferative vitreoretinopathy. Results The average proliferative grades of the three treated groups were all lower than the contol group,. There were statistical significance of the disparity between contol group and the three treated groups. The average proliferative grades of the VitK3 Dispase group were lower than the Dispase group and the VitK3 group. There were statistical significance of the disparity between them. The average number of all proliferated cell and proliferated fibroblast of the pre-retina of the VitK3 group and the VitK3 ＋ Dispase group was lower than the Dispase group and the contol group. There were statistical significance of the disparity between them. It was abnormal for the control group to the hyper micro-construction of the retina. It was normal for the experimental group to the hyper micro-construction of the retina. Conclusion The single use of Dispase and VitK3 could inhibit and cure the formation and development of traumatic PVR effectively and safely in some way and there were no retinal toxicity. The combination use of Dispase and VitK3 was more effective than the single use. The retinal toxicity was not examined.