槲皮素在兔小梁切除术后抗瘢痕作用的实验研究

Experimental study on the anti-scarring effects of qucertin after the filtering surgery in rabbits

目的探讨槲皮素(quercetin,QU)在兔眼小梁切除术后抑制瘢痕形成的可能性及作用机制,为临床应用提供理论依据。方法选择54只兔眼行标准小梁切除术,术后A组予眼膏基质,B组予QU眼膏,C组不予特殊处理。术后大体及裂隙灯检查,并记录滤过泡得分。于术后第1周、第2周、第4周处死动物,行组织学检查和Masson三色染色法观察滤过道新生胶原纤维的增殖情况。应用链酶亲和素免疫组织化学方法(SABC法)检测各组在结膜滤过泡中转化生长因子-β1(transforming growth factor,TGF-β1)和转化生长因子-β1受体(TGF-βR1)的含量。结果各组均未见严重并发症,B组滤过泡得分高于其他两组。HE染色见A组滤过道被大量胶原堵塞,Masson染色显示胶原密度高,且TGF-β1和TGF-βR1的免疫组化染色呈强阳性表达。B组滤过道开放时间较A组长,且胶原纤维更稀疏;Masson染色,各时间点B组胶原纤维的密度较A组低(P<0.05);TGF-β1和TGF-βR1的表达呈弱阳性(P<0.01)。C组滤过泡得分及滤过道情况与A组差异无显著性。结论QU能抑制滤过术后结膜下过分瘢痕化,其作用机制之一为抑制TGF-β1和TGF-βR1的表达。

Objective To explore the mechanism of quereetin, inhibiting on scar formation following glaucoma filtration surgery, and provided theory bases for clinical results. Methods Fifty-four eyes of rabbits received standard trabeculectomy. The rabbits＇ eyes had been divided into three groups. Group A received blank ophthalmic gel twice per day after operation; group B received quercetin ophthalmic gel twice per day after operation; group C received no special treatments. Clinical observations were performed by naked eyes and slit-lamp microscope every day. Meanwhile score of bleb was recorded. Histopathologic changes in filter bleb were investigated at week 1,2,4 after operation. Results There was no serious complication in each group. The group B＇s scores of bleb were the highest. In group A, the filtrating pathway was almost blocked with the newly generated collagen ,Masson staining showed the collagen density was high; and the immunohistochemical staining showed significantly positive expressions of TGF-β1 and TGF-βR1. Comparied with group A, the opening time of filtrating pathway of group B was longer and collagen was sparse; Masson Staining showed the collagen density of group B was lower than that of group A at different time points. There was weekly positive expression of TGF-β1 and TGF-βR1 （P〈0.01）. The situation in group C was similar to group A. Conclusion Quercetin can inhibit the formation of the blab scaring after filtration surgery; one of the mechanisms is decreasing the expression of TGF-β1 and TGF-βR1.