兔眼小梁切除术后c-ski质粒抑制瘢痕形成的作用

Involvement of c-ski in formation of cicatrices after trabeculectomy in rabbit eyes

目的:观察在滤过术后兔眼模型上应用c-ski质粒100μg滤过道组织病理学变化和控制眼压的作用,评估其可能的应用价值。方法:家兔分两组,双眼实行小梁切除术,术中一组右眼应用0.01mol/LPBS一次性给药作为模型对照眼,左眼同法0.2g/L丝裂霉素C(mitomycin C,MMC)处理,另一组右眼术区结膜下自术后起每周注射c-ski质粒100μg至第3wk停止,左眼同法注射等剂量空质粒,术后第7,14,21,30,60d时测量眼压并分批处死家兔,取术区组织,采用组织病理学和免疫组化技术,观察成纤维细胞,新生胶原纤维,炎症细胞的改变。结果:应用空质粒组与模型对照组各时相点的各指标均无差异,相对于模型对照组,MMC在60d内降低眼压作用明显,能长时间抑制成纤维细胞和胶原分泌,c-ski组术后14d才体现出降低眼压的作用,持续至30d,降幅缓和,并能延长滤过泡寿命,c-ski质粒100μg没有抑制成纤维细胞的作用,但可减低术区胶原纤维增殖。结论:c-ski质粒100μg能抑制滤过术后新生胶原的合成,减轻术后滤过道的瘢痕化,可以降低眼压和延长滤过泡寿命,虽然作用不及0.2g/L丝裂霉素,但应用安全性较高。

AIM： To study the histological variances of filtering passageway and changes of intraocular pressure in animal models which were injected 100μg c-ski plasmid after trabeculectomy. And values of c - ski were evaluated. METHODS： The rabbits were divided into two groups and both eyes were performed trabeculectomy. In one group, the right eyes were administered 0.01mol/L PBS as control set, and the left eyes were dealt with 0.2g/L mitomycin C （MMC） in the same way. In the other group, the right eyes were given subconjunctival injection of 100μg c-ski plasmid and the left eyes were given vacant plasmid of same dose in the same way every week after the operation till the third week. On the 7th, 14th, 21st, 30th, 60th day after the operation, intraocular pressure was measured respectively. Rabbits were executed in batches. Fibroblasts, collagen and inflammatory cells of operating area were observed with technology of histopathology and immunohistochemistry. RESULTS： There were no outstanding difference between PBS group and vacant plasmid group. Compared with PBS, MMC can inhibit fibroblasts and secretion of collagen for a long time. And it can Lower intraocular pressure greatly within 60 days. C-ski also can make intraocular pressure lower than PBS from the 14th to the 30th day after trabeculectomy, but its effect is more moderate than MMC. Meanwhile it can prolong the life of filtering bleb. In 100μg dosage, c-ski can＇t inhibit fibroblasts but can reduce the proliferation of collagen in area of operation. CONCLUSION： 100μg c-ski can inhibit synthesis of collagen and reduce cicatrices after operation, which leads to lower intraocular pressure and longer life of filtering bleb. Although its effect is not as good as 0.2g/L MMC, it has higher safety.