紫杉醇在青光眼滤过手术中抗增殖作用的实验研究

Experimental study ofantiproliferative effect ofpaclitaxel on glaucoma filtration surgery

目的观察紫杉醇（paclitaxel）对成纤维细胞活性的影响。方法在兔实验性小梁切除术中，对照组、实验Ⅰ组、实验Ⅱ组巩膜瓣下分别应用0．2mg／ml丝裂霉素C（MMC）、0．3mg／ml紫杉醇、0．3mg／ml紫杉醇5min，实验Ⅱ组术后第3、6、9天结膜下注射紫杉醇30μg。术后第4、7、14、28天通过病理组织学观察滤过道开放情况、增殖细胞核数量及胶原形成情况。结果术后第7、14、28天实验Ⅰ组比对照组PCNA阳性细胞数差异无统计学意义（P〉O．05），实验Ⅱ组比对照组PCNA阳性细胞数少，差异有统计学意义（P〈0．05）；实验Ⅱ组比对照组滤过道开放比率高；实验Ⅱ组在滤过道处形成的Ⅲ型胶原少。结论紫杉醇和丝裂霉素C同样可以有效的抑制成纤维细胞的增殖；紫杉醇在术中及术后联合应用，其抗增殖能力增强。

Objective To investigate the effects of paclitaxel on the fibroblast replication activity. Methods During trabeculectomy in rabbits eyes, 0.2mg/ml mitomycinC （MMC）, 0.3mg/ml paclitaxel, 0.3mg/ml paclitaxel were applied in scleral bed for 5 minutes in control group,experimental group Ⅰ , experimental group Ⅱrespectively. Paclitaxel 30μ g were injected subconjunctiva at days 3,6 and 9 following surgery in experimental group Ⅱ. The following parameters were recorded at days 4,7,14,28 after surgery： filtration passage by histopathology,the number of PCNA positive cells by immunohistochemical staining, collagen formation by 2.4.6-Trinitrophend-Sirius Red F3B. Result The percentage of opened filtration passage was lower in the experimental group I than the control group.But it was higher in experimental group II than control group at 14,28 days after surgery.The difference of the number of positive cells was significant between the experimental group Ⅱ and the control group at 7,14,28 days after surgery （P 〈0.05）. At 14 days, type Ⅲ collagen is crassic and dense in the control group,loose in the experimental group Ⅰ ,piecemeal in the experimental group Ⅱ .Conclusion Paclitaxel is equal to MMC in inhibiting proliferation of fibroblast. Paclitaxel is stronger in inhibiting proliferation of fibroblast by combined using it intraoperatively and postoperatively.