低分子肝素下调房水bFGF含量抑制晶状体囊外摘除术后前房炎症

LMWH inhibits anterior chamber inflammation after extra capsular lens extraction through down-regulation of bFGF in aqueous humor

目的:观察房水中碱性成纤维细胞生长因子(basic fi-bro blast growth factor,bFGF)含量的变化,探讨低分子肝素(low molecular weight heparin,LMWH)抑制晶状体摘除术后前房炎症的机制。方法:家兔84只随机分为对照组和实验组,每组42只,行单眼透明晶状体囊外摘除术。实验组手术结束时用浓度为50kU/L的LMWH进行前房灌注。分别于术后1,3,6,15,30,45,60d每组各取6只家兔,裂隙灯显微镜下对角膜水肿、房水混浊及前房纤维蛋白渗出的程度进行观察和分级,然后处死动物,抽取房水用Elisa法测定bFGF的含量。另选6只健康家兔测定前房bFGF含量作为基线值。结果:术后1～6d,实验组角膜水肿、房水混浊及前房纤维蛋白渗出的程度明显轻于对照组(P<0.01),15d后两组比较无差异。术后实验组和对照组房水bFGF含量同时升高,实验组1d达峰值,而对照组6d达峰值;达峰值后两组bFGF含量均缓慢下降。术后1～30d对照组bFGF含量明显高于实验组(P<0.05),45d后两组比较无显著性差异。结论:应用浓度为50kU/L的LMWH前房灌注能显著降低兔眼晶状体囊外摘除术后前房炎症反应,其机制可能与房水中bFGF含量下调有关。

AIM： To observe the changes of basic fibroblast growth factor （bFGF） in anterior chamber before and after extra capsular lens extraction for investigating the mechanism of low molecular weight heparin （LMWH） inhibiting anterior chamber inflammation. METHODS： Eighty-four rabbits were randomly divided into control and experimental group, 42 rabbits in each group. Extra capsular lens extraction was done on unilateral eye in each rabbit. LMWH was used to perfuse anterior chamber by the concentration of 50 000U/L at the end of operation in experimental group. The degrees of corneal edema, aqueous flare and fibrin were evaluated with slit lamp microscope on postoperative days 1, 3, 6, 15, 30, 45 and 60, respectively. Six eyes were in each group at each time point, Contents of bFGF in aqueous humor were determined by ELISA after animals were killed. Another six eyes were used for determining the baseline level of bFGF in aqueous humor. RESULTS： The degrees of corneal edema, aqueous flare and fibrin were significantly lighter than the control group （P〈 0.01） on postoperative days 1, 3, and 6, respectively. No difference was showed between the two groups at other point time. Contents of bFGF in aqueous humor increased at the same time. Peak of bFGF content was reached on postoperative day 1 in experimental group, while on postoperative day 6 in control group. Contents of bFGF in the two groups declined slowly after reaching peak. The bFGF content in control group were significantly higher than that in the experimental group 1 to 30 days after surgery （P〈 0.05）. No significant difference was shown between the two groups on postoperative days 45 and 60, respectively. CONCLUSION： Perfusion with LMWH by the concentration of 50kU/L can significantly reduce anterior chamber inflammation after extra capsular lens extraction in rabbits, which may be related to down-regulation of bFGF in aqueous humor.