蛇毒降纤酶联合曲安奈德治疗实验性外伤性玻璃体积血

Treament of traumatic vitreous hemorrhage with intravitreal triamcinolone and defibrase injection in a rabbit model

目的观察玻璃体腔注射蛇毒降纤酶和曲安奈德治疗兔眼外伤性玻璃体积血的效果,同时观察玻璃体腔细胞因子含量的变化。方法建立外伤性玻璃体积血兔眼模型。右眼随机分为生理盐水组、蛇毒降纤酶组、曲安奈德组及联合用药组。直接检眼镜观察玻璃体积血指数、增生性玻璃体视网膜病变(PVR)程度;酶联免疫吸附法(ELISA)测定玻璃体腔白介素-1β(IL-1β)、Ⅲ型胶原(CⅢ)浓度。结果联合用药组玻璃体积血指数、PVR程度、玻璃体腔IL-1β、Ⅲ型胶原浓度都低于生理盐水组。结论玻璃体腔注射蛇毒降纤酶和曲安奈德可以促进玻璃体腔积血的吸收;同时下调玻璃体腔IL-1β浓度;减少Ⅲ型胶原的形成,从而降低外伤性PVR程度。

Objective To study the therapeutic effect of intravitreal triamcinolone and defibrase injection for experimental traumatic vitreous bemorrhage and the variance of cytokine in vitreous. Methods All right eyes of 40 New Zealand albino rabbits were created as experimental rabbit model eyes of traumatic vitreous hemorrhage. The rabbits were divided into phosphate buffered saline group,triamcinolone group,defibrase group and triamcinolone combination with defibrase group randomly. The bleeding indexs in vitreous and degrees of proliferative vitreoretinopathy were estimated by direct ophthalmoscope examination. The density of Interleukin- 1β and collagen type Ⅲ in vitreous were detected by enzyme-liked immunosorbent assay. Results The bleeding indexs, degrees of proliferative vitreoretinopathy,density of collagen type m and Interleukin-1β in vitreous in triamcinolone combination with defibrase group are lower than phosphate buffered saline group. Conclusion The therapeutics of intravitreal triamcinolone combination with defibrase injection can promotes the asborption of vitreous hemorrhage and decreases the degrees of proliferative vitreoretinopathy. The role of decreasing the degrees of proliferative vitreoretinopathy may be achieved through suppressing the production of Interleukin-1β and collagen type Ⅲ in vitreous.