外源性结缔组织生长因子在兔眼小梁切除术后滤过泡瘢痕形成中的作用

Role of connective tissue growth factor after trabeculectomy in a rabbit model

目的以兔为动物模型,比较外源性结缔组织生长因子(CTGF)和生理盐水在兔眼小梁切除术后对滤过泡瘢痕形成的影响,初步探讨CTGF在滤过泡瘢痕形成机制中的作用。方法健康成年家兔8只(16只眼),双眼行小梁切除术,16只眼随机分成2组,每组8只眼,滤过泡内分别注入外源性CTGF和生理盐水,术后观察滤过泡形态及眼压变化。结果滤过泡内注入CTGF后,滤过泡失败时间为(12.00±0.82)d,与生理盐水组比较,差别有统计学意义(P<0.01);与术前眼压比较,CTGF组和生理盐水组术后在第1、7天,差别均有统计学意义(P<0.01),术后第14、21天,CTGF组差别均无统计学意义(P>0.05),而生理盐水组术后第14天,差别仍有统计学意义(P<0.05);CTGF组眼压术后第7天与第1天相比,差别有统计学意义(P<0.01),而生理盐水组差别无统计学意义(P>0.05);术后第7天,CTGF组眼压与生理盐水组比较,差别有统计学意义(P<0.01)。结论外源性CTGF注入滤过泡内,可以促进滤过泡瘢痕形成,眼压迅速回升,导致手术提前失败,其在滤过泡瘢痕形成过程中发挥了重要作用。

Objective This study was design to evaluate the role of connective tissue growth factor （CTGF） in scar formation of the filtering bleb that occurs after trabeculectomy by contrasting the effect of exogenous CTGF and physiological saline on scar formation of the filtering bleb. Experiments were performed in a rabbit model. Methods Trabeculectomy was performed on 16 eyes of 8 healthy adult rabbits, then these eyes were randomly divided into 2 groups and every group have 8 eyes. Exogenous CTGF and physiological saline was injected into filtering blabs, then intraocular pressure （IOP） was measured and filtering blabs were observed after surgery. Results The filtering blabs were failure at 12.00 ± 0. 82 days after exogenous CTGF was injected into the blebs, there was statistically significant difference compared to physiological saline group （ P 〈0.01 ）. There was statistically significant difference in IOP in CTGF group at day 1,7 after surgery compared to IOP preoperatively（ P 〈0.01 ） ,and physiological saline group was so that. 14, 21 days, there was no statistically significant difference in IOP in CTGF group, however physiological saline group still had a significant drop at day 14 （ P 〈 0.05 ）. There was statistically significant difference in IOP in CTGF group at 7 days compared to day 1 （ P 〈 0.01 ） , whereas there was no statistically significant difference in physiological saline group （ P 〉 0. 05 ）. 7 days after surgery compared to physiological saline group, there was statistically significant difference in IOP in CTGF group （ P 〈 0. 01 ）. Conclusion The addition of exogenous CTGF in the bleb can promote the scar formation of blebs,increase the rate of IOP to heighten and result in the advance of the failure of surgery. It play an important role in bleb scarring after glaucoma filtering surgery.