摘要
目的研究静脉注射后环丙沙星在眼内炎及眼球穿通伤患者眼内的药物水平。方法老年性白内障对照组25例25眼、眼球穿通伤组21例21眼、眼内炎组12例12眼分别在白内障手术、玻璃体切割手术前1h静脉注射环丙沙星,术中取房水或(和)玻璃体,双缩脲法测定房水蛋白含量,反向高效液相色谱法测定房水及玻璃体环丙沙星的浓度。结果老年性白内障对照组、眼球穿通伤组及眼内炎组房水蛋白含量分别为(0.09±0.05)g·L-1、(2.31±1.71)g·L-1和(7.78±5.34)g·L-1,3组间比较差异均有显著统计学意义(P均<0.01);3组房水环丙沙星浓度分别为(0.18±0.07)mg·L-1、(0.19±0.08)mg·L-1和(0.52±0.18)mg·L-1,眼内炎组明显高于其他2组(P均<0.01),其他2组比较差异无统计学意义(P>0.05);玻璃体环丙沙星浓度眼内炎组为(0.50±0.38)mg·L-1,较眼球穿通伤组的(0.06±0.03)mg·L-1高(P均<0.01);眼内炎组房水和玻璃体中环丙沙星浓度与房水蛋白含量呈正相关(r=0.889和rs=0.841,P均<0.05)。结论眼内炎患者血-眼屏障通透性增高,静脉注射环丙沙星眼内渗透性增加,房水及玻璃体药物浓度可达大部分眼内致病菌最小抑菌浓度,可作为细菌性眼内炎治疗性用药。
Objective To investigate intraocular ciprofloxacin levels after intravenous injection in endophthalmitis and perforating injury of eyeball. Methods There were 25 patients ( 25 eyes) with senile cataract serving as control group, 21 patients (21 eyes) with perforating injury of eyeball and 12 patients (12 eyes)with endophthalmitis. All patients were intravenous injected with ciprofloxacin 1 hour before cataract surgery or vitrectomy. Aqueous humor and vitreous were collected at surgery in all eyes, and the protein concentration of aqueous humor was measured by biuret method. Ciprofloxacin concentration of aqueous humor and vitreous were assayed by reversed-phase high-performance liquid chromatograph simultaneously. Results The protein concentrations of aqueous humor in the patients with senile cataract, perforating injury of eyeball and endophthalmitis were (0.09 ± 0.05 ) g ·L^-1, ( 2.31 ± 1.71 ) g·L^-1 and ( 7.78 ± 5.34 ) g·L^-1,respectively. There was statistical significance among the 3 groups( all P 〈 0.01 ). Ciprofloxacin level of aqueous humor in patients with endophthalmitis was(0. 52 ± 0. 18)mg ·L^-1, significantly higher than those of patients with senile cataract and perforating injury of eyeball(0.18 ± 0.07 ) mg ·L^-1 and ( 0. 19 ± 0.08 )mg·L^-1 ( both P 〈 0. 01 ), and there was no statistical significance between the two groups(P 〉 0.05 ). Ciprofloxacin level of vitreous in patients with endophthalmitis was (0.50 ± 0.38 )mg ·L^-1, significantly higher than those of patients with perforating injury of eyeball ( 0.06 ± 0. 03 ) mg ·L^-1 ( P 〈 0. 01 ). The protein concentration of aqueous humor had positive correlation with ciprofloxacin level of aqueous humor and vitreous in patients with endophthalmitis(r = 0. 889 and rs = 0. 841, both P 〈 0.05 ). Conclusions In patients with endophthalmitis, the permeability of blood-ocular barrier and ocular endosmosis of eyes with intravenous injection of ciprofloxacin can increase;Ciprofloxacin levels of aqueous humor and vitreous after intravenous injection are above the minimum inhibitory concentration for most of the common microorganisms causing endophthalmitis, so intravenously administered ciprofloxacin may be adequate for treatment of bacterial endophthalmitis.
出处
《眼科新进展》
CAS
北大核心
2009年第5期348-350,共3页
Recent Advances in Ophthalmology
基金
广东省中医药管理局基金资助(编号:1050065)~~
关键词
环丙沙星
眼内炎
眼球穿通伤
血-眼屏障
眼内渗透性
ciprofloxacin
endophthalmitis
perforating injury of eyeball
blood-ocular barrier
ocular endosmosis