高三尖杉酯碱脂质体及高三尖杉酯碱注射液对兔滤过术的作用

Effects of homoharringtonine liposomes and homoharringtonine solution on glaucoma filtration surgery in rabbits

目的研究高三尖杉酯碱（ｈｏｍｏｈａｒｉｎｇｔｏｎｉｎｅ，ＨＨＴ）脂质体及高三尖杉酯碱注射液对兔滤过术后抗瘢痕形成的疗效及毒性。方法对４０只家兔双眼行巩膜后唇咬切术，自术后次日起，第１组结膜下注射ＨＨＴ脂质体，第２组结膜下注射空白脂质体（对照组），第３组结膜下注射低剂量ＨＨＴ注射液，第４组结膜下注射生理盐水（对照组），第５组结膜下注射高剂量ＨＨＴ注射液。结果２个对照组的滤过泡在术后７天失败，低剂量ＨＨＴ组的滤过泡在术后９天失败，ＨＨＴ脂质体组的滤过泡在术后１２天失败，高剂量ＨＨＴ组的滤过泡在术后１５天失败。术后５～１０天，高剂量ＨＨＴ组的巩膜瘘道阻塞率为３７５％，其余４组的阻塞率均为１０００％；术后１５～３０天，５组的巩膜瘘道阻塞率均为１０００％。高剂量ＨＨＴ组中６３０％的眼出现中至重度角膜水肿及角膜血管翳。结论对兔眼滤过术后应用ＨＨＴ脂质体和低剂量ＨＨＴ注射液不能明显提高兔眼滤过术的成功率。应用高剂量ＨＨＴ注射液可暂时提高兔眼滤过术的成功率，但副作用亦明显增加。

Objective Homoharringtonine (HHT), a Chinese herbal drug, was used in the form of liposome or solution as an adjunct to glaucoma filtration surgery in rabbits to determine its effect in preventing closure of sclerostomy. Methods Forty rabbits that underwent a standard posterior lip sclerectomy in both eyes were divided into 5 post operative groups. Group 1 received subconjunctival HHT liposomes (0.025%). Group 2 received subconjunctival blank liposomes and served as control. Group 3 and 5 received subconjunctival HHT solution at low (0.025%)and high (0.1%) doses respectively. Group 4 received subconjunctival normal saline and served as control. Intraocular pressure, interval between operation and bleb failure, rate of scleral fistula occlusion and ocular toxicity were determined in each group. Results Subconjunctival treatment with HHT solution at a high dose transiently prolongs the survival of filtration surgery, but the subconjunctival use with HHT liposomes or HHT solution at a low dose does not significantly prolong the survival of filtration surgery in rabbits. Significant corneal haze and corneal neovascularization resulted from using HHT at a high dose. Conclusions The success rate of rabbit filtration surgery can not be markedly increased by the postoperative use of HHT liposomes or its low dose solution. When the high dosage of HHT solution is used, transient elevation of the success rate can be obtained, however the side effect is also significantly increased.