头孢哌酮/舒巴坦玻璃体腔注射治疗兔铜绿假单胞菌性眼内炎

Intravitreal injection of cefoperazone/sulbactam for experiment pseudomonal endophthalmitis

目的评价头孢哌酮/舒巴坦治疗铜绿假单胞菌眼内炎的疗效。方法青紫蓝兔18只,随机分为3组,右眼注菌后6h分别注入100g/L头孢哌酮/舒巴坦、22.5g/L头孢他啶和生理盐水各0.1mL,观察24h。另取青紫蓝兔12只,随机分为2组。早期注药组注菌后6h注入100g/L头孢哌酮/舒巴坦0.1mL,晚期注药组注菌后20h注入100g/L头孢哌酮/舒巴坦0.1mL,观察1周。结果头孢哌酮/舒巴坦组、头孢他啶组与生理盐水组比较除角膜评分外(P>0.05),结膜、前房、玻璃体、视网膜、B型超声检查及组织病理学评分结果差异均有统计学意义(P<0.05);头孢哌酮/舒巴坦组与头孢他啶组相比,除虹膜炎症反应评分差异有统计学意义外(P<0.05),其他评分差异均无统计学意义(P>0.05),但从具体评分来看头孢哌酮/舒巴坦组优于头孢他啶组。早期注药组与晚期注药组相比,1周后结膜、前房、虹膜、玻璃体、视网膜、B型超声检查及组织病理学评分差异均有统计学意义(P<0.05)。结论 100g/L头孢哌酮/舒巴坦0.1mL玻璃体腔注射治疗早期铜绿假单胞菌眼内炎有效。

BackgroundBacterial endophthalmitis is a disease with bad prognosis.Intraocular aminlglycosides is commonly used to treat endophthalmitis,but aminlglycosides have toxicity to retina.Cefoperazone/sulbactam is broad-spectrum antibiotics and sensitive to pseudomonas.ObjectivePresent study was to evaluate the efficacy of intravitreal cefoperazone/sulbactam in the treatment of experimentally induced pseudomonal endophthalmitis.MethodsThe endophthalmitis models were created by injecting the bacterial suspension into vitreous cavity in the right eye of 18 chinchilla rabbits.0.1mL of cefoperazone/sulbactam（100g/L）or ceftazidime（22.5g/L）or normal saline solution was injected into vitreous cavity respectively in 6 rabbits.The animals were sacrificed and eyeballs were enucleated 24 hours after injection of vitreous for histopathologic observation.The effectiveness of drug was evaluated through the clinical score of inflammation based on Peyman criteria.Another 12 rabbits were divided into 2 groups.Cefoperazone/sulbactam（100g/L）0.1mL was injected into vitreous cavity after inoculation of Pseudomonas anruginosa for 6 hours in group one（6 eyes of 6 rabbits）.The same amount of cefoperazone（22.5g/L）was injected into vitreous cavity after inoculation of Pseudomonas anruginosa for 20 hours in another group（6 eyes of 6 rabbits）.Results The scores of conjunctiva,anterior chamber,iris,vitreous,B-scan were significant different between the intravitreal cefoperazone/sulbactam 100g/L or ceftazidime（22.5g/L）and intravitreal normal saline（P0.05）.There were no significant difference in the scores between the intravitreal cefoperazone/sulbactam 100g/L and ceftazidime（22.5g/L）（P0.05）except iris score.But the scores of intravitreal cefoperazone/sulbactam was superior to one of intravitreal ceftazidime.There were significant differences in the scores between intravitreal cefoperazone/sulbactam 100g/L into vitreous cavity for 6 hours and 20 hours（P0.05）.ConclusionIntravitreal injection of cefoperazone/sulbactam 100g/L is effective for the management of experiment-induced pseudomonal endophthalmitis.