兔眼玻璃体腔联合注射赖氨酸-纤溶酶和瑞替普酶诱导玻璃体后脱离

Posterior vitreous detachment induced by intravitreal injection of lysine-plasminogen and reteplase in rabbits

目的 观察兔眼玻璃体腔联合注射赖氨酸-纤溶酶原和瑞替普酶诱导玻璃体后脱离（PVD）的效果及安全性。方法15只健康新西兰白兔分为3组，每组5只兔，右眼为实验眼，左眼为对照眼。实验眼玻璃体腔分别注射1250μg／ml赖氨酸-纤溶酶原0．10ml和不同剂量瑞替普酶0．05ml，3组剂量分别为10^4、3×10^4、10^5U；对照眼玻璃体腔注射平衡盐溶液0．15ml。采用裂隙灯显微镜、＋120D前置镜检查结膜、前房、晶状体、玻璃体及视网膜情况。行视网膜电图（ERG）检查了解视网膜功能。结果3个实验组均发生了PVD。光学显微镜检查结果显示，对照眼及10^4U瑞替普酶组视网膜结构无改变，3×10^4U瑞替普酶组视网膜结构层次清晰，但神经节细胞层细胞和内核层细胞减少，10^5U瑞替普酶组视网膜未见正常结构，只能见到视网膜色素上皮层。ERG检查结果显示，最大混合反应a、b波振幅10‘u瑞替普酶组与对照眼比较，差异无统计学意义（a波：t=0．881，-1．776，0．809；b波：t=-0．223，-0．441，1.400；P〉0．05）；3×10^4U瑞替普酶组（a波：t=-3．20，b波：t=-4．182，-4．103）、10。U瑞替普酶组（a波：t=-0．737；b波：t=-15．150，6．597）与对照眼比较，差异有统计学意义（P〈0．05）。对照眼未发生PVD。结论兔眼玻璃体腔联合注射赖氨酸-纤溶酶原和10^4U瑞替普酶可以诱导完全性PVD，并且对视网膜结构无损害。

Objective To observe the safety and efficacy of posterior vitreous detachment （PVD） induced by combined intravetreal injection of lysine-plasminogen and reteplase in rabbits. Methods Fifteen healthy New Zealand rabbits were divided into three groups with five rabbits in each. Take the right eyes as experimental eyes, while the left eyes as the control. The experimental eyes of three groups received combined intravetreal injection of 1250μg/ml lysine-plasminogen at 0.1 ml dose and 104 U, 3 ×10^4 U, 10^5U reteplase at 0.05 ml dose recpeetively, while the control eyes were injected intravetreally with 0. 15 ml balanced salt solution. The conjunctiva, anterior chamber, lens, vitreous body, and retina were examined by slit lamp microscope and ＋ 120D preset lens. The retinal function was examined by electroretinogram （ERG）. Results All the experimental eyes had PVD. The results of optical microscope showed that no change in retinal structure was found in the control group and 10^4 U reteplase group, clear retinal hierarchical but decreased ganglion cells and kernel layer cells were found in 3 × 10^4 U reteplase group, only retinal pigment epithelium layer but no normal retinal structure was observed in 10^5u reteplase group. The results of ERG showed that compared the maximum mixed reaction of a and b wave amplitude in control group and reteplase group respectively, the difference was not statistically siginificant between 10^4U reteplase group and control group（a wave：t=0. 881,-1. 773,0. 809b wave：t=-0. 223, -0. 441,1. 400; P〉0.05）, the differences were statistically siginificant between 3 × 10^4 U （a wave： t ： -3.20, h wave ： t =4. 182,-4. 103）, 105 U reteplase group（a wave：t=-0. 737,b wave：t=- 15. 150,6. 597） and control group（P〈0.05）. The control eyes didn＇t had PVD. Conclusion Combined intravetreal injection of lysineplasminogen and reteplase can induce complete PVD, and no damage to the retinal structure in rabbits.