替奈替普酶诱导兔玻璃体后脱离的实验研究

An experimental study on tenecteplase-induced posterior vitreous detachment in rabbits

目的研究玻璃体内替奈替普酶诱发玻璃体后脱离(posterior vitreous detachment,PVD)的效果及安全性。方法 30只灰兔分为A、B、C3组,每组10只。TNK-TPA100mg/L,150mg/L,250mg/L,分别注入3组兔的左眼作为实验组,0.1ml平衡盐溶液(BSS)分别注入右眼作为对照组。实验后分别观察1h、1d、3d的情况。扫描电镜、眼底检查、超声用于PVD观察,透射电镜和视网膜电图用于药物安全性判断。结果眼底和超声波检查发现实验A、B、C3组PVD发生率分别为20%、40%、90%,总发生率为50%,对照组无PVD发生,差异有统计学意义(P<0.01)。扫描和透射电镜显示实验C组发生完全性PVD,实验A和B组内界膜表面有玻璃体胶原残留。透射电镜和光镜检查发现各实验组的视网膜组织细胞未见异常,用药前后的视网膜电图差异无统计学意义(P>0.05)。结论 TNK-TPA能诱发人工PVD,250mg/L在兔眼能安全和有效地诱发完全性PVD。

Objective To investigate the efficiency and safety of tenecteplase in inducing posterior vitreous detachment（PVD）in the eyes of rabbits.Methods Thirty pigmented rabbits were randomly divided into 3 groups（group A,B,C）,which received respectively 100 mg/L,150 mg/L,250 mg/L TNK-TPA in 1eft eye.The right eyes were injected with 0.1ml BSS as controls.1 hour,1 day and 3 days after the operation,PVD was evaluate by biomicroscopy,ultrasonography,scanning electron microscopy respectively.The safety was evaluated by transmission electron,light microscopy and electroretinogram.Results In group A,B,C,the incidence of PVD was 20%,40%,90% respectively according to biomicroscopy and ultrasonography examination.In experimental group,the total incidence of PVD was 50%.However PVD didn＇t occur in control group（P〈0.01）.The complete PVD was observed in group C that received 250 mg/L TNK-TPA under scanning and transmission electron microscopy.The collagen fiber staining on the inner limiting membrane was observed in group A and group B.In all experimental groups,safety was proved by the direct observation,microscopy and electroretinogram examination（P〉0.05）.Conclusion The intravitreal injection of TNK-TPA at dose of 250 mg/L can effectively and safely induce complete PVD in rabbits.