氯化十六烷吡啶治疗豚鼠真菌性角膜炎的对比研究

Cetylpyridinium chloride in treatment of fungal keratitis of guinea pig

目的探讨氯化十六烷吡啶滴眼液治疗豚鼠真菌性角膜炎的效果,最终为临床提供理想的抗真菌眼药提供实验依据。方法健康豚鼠80只,利用改良的制作模型方法复制真菌性角膜炎动物模型,选择感染程度相似的60只豚鼠随机分为5组(A组:空白对照组;B组:氟康唑组;C组:那他霉素组;D组:CYC滴眼液-1组;E组:CYC滴眼液-2组)。予药物滴眼,裂隙灯下直接观察、光镜观察各组角膜组织学改变及真菌孢子和菌丝,并对真菌性角膜炎进行临床评分,对比CYC对真菌性角膜病的疗效。结果打开睑裂后第10天,临床评分:空白对照组为6.667±1.367,氟康唑组为4.833±1.472,那他霉素组为3.167±1.330,CYC-1组为1.500±1.225,CYC-2组为0.667±0.817。CYC组临床评分较其他各组缩小明显,差异有统计学意义(P<0.05)。CYC-1组和CYC-2组至打开睑裂第8天左右,溃疡已消失,角膜表面光滑,光镜下几乎不见真菌丝和孢体;而其他3组均可见炎性坏死,坏死组织周围可见大量菌丝和孢子。结论采用剖除豚鼠角膜上皮、眼睑缝合、菌液滴眼的方法可以成功建立真菌性角膜炎的动物模型;CYC滴眼液较氟康唑和那他霉素能够更有效的治疗豚鼠茄病镰刀菌性角膜溃疡。

Objective To evaluate the effect of cetylpyridinium chloride（CYC）eye drop on fungal keratitis of guinea pig,and provide the experimental basis for developing the ideal anti-fungus drug.Methods Eighty healthy guinea pig were used to establish the experimental fungal keratitis model by improved methods,60 cases with the similar infection degree were selected and randomly divided into five groups,group A：control group;group B：fluconazole group;group C：natamycin group;group D：CYC eye drop-1 group;group E：CYC eye drop-2 group.Group B,C,D,E received fluconazole,natamycin and CYC eye drops,respectively.The corneal histological changes,the fungal spore and hypha in each group were observed by slit lamp and light microscope,the clinical scoring for fungal keratitis was made,and the curative effect of CYC on fungal keratitis was compared.Results The clinical scoring at 10 days after opened the eyelid in group A,B,C,D,E were 6.667±1.367,4.833±1.472,3.167±1.330,1.500±1.225 and 0.667±0.817,respectively.The scoring of CYC group were obviously lower than that of other groups,there was statistical difference（P〈0.05）.At 8 days after opened the eyelid,the ulcer were disappeared and the corneal surface were smooth and glossy,no fungal spore and hypha was seen in group D and group E,but in other three groups many sporesand hypha were surrounded the inflammatory necrosis.Conclusion By splitting eliminates the epithelia corneal,suturing the eyelid,dropping colony to eye,the experimental fungal keratitis model can be established successfully.CYC eye drop is superior to fluconazole and natamycin on treating the experimental keratomycosis of guinea pig.