雷公藤多苷治疗家兔青光眼三联手术后葡萄膜炎研究

Study on the anterior uveitis after tripie combined surgery for the experimental rabbits glaucoma

目的研究雷公藤多苷治疗家兔青光眼模型晶体摘除人工晶体植入联合小梁切除手术后葡萄膜炎的发生情况,比较不同治疗方法的疗效。方法前房注射甲基纤维素建立20只兔青光眼模型,行小梁切除联合晶体摘除人工晶体植入手术。术后随机分成4组:A组,空白组,给予妥布霉素眼药水点眼;B组,给予妥布霉素、地塞米松眼药水点眼;C组,给予妥布霉素眼药水点眼,口服雷公藤多苷片;D组,给予妥布霉素、地塞米松眼药水点眼,雷公藤多苷片灌胃。术前术后进行眼部检查(前房、眼压)和免疫生化指标(C3、免疫复合物CIC)测定,比较及评价4种不同治疗方法的疗效。结果①前房渗出:手术后7d,D组与A组、C组有统计差异;②CIC变化值:手术后7 d,A组与B、C组比无统计差异,其余各组间有统计差异。③C3变化值:手术后7 d,A组与C组、B组比无统计差异,其余各组间有统计差异。家兔青光眼模型三联手术后局部应用抗生素、糖皮质激素、雷公藤多苷片,对前房渗出、CIC变化值、C3变化值有更好的疗效。结论雷公藤多苷联合糖皮质激素治疗家兔青光眼联合晶体摘除手术后前葡萄膜炎,较单纯使用糖皮质激素有更好的疗效。

Objective To observe the anterior uveitis after lens extaction,intraocular lens implantation combined with trabeculectomy surgery for the experimental rabbits glaucoma and compare the outcomes of four different treatments.Methods To develop rabbits glaucoma model,methylcellulose was injected in anterior chamber and all rabbits received lens extaction,intraocular lens implantation combined with trabeculectomy surgery.Twenty rabbits were divided randomly into four groups： Group A with Tobrex eye solution,eye drip,Group B with Tobradex eye solution,Tropicamide-Phenylephrine eye solution,eye drip,Group C with Tryptergium Wilfordii Polyglyco-sidium（TWP）,po,Tropicamide-Phenylephrine eye solution,eye drip,Group D with Tryptergium Wilfordii Polyglyco-sidium（TWP）,po;Tobradex eye solution,Tropicamide-Phenylephrine eye solution,eye drip.The anterior chamber exudate,intraocular pressure（IOP）,circulating immune complex（CIC） and complement C3 were observed.Results ① The anterior chamber exudated： There were no significant differences among any groups at first day postoperatively.Group D had better effect than groups A,C at 7th day postoperatively.② The change value of CIC： There were no significant differences among any groups at first day postoperatively.Group D had better effect than groups A,B,C at 7th day postoperatively.③ The change value of C3： There were no significant differences among any groups at first day postoperatively.Group D has better effect than groups A,B,C at 7th day postoperatively.Conclusion Group D has better effect in anterior chamber exudate,CIC and C3 than other there groups.Application of glucocorticoid combined with TWP has better effect in anterior chamber exudate,CIC and C3 than the application of glucocorticoid alone.