玻璃体内持续释放阿霉素防治增生性玻璃体视网膜病变

Biodegradable microspheres containing adriamycin in thetreatment of proliferative vitreoretinopathy

目的 探索生物降解性的阿霉素聚乳酸微球 (ADR -PLA -MS)对兔眼实验性增殖性玻璃体视网膜病变的防治作用。方法 成年健康灰免 3 0只 ,随机分组 ,对照组 2 0只眼内注入 1%空白微球悬液或磷酸缓冲液 (PBS) ;阿霉素微球组 (含阿霉素 0 0 5mg/ml或 0 1mg/ml ,2组各 2 0只眼 )。各组均 2次行气体压迫玻璃体手术。所有实验眼玻璃体腔内注入成纤维细胞悬液 2× 10 5/0 1ml后 ,再分别注入空白微球 ,PBS或载药微球悬液 0 1ml,连续四周以间接检眼镜观察牵引性视网膜脱离发生情况。结果 对照组 ,阿霉素微球 0 0 5mg/ml组和 0 1mg/ml组在 4周末时的牵引性视网膜脱离的发生率分别为 85 % ;65 %和 2 5 % ,阿霉素微球 (0 1mg/ml)组与对照组相比有显著性差异 (P<0 0 1) ,而阿霉素微球 (0 0 5mg/ml)组与对照组相比差异不显著 (P >0 0 5 )。 结论 一次性注入含 10ug阿霉素的生物降解性微球能够有效地减少牵引性视网膜脱离的发生率。

Objective To investigate the possibility of biodegradable adriamycin polylactic acid microspheres (ADR-PLA-MS) for the treatment of proliferative vitreoretinopathy(PVR) in an experimental rabbit model.Methods Thirty pigmented rabbits(60 eyes) were divided into three groups.The blank microspheres (10 eyes) and phosphate buffer solution(PBS)(10 eyes) were injected intravitreally as the control.The ADR-PLA-MS containing 0.05mg/ml(20 eyes)or 0.1 mg/ml(20 eyes) of ADR were injected into other two groups respectively.Seven days after second gas-compression vitrectomy,2×10 5 fibroblastes and ADR-PLA-MS(or control)were injected in all eyes sequentially.The morbidity of tractional retinal detachment(TRD) were observed by ophthalmoscope for 4 weeks.Results 4 weeks later,the morbidity of TRD in control,0.05mg/ml and 0.1mg/ml ADR-PLA-MS group was 85%,65%,and 25% respectively.Significant statistical difference was found between the control group and the ADR-PLA-MS(0.1mg/ml)group( P <0.01),but no significant difference was observed between the control group and the ADR-PLA-MS(0.05mg/ml)group( P >0.05).Conclusions The microspheres containing 0.1mg/ml of ADR can inhibit the occurrence of TRD effectively.