【摘要】 目的观察玻璃体腔注射蛇毒降纤酶和曲安奈德治疗外伤性玻璃体出血的效果，同时观察玻璃体腔细胞因子含量的变化。方法建立外伤性玻璃体出血动物模型。实验眼(右眼)随机分为生理盐水组、蛇毒降纤酶组、曲安奈德组、联合用药组。直接眼底镜观察玻璃体出血指数、增生性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)程度;酶联免疫吸附法(enzyme-liked immunosorbent assay,ELISA)测定玻璃体液中细胞因子浓度。结果联合用药组玻璃体出血指数、PVR程度、玻璃体腔白介素-1β(Interleukin-1β，IL-1β)低于生理盐水组。玻璃体腔基质金属蛋白9、血小板源性生长因子、转化生长因子β1、表皮生长因子浓度与生理盐水组比较未见统计学意义。结论玻璃体腔注射蛇毒降纤酶和曲安奈德可以促进玻璃体腔出血的吸收及降低外伤性PVR程度;同时下调玻璃体腔IL-1β浓度。
【关键词】 蛇毒降纤酶; 曲安奈德; 治疗; 外伤性玻璃体出血
Combination Therapy for Traumatic Vitreous Hemorrhage in A Rabbit Model
ZHAO Zhiyi, PENG Yanyi
(Affiliated Hospital of Guilin Medical University, Guilin 510632,China)
Abstract：ObjectiveTo study the therapeutic effect of intravitreal triamcinolone and defibrase injection for experimental traumatic vitreous hemorrhage and the variance of cytokines in vitreous.MethodsAll right eyes of 40 New Zealand albino rabbits were created as experimental rabbit model eyes of traumatic vitreous hemorrhage. The rabbits were divided into phosphate buffered saline group，triamcinolone group ，defibrase group and triamcinolone in combination with defibrase group randomly. The bleeding indexes in vitreous and degrees of proliferative vitreoretinopathy were estimated by direct ophthalmoscope examination. The contents of cytokines in vitreous were detected by enzyme-liked immunosorbent assay. ResultsThe bleeding indexes ，degrees of proliferative vitreoretinopathy,level of Interleukin-1β in vitreous in triamcinolone combination with defibrase group were lower than those of phosphate buffered saline group. ConclusionIntravitreal triamcinolone in combination with defibrase injection can promote the absorption of vitreous hemorrhage and decrease the degrees of proliferative vitreoretinopathy.
Key words： Defibrase; Triamcinolone ; Therapia; Traumatic vitreous hemorrhage
临床上，伴玻璃体出血的眼球穿通伤PVR发生率远远高于视网膜脱离手术后PVR发生率[1，2]。目前治疗玻璃体出血的药物并不理想。蛇毒降纤酶是从一种纯化的凝血酶样酶制剂，它能水解纤维蛋白，促进出血的吸收[3，4]。曲安奈德是一种长
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