中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2011年
6期
521-524
,共4页
腺病毒载体%胸苷激酶%丙氧鸟苷%晶状体%后囊膜混浊
腺病毒載體%胸苷激酶%丙氧鳥苷%晶狀體%後囊膜混濁
선병독재체%흉감격매%병양조감%정상체%후낭막혼탁
Adenovirus vector%Thymidine kinase%Ganciclovir%Lens%Posterior capsule opacification
背景 晶状体后囊膜混浊(PCO)目前尚无有效的防治途径.目的 研究腺病毒载体介导的单纯疱疹病毒胸苷激酶(HSV-tk)/丙氧鸟苷(GCV)系统对PCO的抑制作用.方法 选取新西兰白兔12只,用电脑随机选号法随机分为BSS+BSS组、BSS+GCV组、HSV-tk+BSS组及HSV-tk+GCV组,每组3只.兔眼行晶状体超声乳化摘出术,术中依据分组情况分别在晶状体囊袋中注入0.1ml BSS 或携带有HSV-tk基因的腺病毒载体,术后12h分别在BSS+BSS组和HSV-tk+BSS组兔眼前房注入0.1ml BSS,BSS+GCV组及HSV-tk+GCV组以同样的方法注入GCV,每日1次,共3次.术后裂隙灯下观察眼前节情况,PCO分级按照Couderc的方法.术后4周摘除兔眼,采用Miyake-Apple法观察PCO情况,显微镜下取出晶状体囊袋后以电子天平称出整个囊袋湿质量,并行晶状体囊袋的组织学检查.结果 术后1～3d各组均可见角膜轻度水肿与房水混浊,2周内基本恢复正常.术后4周,HSV-tk+GCV组PCO明显轻于其他3组,差异均有统计学意义(H=2.647、H=2.939、H=2.884,P<0.05),而BSS+BSS组、BSS+GCV组、HSV-tk+BSS组组间的差异均无统计学意义(H=0.631、H=0.924、H=0.589,P>0.05).Miyake-Apple法观察显示,HSV-tk+GCV组PCO面积与密度小于其他3组,晶状体囊袋湿质量也明显轻于其他3组,差异均有统计学意义(q=9.93、q=10.15、q=10.07,P<0.05),BSS+BSS组、BSS+GCV组、HSV-tk+BSS组组间差异均无统计学意义(q=0.22、q=0.07、q=0.15,P>0.05).囊袋组织学检查提示HSV-tk+GCV组可见少量赤道部晶状体上皮细胞(LECs)增生并向后囊膜迁移,在囊袋外周形成稀薄的soemmering环,在中央部无细胞和皮质,或仅形成单细胞层纤维膜.BSS+BSS组、BSS+GCV组、HSV-tk+BSS组可见大量赤道部LECs增生和迁移,在囊袋外周部soemmering环稠厚,在中央部形成多细胞层纤维膜.结论 腺病毒载体介导的HSV-tk/GCV系统能有效抑制PCO.
揹景 晶狀體後囊膜混濁(PCO)目前尚無有效的防治途徑.目的 研究腺病毒載體介導的單純皰疹病毒胸苷激酶(HSV-tk)/丙氧鳥苷(GCV)繫統對PCO的抑製作用.方法 選取新西蘭白兔12隻,用電腦隨機選號法隨機分為BSS+BSS組、BSS+GCV組、HSV-tk+BSS組及HSV-tk+GCV組,每組3隻.兔眼行晶狀體超聲乳化摘齣術,術中依據分組情況分彆在晶狀體囊袋中註入0.1ml BSS 或攜帶有HSV-tk基因的腺病毒載體,術後12h分彆在BSS+BSS組和HSV-tk+BSS組兔眼前房註入0.1ml BSS,BSS+GCV組及HSV-tk+GCV組以同樣的方法註入GCV,每日1次,共3次.術後裂隙燈下觀察眼前節情況,PCO分級按照Couderc的方法.術後4週摘除兔眼,採用Miyake-Apple法觀察PCO情況,顯微鏡下取齣晶狀體囊袋後以電子天平稱齣整箇囊袋濕質量,併行晶狀體囊袋的組織學檢查.結果 術後1～3d各組均可見角膜輕度水腫與房水混濁,2週內基本恢複正常.術後4週,HSV-tk+GCV組PCO明顯輕于其他3組,差異均有統計學意義(H=2.647、H=2.939、H=2.884,P<0.05),而BSS+BSS組、BSS+GCV組、HSV-tk+BSS組組間的差異均無統計學意義(H=0.631、H=0.924、H=0.589,P>0.05).Miyake-Apple法觀察顯示,HSV-tk+GCV組PCO麵積與密度小于其他3組,晶狀體囊袋濕質量也明顯輕于其他3組,差異均有統計學意義(q=9.93、q=10.15、q=10.07,P<0.05),BSS+BSS組、BSS+GCV組、HSV-tk+BSS組組間差異均無統計學意義(q=0.22、q=0.07、q=0.15,P>0.05).囊袋組織學檢查提示HSV-tk+GCV組可見少量赤道部晶狀體上皮細胞(LECs)增生併嚮後囊膜遷移,在囊袋外週形成稀薄的soemmering環,在中央部無細胞和皮質,或僅形成單細胞層纖維膜.BSS+BSS組、BSS+GCV組、HSV-tk+BSS組可見大量赤道部LECs增生和遷移,在囊袋外週部soemmering環稠厚,在中央部形成多細胞層纖維膜.結論 腺病毒載體介導的HSV-tk/GCV繫統能有效抑製PCO.
배경 정상체후낭막혼탁(PCO)목전상무유효적방치도경.목적 연구선병독재체개도적단순포진병독흉감격매(HSV-tk)/병양조감(GCV)계통대PCO적억제작용.방법 선취신서란백토12지,용전뇌수궤선호법수궤분위BSS+BSS조、BSS+GCV조、HSV-tk+BSS조급HSV-tk+GCV조,매조3지.토안행정상체초성유화적출술,술중의거분조정황분별재정상체낭대중주입0.1ml BSS 혹휴대유HSV-tk기인적선병독재체,술후12h분별재BSS+BSS조화HSV-tk+BSS조토안전방주입0.1ml BSS,BSS+GCV조급HSV-tk+GCV조이동양적방법주입GCV,매일1차,공3차.술후렬극등하관찰안전절정황,PCO분급안조Couderc적방법.술후4주적제토안,채용Miyake-Apple법관찰PCO정황,현미경하취출정상체낭대후이전자천평칭출정개낭대습질량,병행정상체낭대적조직학검사.결과 술후1～3d각조균가견각막경도수종여방수혼탁,2주내기본회복정상.술후4주,HSV-tk+GCV조PCO명현경우기타3조,차이균유통계학의의(H=2.647、H=2.939、H=2.884,P<0.05),이BSS+BSS조、BSS+GCV조、HSV-tk+BSS조조간적차이균무통계학의의(H=0.631、H=0.924、H=0.589,P>0.05).Miyake-Apple법관찰현시,HSV-tk+GCV조PCO면적여밀도소우기타3조,정상체낭대습질량야명현경우기타3조,차이균유통계학의의(q=9.93、q=10.15、q=10.07,P<0.05),BSS+BSS조、BSS+GCV조、HSV-tk+BSS조조간차이균무통계학의의(q=0.22、q=0.07、q=0.15,P>0.05).낭대조직학검사제시HSV-tk+GCV조가견소량적도부정상체상피세포(LECs)증생병향후낭막천이,재낭대외주형성희박적soemmering배,재중앙부무세포화피질,혹부형성단세포층섬유막.BSS+BSS조、BSS+GCV조、HSV-tk+BSS조가견대량적도부LECs증생화천이,재낭대외주부soemmering배주후,재중앙부형성다세포층섬유막.결론 선병독재체개도적HSV-tk/GCV계통능유효억제PCO.
Background There is no effective preventing way for the posterior capsular opacification(PCO) after cataract surgery.Objective The aim of this study was to investigate the preventing effect of adenovirus-mediated herpes simplex virus thymidine kinase/ganciclovir(HSV-tk/GCV) system on PCO.Methods Twelve New Zealand white rabbits were divided into BSS+BSS group,BSS+GCV group,HSV-tk+BSS group and HSV-tk+GCV group at random.Phacoemulsification was performed in bilateral eyes of rabbits,and 0.1ml of BSS or adenovirus vector with HSV-tk gene were injected into lens capsular bag during the operation based on the grouping.In 12 hours after operation,0.1ml BSS was injected into the anterior chamber daily for 3 times in BSS+BSS group and HSV-tk+BSS group,and 0.1ml GCV was used in the same way in BSS+GCV group and HSV-tk+GCV group.The situations of the anterior segment and the posterior capsule were examined under the slit lamp postoperatively.All the wet weight of capsular bags was assessed using electronic balance.The capsular membrane was histopathologically examined in the 4th week after injection.PCO was graded according to the method of Couderc.Results Mild corneal edema and aqueous humor opacity were observed in all the eyes within 3 days and returned to normal level gradually within 2 weeks postoperatively.PCO scores were higher in BSS+BSS group,BSS+GCV group,HSV-tk+BSS group than the HSV-tk+GCV group,showing the significant differences between them(H=2.647,P=0.008;H=2.939,P=0.003;H=2.884,P=0.004).No obvious difference was seen in PCO score among BSS+BSS group,BSS+GCV group,HSV-tk+BSS group(P＞0.05).The wet weight of the capsular bags in HSV-tk+GCV group was reduced in comparison with BSS+BSS group,BSS+GCV group,HSV-tk+BSS group with the statistically significant difference between them(q=9.93,q=10.15,q=10.07,P＜0.05).Histopathological examination revealed that mild proliferation of lens epithelial cells(LECs) at the capsular equator and migration toward the posterior capsule to form a thin soemmering ring in the periphery of the capsular bags and thin fibromembrane at the center of the capsular bags without cells or cortices in HSV-tk+GCV group.However,in BSS+BSS group,BSS+GCV group and HSV-tk+BSS group,the proliferation and migration of LECs were more obvious to form a dense soemmering ring in the periphery of the capsular bags and thick fibromembrane in the center of capsular bags.Conclusion Adenovirus-mediated HSV-tk/GCV system can effectively prevent PCO.
