CAJ | 학술논문

目的探讨组织型纤溶酶原激活剂(t-PA)在兔眼青光眼滤过术毕前房小剂量(25μg)注射的有效性。方法采用前瞻性、盲法对照研究，20只健康白色家兔双眼行全厚巩膜咬切滤过手术，术毕随机选一眼为t-PA治疗眼，另一眼为等量生理盐水对照眼，术后临床观察结合光电镜检查。结果生理盐水对照组术后1日和3日滤过道及滤泡腔内有纤维蛋白凝块及红细胞栓子阻塞，而t-PA治疗组滤过道完全开放，炎性细胞及成纤维细胞的数量明显减少；术后7日和14日t-PA治疗组手术区肉芽组织和瘢痕组织的量亦明显少于对照组。与组织学检查相一致，术后1周内治疗组滤过泡比对照组明显增大。两组均未见明显毒副作用。结论 t-PA可有效溶解滤过道及滤泡腔内的纤维蛋白凝块，提高青光眼滤过手术的成功率。
목적탐토조직형섬용매원격활제(t-PA)재토안청광안려과술필전방소제량(25μg)주사적유효성。방법채용전첨성、맹법대조연구，20지건강백색가토쌍안행전후공막교절려과수술，술필수궤선일안위t-PA치료안，령일안위등량생리염수대조안，술후림상관찰결합광전경검사。결과생리염수대조조술후1일화3일려과도급려포강내유섬유단백응괴급홍세포전자조새，이t-PA치료조려과도완전개방，염성세포급성섬유세포적수량명현감소；술후7일화14일t-PA치료조수술구육아조직화반흔조직적량역명현소우대조조。여조직학검사상일치，술후1주내치료조려과포비대조조명현증대。량조균미견명현독부작용。결론 t-PA가유효용해려과도급려포강내적섬유단백응괴，제고청광안려과수술적성공솔。
Objective To investigate the effect of 25ug tissue plasminogen ctivator (t-PA) used by intracameral injection immediately after glaucoma filtration surgery in rabbits. Methods Forty eyes of 20 rabbits were randomly divided into 2 groups. A prospective, randomized, masked-observer, placebocontrolled study was performed. Light microscopic and electronic microscope examination was also studied. Results Fibrin clots and red blood cells occluded the fistulas and subconjuctival space in 1d and 3d after surgery in the control group, while patent fistulas were opened in the t-PA treated group and the amount of inflammatory cells and fibroblasts was also significantly reduced. In 7 and 14 d after surgery,light microscope showed that in treated group,the amount of granulation and scar tissue was both obviously less than that of control group. The histological examination is associated with persistence of clinically larger filter bleb in treated group during one week after surgery. There is no obvious adverse effects both in two groups. Conclusion t-PA which degrades the fibrin clots of fistula and filter bleb may promote the success of filtering urgery.