CAJ | 학술논문

背景曲安奈德(TA)在眼科常用于治疗葡萄膜炎、糖尿病视网膜病变等眼底疾病,但其对眼周围正常组织是否有毒性作用尚需进一步研究. 目的探讨球周注射TA对兔眼周围组织的影响.方法将27只新西兰大白兔按随机数字表法随机分为实验组、生理盐水组和空白对照组,实验组于喂养的第5周和第9周球周注射20 mg TA悬浮液(0.5 ml)各1次,生理盐水组兔眼分别注射0.5ml等容量生理盐水,方法同实验组,空白对照组兔不给予任何干预.分别于注药前1d及第2次注射后1、2、3个月以过量麻醉法分别处死各组实验兔各3只,制备兔眼各条眼外肌、球周脂肪、泪腺及视神经组织标本,行常规苏木精-伊红染色,分别在光学显微镜和透射电子显微镜下观察上述组织的组织病理学和超微结构改变. 结果注射前及注射后1、2、3个月各组兔眼的眼压差异均无统计学意义(F分组=0.952,P=0.881;F时间=7.297,P=0.411).空白对照组与生理盐水组兔眼各条眼肌、泪腺、视神经及球周脂肪组织的形态学和超微结构均未发现明显异常,但实验组兔眼光学显微镜下各条眼肌均可见肌横纹结构消失,肌浆网扩张,间隙增宽；泪腺可见腺上皮细胞数量增多,细胞核增大,细胞质混浊、肿胀,嗜酸性增强,腺体数量增加；视神经纤维可见排列紊乱,空泡变性,神经胶质细胞数量减少,细胞核大小不一.透射电子显微镜下实验组兔眼各眼外肌组织结构均可见肌纤维排列紊乱,横纹、明带、暗带部分消失,肌浆网扩张,细胞核呈椭圆形位于肌膜下方；泪腺可见腺上皮细胞肿胀,体积增大,细胞核膜增厚,轻度扭曲,细胞膜水肿,细胞器数目明显增多；视神经纤维髓鞘厚薄不均,轴突与髓鞘间腔隙形成,髓鞘结构紊乱,出现板层分离现象,部分松解、变性.实验组兔眼球周脂肪组织在光学显微镜和透射电子显微镜下均未见明显结构异常.结论球周注射20 mg TA 2次对兔眼眼压无明显影响,但可造成各条眼肌、泪腺、视神经组织形态学和超微结构的损伤. 揹景麯安奈德(TA)在眼科常用于治療葡萄膜炎、糖尿病視網膜病變等眼底疾病,但其對眼週圍正常組織是否有毒性作用尚需進一步研究. 目的探討毬週註射TA對兔眼週圍組織的影響.方法將27隻新西蘭大白兔按隨機數字錶法隨機分為實驗組、生理鹽水組和空白對照組,實驗組于餵養的第5週和第9週毬週註射20 mg TA懸浮液(0.5 ml)各1次,生理鹽水組兔眼分彆註射0.5ml等容量生理鹽水,方法同實驗組,空白對照組兔不給予任何榦預.分彆于註藥前1d及第2次註射後1、2、3箇月以過量痳醉法分彆處死各組實驗兔各3隻,製備兔眼各條眼外肌、毬週脂肪、淚腺及視神經組織標本,行常規囌木精-伊紅染色,分彆在光學顯微鏡和透射電子顯微鏡下觀察上述組織的組織病理學和超微結構改變. 結果註射前及註射後1、2、3箇月各組兔眼的眼壓差異均無統計學意義(F分組=0.952,P=0.881;F時間=7.297,P=0.411).空白對照組與生理鹽水組兔眼各條眼肌、淚腺、視神經及毬週脂肪組織的形態學和超微結構均未髮現明顯異常,但實驗組兔眼光學顯微鏡下各條眼肌均可見肌橫紋結構消失,肌漿網擴張,間隙增寬；淚腺可見腺上皮細胞數量增多,細胞覈增大,細胞質混濁、腫脹,嗜痠性增彊,腺體數量增加；視神經纖維可見排列紊亂,空泡變性,神經膠質細胞數量減少,細胞覈大小不一.透射電子顯微鏡下實驗組兔眼各眼外肌組織結構均可見肌纖維排列紊亂,橫紋、明帶、暗帶部分消失,肌漿網擴張,細胞覈呈橢圓形位于肌膜下方；淚腺可見腺上皮細胞腫脹,體積增大,細胞覈膜增厚,輕度扭麯,細胞膜水腫,細胞器數目明顯增多；視神經纖維髓鞘厚薄不均,軸突與髓鞘間腔隙形成,髓鞘結構紊亂,齣現闆層分離現象,部分鬆解、變性.實驗組兔眼毬週脂肪組織在光學顯微鏡和透射電子顯微鏡下均未見明顯結構異常.結論毬週註射20 mg TA 2次對兔眼眼壓無明顯影響,但可造成各條眼肌、淚腺、視神經組織形態學和超微結構的損傷.
배경 곡안내덕(TA)재안과상용우치료포도막염、당뇨병시망막병변등안저질병,단기대안주위정상조직시부유독성작용상수진일보연구. 목적 탐토구주주사TA대토안주위조직적영향.방법 장27지신서란대백토안수궤수자표법수궤분위실험조、생리염수조화공백대조조,실험조우위양적제5주화제9주구주주사20 mg TA현부액(0.5 ml)각1차,생리염수조토안분별주사0.5ml등용량생리염수,방법동실험조,공백대조조토불급여임하간예.분별우주약전1d급제2차주사후1、2、3개월이과량마취법분별처사각조실험토각3지,제비토안각조안외기、구주지방、루선급시신경조직표본,행상규소목정-이홍염색,분별재광학현미경화투사전자현미경하관찰상술조직적조직병이학화초미결구개변. 결과 주사전급주사후1、2、3개월각조토안적안압차이균무통계학의의(F분조=0.952,P=0.881;F시간=7.297,P=0.411).공백대조조여생리염수조토안각조안기、루선、시신경급구주지방조직적형태학화초미결구균미발현명현이상,단실험조토안광학현미경하각조안기균가견기횡문결구소실,기장망확장,간극증관；루선가견선상피세포수량증다,세포핵증대,세포질혼탁、종창,기산성증강,선체수량증가；시신경섬유가견배렬문란,공포변성,신경효질세포수량감소,세포핵대소불일.투사전자현미경하실험조토안각안외기조직결구균가견기섬유배렬문란,횡문、명대、암대부분소실,기장망확장,세포핵정타원형위우기막하방；루선가견선상피세포종창,체적증대,세포핵막증후,경도뉴곡,세포막수종,세포기수목명현증다；시신경섬유수초후박불균,축돌여수초간강극형성,수초결구문란,출현판층분리현상,부분송해、변성.실험조토안구주지방조직재광학현미경화투사전자현미경하균미견명현결구이상.결론 구주주사20 mg TA 2차대토안안압무명현영향,단가조성각조안기、루선、시신경조직형태학화초미결구적손상.
Background Triamcinolone acetonide (TA) is often used in the treatment of uveitis and fundus disease,but whether it has toxic effect to normal tissue around eyes is unclear.Objective The aim of this study was to explore the adverse and toxic effects of TA on the periorbitally normal tissue following the periocular injection.Methods Twenty-seven New Zealand albino rabbits were randomly divided into experimental group,normal saline solution group and blank control group.TA was periocularly injected twice (20 mg for each) at 1-month interval in the rabbits of the experimental group,and 0.5 ml normal saline solution was used in the same way in the rabbits of the normal saline solution group.Not any drug was used in the blank group.The rabbits were sacrificed 1 month and 2 months,3 months after the secondary injection.For the preparation of the specimens of extraocular muscles,peribulbus adipose tissue,lacrimal gland and optic nerve.Hematoxylin and eosin staining of the specimens was performed to examine the the pathological change under the optical microscope,and the ultrastructural of peribulbus tissues was observed under the transmission electron microscope.Results No statistically significant change was found in IOP among various time points and groups (Fgroup =0.952,P =0.881 ; Ftime =7.297,P =0.411).The hyphological structures and ultrastructure of extraocular muscles,peribulbus adipose tissue,lacrimal gland and optic nerve were normal in the rabbits of the normal saline solution group and the blank control group.However,the optical microscopy showed varying degrees of atrophy or dissolving in the extraocular muscle fibers,the increase of glandular epithelial cells and enlargement of nuclei in the lacrimal gland as well as visible disorder arrangement of nerve fibers,vacuoles degeneration and the decrease of glial cells in optial nerve tissue in the rabbits of the experimental group from 1 month though 3 months after the secondary injection.Under the transmission electron microscope,the muscle stripes,bright band and dark band were incompletely disappeared,and expansionary sarcoplasmic reticulum and oval nucleus at the inferior to sarolemma were seen in the extraocular muscles.In addition,swelling lacrimal gland epithelial cells,thickening nuclear membrane and more organelles were exhibited in the lacrimal gland.In the optic never tissue,uneven myelin,space between axons and myelin,lamellar separation and degeneration also were revealed in the rabbits of the experimental group after injection of TA.Peribulbus adipose tissue was near normal both by optical microscope and transmission electron microscope in the experimental group.Conclusions The periocular injection of TA dose not elevated the IOP.However,it will result in the histogical and ultrastructural damages of extraocular muscles,lacrimal gland and optic nerve.