中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2014年
2期
81-85
,共5页
姚晓明%黎明%曹端荣%诸凤娇
姚曉明%黎明%曹耑榮%諸鳳嬌
요효명%려명%조단영%제봉교
贝伐单抗%新生血管%化学烧伤%共焦显微镜
貝伐單抗%新生血管%化學燒傷%共焦顯微鏡
패벌단항%신생혈관%화학소상%공초현미경
Bevacizumab%Neovascularization%chemical burn%Microscope,confocal,corneal
目的 观察碱烧伤后不同时间结膜下注射贝伐单抗(Bevacizumab)角膜新生血管(CNV)的形成与转归.方法 新西兰白兔54只,制成单眼碱烧伤模型,随机分为3组,每组18只眼,A组碱烧伤后结膜下立即注射贝伐单抗2.5 mg(0.1 ml),B组碱烧伤后3d结膜下注射贝伐单抗2.5 mg(0.1 ml),C组结膜下注射生理盐水0.1ml,为对照组.共观察28 d.裂隙灯显微镜下观察角膜新生血管生长情况,行眼前段照相并计算其面积,伤后7、14、28 d各组随机取6例角膜行共焦显微镜检查,观察角膜组织炎性细胞浸润情况及角膜新生血管形态学变化.结果 A、B及C组角膜新生血管开始出现的时间分别为(5.9+0.8)d、(3.5+0.6)d及(3.4+1.1)d,其中A组明显较C组延长(P＜0.05),B组与C组差异无统计学意义(P =0.068).伤后各时间点A、B组角膜新生血管的生长面积均明显较C组减少(P＜0.05),A组与B组角膜新生血管面积比较,差异有统计学意义(P＜0.05).共焦显微镜检查可见C组烧伤区大量炎性细胞浸润及新生血管形成,而A组角膜炎性细胞较少,烧伤区无新生血管形成,B组见少量新生血管侵入烧伤区.3组基质层均可见纤维及瘢痕组织增生,其中治疗组纤维增生程度与瘢痕组织均较对照组轻.结论 结膜下注射贝伐单抗可抑制角膜炎性细胞形成,改善损伤角膜基质,促进角膜愈合,从而减少碱烧伤引起的角膜新生血管的生长,在早期注射能取得更好的疗效.
目的 觀察堿燒傷後不同時間結膜下註射貝伐單抗(Bevacizumab)角膜新生血管(CNV)的形成與轉歸.方法 新西蘭白兔54隻,製成單眼堿燒傷模型,隨機分為3組,每組18隻眼,A組堿燒傷後結膜下立即註射貝伐單抗2.5 mg(0.1 ml),B組堿燒傷後3d結膜下註射貝伐單抗2.5 mg(0.1 ml),C組結膜下註射生理鹽水0.1ml,為對照組.共觀察28 d.裂隙燈顯微鏡下觀察角膜新生血管生長情況,行眼前段照相併計算其麵積,傷後7、14、28 d各組隨機取6例角膜行共焦顯微鏡檢查,觀察角膜組織炎性細胞浸潤情況及角膜新生血管形態學變化.結果 A、B及C組角膜新生血管開始齣現的時間分彆為(5.9+0.8)d、(3.5+0.6)d及(3.4+1.1)d,其中A組明顯較C組延長(P＜0.05),B組與C組差異無統計學意義(P =0.068).傷後各時間點A、B組角膜新生血管的生長麵積均明顯較C組減少(P＜0.05),A組與B組角膜新生血管麵積比較,差異有統計學意義(P＜0.05).共焦顯微鏡檢查可見C組燒傷區大量炎性細胞浸潤及新生血管形成,而A組角膜炎性細胞較少,燒傷區無新生血管形成,B組見少量新生血管侵入燒傷區.3組基質層均可見纖維及瘢痕組織增生,其中治療組纖維增生程度與瘢痕組織均較對照組輕.結論 結膜下註射貝伐單抗可抑製角膜炎性細胞形成,改善損傷角膜基質,促進角膜愈閤,從而減少堿燒傷引起的角膜新生血管的生長,在早期註射能取得更好的療效.
목적 관찰감소상후불동시간결막하주사패벌단항(Bevacizumab)각막신생혈관(CNV)적형성여전귀.방법 신서란백토54지,제성단안감소상모형,수궤분위3조,매조18지안,A조감소상후결막하립즉주사패벌단항2.5 mg(0.1 ml),B조감소상후3d결막하주사패벌단항2.5 mg(0.1 ml),C조결막하주사생리염수0.1ml,위대조조.공관찰28 d.렬극등현미경하관찰각막신생혈관생장정황,행안전단조상병계산기면적,상후7、14、28 d각조수궤취6례각막행공초현미경검사,관찰각막조직염성세포침윤정황급각막신생혈관형태학변화.결과 A、B급C조각막신생혈관개시출현적시간분별위(5.9+0.8)d、(3.5+0.6)d급(3.4+1.1)d,기중A조명현교C조연장(P＜0.05),B조여C조차이무통계학의의(P =0.068).상후각시간점A、B조각막신생혈관적생장면적균명현교C조감소(P＜0.05),A조여B조각막신생혈관면적비교,차이유통계학의의(P＜0.05).공초현미경검사가견C조소상구대량염성세포침윤급신생혈관형성,이A조각막염성세포교소,소상구무신생혈관형성,B조견소량신생혈관침입소상구.3조기질층균가견섬유급반흔조직증생,기중치료조섬유증생정도여반흔조직균교대조조경.결론 결막하주사패벌단항가억제각막염성세포형성,개선손상각막기질,촉진각막유합,종이감소감소상인기적각막신생혈관적생장,재조기주사능취득경호적료효.
Objective To evaluate the effect of subconjunctival bevacizumab on experimental corneal neovascularization (NV) in rabbits at different time points.Methods The right eyes of 54 white New Zealand rabbits were chemically burned with 1mol/L NaOH and randomly divided into three groups.Eighteen eyes (group A) received subconjunctival injection of bevacizumab (2.5 mg,0.1 mL) immediately after burn.Eighteen eyes (group B) received subconjunctival injection of bevacizumab (2.5 mg,0.1 mL) 3 days after burn with subconjunctival injection of normal saline.Group C was the control group.The angiogenesis and inhibition of corneal neovascularization were detected respectively by measuring the length and area of NV under slit lamp microscopy everyday.Corneal confocal microscope was used to detect the cornea at 7 days,14 days and 28 days after corneal burn.Results The occurrence time of corneal NV was (5.9± 0.8) d,(3.5 ± 0.6) d and (3.4 ± 1.1) d in group A,B and C.Compared with the group C,the corneal NV occurrence was significantly delayed in group A and B.No significant difference in the occurrence time of corneal NV was found between group B and group C (P =0.068).The corneal NV areas of group A and group B were smaller than the group C at different time points,and the difference has statistical significance (P ＜ 0.05).The degrees of fibrous structures and scars in corneal stroma of treatment groups were slightly less than the group C.Conclusion Subconjunctival injection of bevacizumab can sufficiently decrease the number of inflammatory cells in the cornea after chemical burn,improve the microenvironment of injured corneal stroma and accelerate the cornea wound healing,which eventually inhibit the growth of corneal NV.The anti-neovascular effect of bevacizumab is better if the injection is performed at the early stage of corneal angiogenesis.
