吲哚青绿血管造影在老年性黄斑变性中的应用与研究

目的:探讨吲哚青绿血管造影(ICGA)在老年黄斑变性(AMD)脉络膜循环中的应用与对比研究.方法:采用日本Topcon TRC - 50IX眼底照相机+ICG造影仪、SONY图像处理系统、KODAY - 8650打印系统,对86例AMD患者的86眼以及正常对照者27例35眼进行ICGA检查,对比观察黄斑部脉络膜血管充盈时间(CFP)及脉络膜充盈情况.结果:渗出型AMD较正常对照组、萎缩型AMD及黄斑玻璃疣眼的CFP均显著延长(P＜0.05).86例AMD患眼中有40眼ICGA有局限性或广泛性脉络膜充盈不良或延迟,其中渗出型AMD 24眼,萎缩型AMD12眼,黄斑玻璃疣4眼.结论:AMD中黄斑玻璃疣患者黄斑部CFP延长及脉络膜血管充盈异常.     

1型与2型糖尿病大鼠周围神经病变的比较

目的观察链脲佐菌素(STZ)诱导的1型与2型糖尿病大鼠周围神经病变的区别。方法 SD大鼠分组,每组各10只,腹腔注射STZ建立1型糖尿病(T1DM)模型;高脂高糖饲养6周后按体质量35 mg/kg单次腹腔注射STZ建立2型糖尿病(T2DM)模型;设立正常对照(Con)组。检测不同时间点大鼠的体质量、血糖水平。成模8周后,电子Von Frey仪检测机械痛阈值,热水甩尾试验检测甩尾潜伏期,并取坐骨神经进行病理形态学检查。结果成模后第1、8周,与对照组及T2DM组相比,T1DM组大鼠的体质量显著下降(P0. 01); T1DM组与T2DM组的血糖均显著高于对照组(P0. 01); DM组的甩尾潜伏期均较对照组延长(P0. 01),T2DM组较T1DM组延长更显著(P0. 05)。DM组的机械痛阈值均较对照组显著降低(P0. 01),T2DM组较T1DM组降低更明显(P0. 01); DM组大鼠的坐骨神经有髓神经纤维排列紊乱,轴索肿胀或皱缩,髓鞘密度不均匀,空泡变性,部分神经纤维髓鞘脱失; T2DM组的神经损害程度较T1DM严重。结论 STZ诱导的2型糖尿病大鼠的周围神经病变程度严重于1型糖尿病大鼠。     

糖尿病大鼠早期玻璃体中IRBP含量的变化

目的观察糖尿病大鼠早期玻璃体中感光细胞间维生素A类结合蛋白(interphotoreceptor retinoid-binding protein,IRBP)含量的变化。方法 SD雄性大鼠40只,分为正常对照组和糖尿病组,每组20只,糖尿病模型通过链脲佐菌素(streptozocin,STZ)60mg.kg-1左下腹腔一次性注射诱导,模型成功后饲养4周,正常对照组和糖尿病组分别随机选取10只(20眼)处死摘除眼球,取玻璃体ELISA法检测IRBP的含量,选取5只(10眼)做石蜡切片观察视网膜大体结构,另5只(10眼)做电镜标本观察超微结构。结果正常对照组玻璃体中IRBP含量为(122.16±7.88)pg.L-1,糖尿病组为(90.53±7.60)pg.L-1,2组间差异有统计学意义(t=12.92,P<0.05)。光镜下2组视网膜结构无明显变化,电镜下观察发现糖尿病组部分视细胞外节膜盘模糊不清,结构紊乱,间隙略有扩大。结论糖尿病大鼠玻璃体中IRBP含量降低,可能影响其在视觉周期中发挥作用,从而可能在糖尿病视网膜病变的发生发展中起一定的作用。     

息肉状脉络膜血管病变在眼底FFA 与ICGA中特征分析

目的 探讨息肉状脉络膜血管病变(PCV)眼底荧光素血管造影(FFA)和吲哚青绿血管造影(ICGA)同步检查的影像学特征及其临床意义.方法 选取62例患者(75只眼)进行眼底彩色照相、FFA 和ICGA同步检查,对黄斑部视网膜下出血病灶其形态及特征做以对比分析.结果 FFA图像显示:PCV75只眼中斑块样视网膜下出血48只眼,占64.0%;伴浆液性视网膜色素上皮(RPED)脱离12只眼,占16.0%;出血性RPED8只眼,占10.7%;脉络膜血管网及息肉样结节7只眼,占9.4%,早期即出现荧光素渗漏并逐渐增强,CNV末端膨大处出现点状高荧光.ICGA图像显示:75只患眼中72只眼呈"蘑菇"状或"树枝"状异常扩张,其血管网末端多个息肉样膨大与彩色照相所见的结节样病变部位吻合.结论 FFA和ICGA同步检查,不但对PCV患者病灶其形态及特征作出对比分析,ICGA检查还能提高PCV视网膜下脉络膜新生血管膜(CNV)的检出率,同时提高PCV患者激光光凝的可能性,而FFA对评估PCV 视网膜下出血及出血性或浆液性视网膜色素上皮脱离、脉络膜血管网及息肉状结节则均有较好的效果.

Abstract：

Objective To observe on fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) in polypoidal choroidal vasculopathy (PCV), and sync examine of its image features and clinical meaning. Methods Sixty-two patients (75 eyes) applied fundus camera, FFA and ICGA synchronous examination, do comparison analysis in macular sub-retinal hemorrhage shape and area. Results FFA image in 75 PCV patients showed 48 eyes (64.0%) with plaque sub-retinal hemorrhage, 12 eyes (16.0%) accompanied with retinal pigment epithelial detachments (RPED), 8 eyes (10.7%) with bleeding RPED, 7 eyes (9.4%) with choroid blood vessel net and polypoidal node of early stage flouresence leakage. ICGA showed that 75 eyes had abnormal choroid blood vessel net extension, 72 with "mushroom" shape or "tree-branch" shape with more polypoidal enlarge in the end which was the same as seen under ophthalmoscope. Conclusions It proves that FFA and ICGA synchronous examination, not only can be used for PCV patients' tissue shape and area comparison analysis, but also improves the finding rate of the choroidal neovascularization (CNV) in PCV, increases the feasibility of photocoagulation to PCV. FFA gives good result to evaluate PCV sub-retinal hemorrhage.     

巩膜扣带术治疗周边裂孔继发黄斑裂孔视网膜脱离的临床观察

目的 观察巩膜扣带术治疗视网膜周边裂孔继发黄斑裂孔视网膜脱离的手术疗效.方法 患者18例(18只眼),常规检眼镜下检查确诊为视网膜脱离,均为周边裂孔的視网膜脱离继发黄斑裂孔.治疗在局麻下行常规視网膜脱离复位术,冷凝周边裂孔,14例采用环扎带,周边裂孔位置外加压,4例单纯外加压.12例球内注入0.5~0.7 ml SF6...     

复方公英片中咖啡酸的质量标准研究

目的建立复方公英片中咖啡酸的含量测定方法。方法采用高效液相色谱法测定制剂中咖啡酸的含量,色谱条件:C18柱,流动相:流动相以甲醇为流动相A,以0.1%磷酸溶液为流动相B,依法进行梯度洗脱,检测波长为323nm。结果咖啡酸在(0.01281~0.3331)μg范围内线性关系良好。加样回收率为106.3%,RSD为0.88%。结论方法简便准确,重现性好,可用于复方公英片的质量控制。     

鼠神经生长因子对早期糖尿病大鼠玻璃体中感光细胞间维生素A类结合蛋白含量的影响

Objective To observe the effect of intravitreal injection of mouse nerve growth factor (NGF)on interphotoreceptor retinoid-binding protein(IRBP)in the vitreous of diabetic rats at early stages.Methods Ninety-six male Sprague Dawley(SD)rats were divided into control group(group A,24 rats)and experimental group(72 rats).The rats in experimental group were induced with streptozotocin injection for diabetic retinopathy model,and then randomly divided into positive control group(group B),normal saline group(group C)and NGF group(group D),24 rats in each group.The rats in the group A and B were not intervened.The rats were received intravitreal injection with 4μl normal saline(group C)or 4 μl(0.5 μg/μ1)NGF(group D).At 2,4,6 and 8 weeks after injection,IRBP levels were detected bv enzvmelinked immunosorbent assay(ELISA);hematoxylin-eosin(HE)staining and light microscope were used to observe the morphological changes of the retina;transmission electron microscope was used to observe the retinal uhrastructure.Results At 2 weeks after injection,there was no significant difference in IRBP expression between group A,B,C and D(F=2.833,P=0.052).At 4,6,8 weeks after injection,the differences of IRBP expression between group A,B,C and D were significant(F=22.252,108.459,105.726;P=0.000).At different time points after injection,there was no significant difference in IRBP expression of group A(F=1.462,P=0.241),but there were significant differences in IRBP expression of group B.C and D(F=150.98,63.519,64.604;P=0.000).Light microscope found that the retinal structure was clear in group A and in group B,C,D at 2,4 weeks after injection;the retinal thickness were thinner in group B,C,D at 8 weeks after injection.Transmission electron microscope displayed that the structure of rod outer segments was clear in group A and in group B,C,D at 2 weeks after injection;partly unclear structure of rod outer segments and slightly enlarged gap were observed in group B,C,D at 4,8Weeks after injection.Conclusion Intravitreal injection with NGF can stabilize the IRBP expression in the vitreous of diabetic rats at early stages effectively.     

玻璃体腔注射鼠神经生长因子对糖尿病大鼠视网膜结构的影响

目的观察玻璃体腔注射鼠神经生长因子对糖尿病大鼠视网膜结构的影响。方法选取SD雄性大鼠36只,随机分为正常对照组(A组)12只和糖尿病组24只,糖尿病动物模型通过链脲佐菌素60mg.kg-1左下腹腔一次性注射诱导,模型成功后随机分为玻璃体腔生理盐水注射组(B组)12只和鼠神经生长因子注射组(C组)12只,B组玻璃体腔注射生理盐水每次4μL,每周1次;C组注射鼠神经生长因子每次4μL(0.5g.L-1),每周1次。A组、B组和C组分别在4周和8周时随机选取3只(6眼)处死摘除眼球做石蜡切片观察视网膜光镜结构及3只(6眼)做电镜标本观察视网膜超微结构。结果各组大鼠血糖值:4周时A组(6.42±0.43)mmol.L-1、B组(30.07±3.62)mmol.L-1、C组(29.34±4.56)mmol.L-1,A组与B、C组之间差异均有统计学意义(均为P<0.05),B组与C组之间差异无统计学意义(P>0.05);8周时A组(5.78±0.47)mmol.L-1、B组(29.81±5.58)mmol.L-1、C组(31.26±4.03)mmol.L-1,A组与B、C组之间差异均有统计学意义(均为P<0.05),B组与C组之间差异无统计学意义(P>0.05)。视网膜光镜观察结果:A组视网膜各层结构清晰,排列整齐;B组4周时,视网膜结构改变不明显,8周时视网膜变薄,内外颗粒层变薄疏松,排列紊乱,神经节细胞减少;C组4周、8周时无明显改变。视网膜电镜观察结果:B组4周时视细胞外节膜盘模糊不清,膜盘间隙扩大,8周时视细胞膜盘间隙进一步扩大,排列紊乱,局部断裂,线粒体肿胀,并可见空泡变;C组较B组结构规则,4周时未见明显改变,8周时外节膜盘部分模糊,排列尚规则,间隙轻度扩大。结论玻璃体腔注射鼠神经生长因子对糖尿病大鼠视网膜结构具有明显保护作用。     

使用气垫床消灭褥疮94例临床分析

对94例昏迷、危重及瘫痪的老年病人在入院时给予睡气垫床,观察其褥疮发生情况,其结果是使用气垫床,可使患者卧位舒服,体压分散,皮肤干燥,加上护士主动积极的进行基础护理,无一例发生褥疮,从而减少病人的痛苦和护理工作量,得到患者及家属的好评,值得推广。     

半剂量光动力疗法治疗中心性浆液性脉络膜视网膜病变观察

目的 观察半剂量光动力疗法治疗中心性浆液性脉络膜视网膜病变的疗效及安全性.方法 2008年4月至2010年9月在门诊确诊的中心性浆液性脉络膜视网膜病变患者24例24只眼,其中男20例20只眼,女4例4只眼,年龄27～48岁,平均36.8岁,最佳矫正视力0.2～0.5,平均0.42,行半剂量光动力疗法治疗,随访按照术后l周、1月、3月、6月、9月进行,随访时间3～8月,平均4.8月,随访期间分别行裂隙灯眼底镜检查、最佳矫正视力、OCT及FFA检查,观察治疗的有效性和安全性.结果 术后l周,OCT显示4只眼视网膜下积液吸收,19只眼视网膜下积液部分吸收,1只眼视网膜下积液无明显变化;术后1月,OCT显示18只眼视网膜下积液吸收,5只眼视网膜下积液部分吸收,1只眼视网膜下积液无明显变化;FFA显示19只眼荧光渗漏消失,4只眼渗漏减轻,1只眼渗漏无明显变化.术后3月,OCT最示23只眼视网膜下积液吸收,1只眼视网膜下积液部分吸收;FFA显示23只眼荧光渗漏消失,1只眼渗漏减轻.对渗漏未完全消失眼再次行半剂量光动力疗法,1月后OCT显示视网膜下积液吸收,FFA显示荧光渗漏消失呈荧光着染.末次随访时最佳矫正视力0.5～1.0,提高2行以上者19只眼.结论 半剂量光动力疗法治疗中心性浆液性脉络膜视网膜病变疗效显著,安全.