| 大蒜素对青光眼滤过术后兔眼滤过泡瘢痕化的抑制作用 |
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| 引用本文： | 吕玉娟,车慧欣,于利. 大蒜素对青光眼滤过术后兔眼滤过泡瘢痕化的抑制作用[J]. 眼科新进展, 2018, 0(7): 625-629. DOI: 10.13389/j.cnki.rao.2018.0147 |
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| 作者姓名： | 吕玉娟 车慧欣 于利 |
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| 作者单位： | 121000 辽宁省锦州市，锦州医科大学附属三院眼科 |
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| 摘 要： | 目的 探讨大蒜素对青光眼滤过术后兔眼滤过泡瘢痕化的抑制作用。方法 取健康同品系大白兔36只72眼，随机分成大蒜素组、丝裂霉素组、生理盐水组，每组24眼，均行小梁切除术。各组分别将浸有大蒜素（1.112 kg·L-1）、丝裂霉素（0.3 g·L-1）、生理盐水的棉片放置于结膜囊-巩膜瓣-巩膜床层间，5 min后完全取出棉片，充分冲洗。术后各组分别测眼压，观察滤过泡的形态，计算滤过泡面积并行眼前节照相。术后28 d处死各组兔，行HE染色及Masson染色对比观察各组结膜下瘢痕增生情况。结果 术后第1天3组眼压较术前降低，随后眼压逐渐回升。各组不同时间内的眼压差异均有统计学意义（均为P<0.05）。术前及术后1 d、4 d、7 d、14 d两两比较中除术后4 d丝裂霉素组眼压比生理盐水组低（P=0.025）外，其余各时间眼压两两比较，差异均无统计学意义（均为P>0.05）。术后28 d生理盐水组眼压高于大蒜素组和丝裂霉素组（均为P<0.05），大蒜素组和丝裂霉素组相比差异无统计学意义（P>0.05）。术后1~4 d 3组滤过泡面积分别达到最大值，之后滤过泡面积逐渐减小。统计学分析结果示3组滤过泡面积减小量在不同的时间点上是不同的（P<0.05）。不同分组之间的滤过泡面积减小量有明显差异（P<0.05）。术后大蒜素组与丝裂霉素组滤过泡面积减小幅度相同，差异无统计学意义（P>0.05），生理盐水组比大蒜素组和丝裂霉素组的滤过泡面积减小速度更快，差异均有统计学意义（均为P<0.05）。术后28 d各组结膜上皮均完整无破损及增厚。HE染色显示大蒜素组和丝裂霉素组兔眼瘢痕组织较少，滤过通道较宽；生理盐水组兔眼瘢痕组织较多，滤过通道狭窄。Masson染色显示大蒜素组和丝裂霉素组可见少量炎性细胞浸润，滤过区成纤维细胞及胶原纤维疏松，结膜及巩膜间隙较宽；生理盐水组可见大量炎性细胞浸润，滤过区成纤维细胞及胶原纤维致密，结膜及巩膜间隙较窄，形成大量的瘢痕组织。术后 28 d 根据胶原纤维占整个结膜和巩膜空间总面积的百分比分析，大蒜素组［（58.13±5.33）%］比丝裂霉素组［（62.42±2.95）%］胶原纤维少，差异有统计学意义（P<0.05），大蒜素组和丝裂霉素组均比生理盐水组［（89.75±3.91）%］胶原纤维少，差异均有统计学意义（均为P<0.05）。结论 大蒜素和丝裂霉素有着相同的功效，可通过抑制小梁切除术后滤过泡瘢痕化，对功能性滤过泡有一定的维持作用。
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| 关 键 词： | 大蒜素 小梁滤过术 瘢痕形成 青光眼 结膜 兔 |
Effects of allicin on anti-scarring of filtering bleb after glaucoma filtering surgery in rabbit eyes |
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| LV Yu-Juan,CHE Hui-Xin,YU Li. Effects of allicin on anti-scarring of filtering bleb after glaucoma filtering surgery in rabbit eyes[J]. Recent Advances in Ophthalmology, 2018, 0(7): 625-629. DOI: 10.13389/j.cnki.rao.2018.0147 |
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| Authors: | LV Yu-Juan CHE Hui-Xin YU Li |
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| Affiliation: | Ophthalmology，the Third Affiliated Hospital of Jinzhou Medical University，Jinzhou 121000，Liaoning Province，China |
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| Abstract: | Objective To investigate the effect of allicin on the inhibition of subconjunctivalscar formation after trabeculectomy in rabbits.Methods Together 36 healthy rabbits of the same strain were randomly divided into three groups:allicingroup，mitomycin group and saline group.Trabeculectomy was performed on all 24 eyes of each group.During the operation，the cotton slices soaked respectively in allicin（1.112 kg·L-1），mitomycin（0.3 g·L-1） and saline were placed between conjunctival sac and scleral flap for 5 minutes，then the cotton was removed completely and the eye was rinsed thoroughly.After the operation，the intraocular pressure of each group was measured and the filter bleb was observed and measured to calculate the filter bleb area and anterior segment photography was used.Each group of rabbits was sacrificed on day 28 after surgery，and HE staining and Masson staining were used to observe the degree of scar hyperplasia under the conjunctiva.Results On the first day after the operation，the eye pressure of each group was lower than before operation，and then gradually rose again.The intraocular pressure of each group at different time points was statistically significant （all P<0.05）.On the 4th day after the operation，the intraocular pressure of the mitomycin group was lower than that of the saline group （P=0.025）.As for the rest time-point of the preoperative and postoperative 1 day，4 days，7days，14 days，there were no significant differences in pairwise comparison （all P>0.05） in terms of intraocular pressure.On the 28th day after the operation，the intraocular pressure of the saline group was higher than that of the allicin and mitomycin groups （all P<0.05） and there was no significant difference between the allicin group and the mitomycin group （P>0.05）.From the first day to the fourth day after the operation，the area of the filter bleb reached its maximum，and then the area of the filtered bubbles gradually decreased.Statistical analysis showed that the reduction filtered bubbles area of three groups at different times was different （P<0.05）.There was a significant difference in the reduction of filtering bleb between different groups （P<0.05）.The reduced extent of filtering blebs in the allicin group and mitomycin group was the same after surgery，and there was no significant difference （P>0.05）.The reduced rate of filtration bubbles in saline group was faster than that of allicin group and mitomycin group，and the differences were statistically significant （all P<0.05）.On the 28th day after the operation，the conjunctival epithelium was intact without any damage or thickening.HE staining showed that the allicin group and mitomycin group had less scar tissue and wider filtration channels in rabbit.Rabbit eyes in the saline group had more scar tissue narrow filtration channels.Masson staining revealed a small amount of inflammatory cell infiltration in the allicin group and the mitomycin group，fibroblasts and collagen fibers in the filtration area were loose，and the conjunctiva and scleral space were wide.In the saline group，a large number of inflammatory cells infiltrated，fibroblasts and collagen fibers in the filtration area were dense，the conjunctival and scleral spaces were narrow，and scar tissue was formed.Based on the percentage of collagen fibers in the total area of conjunctiva and sclera space on the 28th day after surgery，the allicin group ［（58.13±5.33）%］ had less collagen fibers than the mitomycin group ［（62.42±2.95）%］，the difference was statistically significant （P<0.05）.The allicin group and mitomycin group had less collagen fibers than the normal saline group［（89.75±3.91）%］ （all P<0.05）.Conclusion Allicin and mitomycin have the same effect.They can both maintain the functional filtration blebs by inhibiting the bleb scars after Trabeculectomy. |
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| Keywords: | allicin trabeculectomy scar formation glaucoma conjunctival rabbits |
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