国产与进口盐酸哌唑嗪对家兔眼压及房水葡萄膜巩膜途径影响的比较

目的　通过兔眼局部分别滴用国产和进口选择性α1受体阻断剂盐酸哌唑嗪( prazosin ,PZ) ,比较其对眼压以及房水葡萄膜巩膜途径形态的影响 ,评估国产PZ的可用性及有效性。方法　正常家兔随机分为 1g·L-1国产PZ组、1g·L-1进口PZ组及生理盐水对照组 ,各组均单侧滴眼 ,观测处理眼及对侧眼在不同时间点眼压的变化。前房注入微量示踪剂异硫氰酸荧光素牛血清白蛋白 (fluoresceinisothiocyanate bovineserumalbumin ,FITC BSA)于PZ滴眼后 2、4、6、8、10h各处死家兔 2只 ,摘除双侧眼球作冰冻切片 ,荧光显微镜下观察并确定睫状体、脉络膜上腔、前后巩膜和脉络膜的荧光强度等级。光镜下观察其组织结构变化。结果　国产PZ及进口PZ与对照组相比 ,均可显著降低双眼眼压 ;国产PZ滴眼后处理眼眼压最大下降幅度为 9.36mmHg( 1kPa =7.5mmHg) ,对侧眼为5 .73mmHg ;进口PZ滴眼后处理眼眼压最大下降幅度为 8.92mmHg ,对侧眼为6 .92mmHg。 2组间相比 ,尽管各时间点降眼压幅度不同 ,但降眼压效果无显著性差异。PZ滴眼后葡萄膜巩膜途径各部位的荧光强度均比对照组显著增强 ,光镜观察发现睫状肌细胞间隙扩大。结论　国产PZ滴眼后通过促进房水从葡萄膜巩膜途径排出可使眼压下降 ,与进口PZ房水排出途径基本一致。国产PZ可以替代     

盐酸哌唑嗪点眼房水葡萄膜巩膜途径的形态观察

目的观察兔眼房水葡萄膜巩膜途径的形态，探讨选择性α１受体阻断剂盐酸哌唑嗪（ｐｒａｚｏｓｉｎ，ＰＺ）点眼对该途径的形态学影响。方法前房注入微量示踪剂异硫氰酸荧光素牛血清白蛋白（ｆｌｕｏｒｅｓｃｅｉｎｉｓｏｔｈｉｏｃｙａｎａｔｅ－ｂｏｖｉｎｅｓｅｒｕｍａｌｂｕｍｉｎ，ＦＩＴＣ－ＢＳＡ）于ＰＺ点眼后２，４，６，８，１０，１２ｈ各处死家兔２只，摘除双侧眼球作冰冻切片，荧光显微镜下观察并确定睫状体、脉络膜上腔、前后巩膜和脉络膜的荧光强度等级。光镜下观察其组织结构变化。结果ＰＺ点眼后眼压出现有统计学意义的下降。ＰＺ点眼后葡萄膜巩膜途径各部位的荧光强度均比对照组显著增强，光镜观察仅见ＰＺ组睫状肌细胞间隙扩大。结论ＰＺ点眼可使眼压下降，点眼后促进房水从葡萄膜巩膜途径排出，房水由睫状肌细胞间隙到脉络膜上腔后，主要经前巩膜排出，后巩膜及脉络膜排出较少。     

哌唑嗪点眼对脱交感兔眼葡萄膜巩膜房水流出量的影响

目的　探讨哌唑嗪（ＰＺ） 对脱交感眼的降眼压机理。 方法　制作家兔单侧颈上交感神经节切除模型,交感神经节切除侧之兔眼点用０ ．１ ％ ＰＺ,用示踪剂异硫氰酸荧光素牛血清白蛋白（ＦＩＴＣＢＳＡ） 对正常对照组和脱交感组（ＳＣＧ 组）兔眼进行前房灌注,测定葡萄膜巩膜房水流出量。 结果　脱交感眼葡萄膜巩膜房水流出量为（０ ．２４５ ±０ ．００９）μｌ／ｍｉｎ ,比正常对照组显著增加（ Ｐ＜ ０ ．０１） 。 结论　葡萄膜巩膜途径房水排出增加是脱交感眼ＰＺ 降眼压的机理     

盐酸哌唑嗪点眼对葡萄膜巩膜房水流出量的影响

目的探讨盐酸哌唑嗪（ＰＺ）点眼对葡萄膜巩膜房水流出量的影响。方法用示踪剂异硫氰酸荧光素牛血清白蛋白（ＦＩＴＣＢＳＡ）对兔眼进行前房灌注，测定对照组和ＰＺ点眼组双眼前葡萄膜、前巩膜、后葡萄膜、后巩膜、视网膜和残余液体的前房水再现量，计算葡萄膜巩膜流出量。结果ＰＺ组双眼葡萄膜巩膜流出量显著高于对照组，ＰＺ点眼侧显著高于对侧眼。对照组和ＰＺ组双眼的前房水再现量均以前葡萄膜、前巩膜和残余液体为多。结论家兔ＰＺ点眼后增加葡萄膜巩膜途径房水流出量，房水主要由前巩膜排出。科     

匹罗卡品对兔眼葡萄膜巩膜途径作用的形态学研究

目的：从形态学方面探讨匹罗卡品对兔眼葡萄膜巩膜途径的作用。方法：通过前房内注入微量示踪剂异硫氰酸荧光素牛血清白蛋白（Fluorescein isothiiocyanate-bovine serum albumin,FITC-BSA),匹罗卡品点眼后2,4,6,8,10和12h各处死家兔2只,摘除眼球作冰冻切片,于荧光显微镜下观察并确定睫状体、脉张膜上腔、前、后巩膜和脉络膜的荧光强度等级,并于光镜下观察其组织结构改变。结果：匹罗卡品点眼后眼压下降,点眼后睫状体、脉络膜上腔和前巩膜荧光强度均显著减弱,后巩膜、脉络膜无明显变化。光镜观察见睫状肌细胞间隙缩小。结论：匹罗卡品通过收缩睫状肌而减少房水从葡萄膜巩膜途径排出。     

眼调节对葡萄膜巩膜房水外流途径影响的形态学观察

目的　通过形态学观察探讨眼调节对葡萄膜巩膜房水外流途径的影响。方法　14只健康日本大耳白兔,10只（20眼）用于荧光显微镜观察,4只（8眼）用于光镜观察,按用药方法不同各分为调节状态组和非调节状态组。所有白兔双眼分别采用5 g·L^-1硝酸毛果芸香碱滴眼液和10 g·L^-1盐酸环喷托酯滴眼液模拟眼调节态和非调节态,测量滴眼前及末次滴眼后30 min的眼压,于滴眼后30 min将5 μL异硫氰酸荧光素标记牛血清白蛋白（FITC-BSA）注入前房,于前房注射后0.5 h、1.5 h、2.5 h、3.5 h、4.5 h各处死2只白兔,摘取双眼作冰冻切片,于荧光显微镜下观察调节态和非调节态葡萄膜巩膜途径的房水荧光强度及其分布形态;于滴眼后30 min处死4只白兔,摘取双眼通过HE染色和抗平滑肌抗体染色在普通光镜下观察兔眼睫状肌形态、肌间隙。结果　调节状态组基线眼压（19.13±1.75）mmHg（1 kPa=7.5 mmHg),毛果芸香碱模拟眼调节后眼压下降,滴眼后眼压为（16.56±1.67）mmHg,差异有统计学意义（t=9.37,P=0.00)。调节状态组睫状体、脉络膜上腔和前巩膜荧光强度较非调节状态组均显著减弱（均为P<0.05）,而两组间后巩膜、脉络膜差异均无统计学意义（均为P＞0.05）。光镜观察见非调节状态组放射肌区域有明显肌间隙,而在调节状态组未发现此间隙。结论　眼调节可通过收缩睫状肌从而减少房水从葡萄膜巩膜房水外流道排出。     

葡萄膜巩膜途径降眼压机制治疗青光眼的研究进展

房水排出障碍导致的眼压升高是引起青光眼发病的主要原因,而降眼压仍是目前青光眼治疗的主要方法。房水外流主要通过传统的小梁网途径和非传统的葡萄膜巩膜途径,通过非压力依赖性的葡萄膜巩膜途径降低眼压以治疗青光眼越来越受到重视。本文综述了应用药物和手术从葡萄膜巩膜途径降眼压机制治疗青光眼的研究进展。     

非穿透性小梁切除术房水葡萄膜巩膜途径的实验研究

目的　探讨非穿透性小梁切除术 (nonpenetratingtrabecularsurgeryNPTS)房水葡萄膜巩膜引流途径的形态学情况 ,进一步阐明其降压机制。方法　 2 0只兔 4 0眼随机分为实验组 (NPTS) ,对照组 (小梁切除 +虹膜根切术 )和正常组 ,术后 1周于正常组前房内注入微量示踪剂异硫氰酸荧光素牛血清白蛋白 (fluoresceinisothiocyanate bovineserumalbumin ,FITC BSA) ,于 2、4、6、8、10h各处死家兔 4只 ,摘除双侧眼球作冰冻切片 ,荧光显微镜下观察并确定睫状体、房水池、脉络膜上腔、前、后巩膜和脉络膜的荧光强度等级。结果　实验组和对照组术前眼压相似 (实验组 2 .19kPa± 0 .37kPa ,对照组 2 .0 0kPa± 0 .34kPa ;P >0 .0 5 ) ,术后 1周时眼压差别没有统计学意义 (实验组 1.5 1kPa± 0 .35kPa ,对照组 1.4 4kPa± 0 .31kPa;P >0 .0 5 )。实验组术后葡萄膜巩膜途径各部位的荧光强度均比正常组和对照组增强 ,而正常组亦强于对照组。结论　NPTS具有和小梁切除术相似的降压效果 ,房水由房水池和 (或 )睫状体间隙到脉络膜上腔后 ,主要经前巩膜排出 ,后巩膜及脉络膜排出较少 ,是其降压的主要机制之一。     

射频烧灼兔眼巩膜对眼压的影响

目的　探讨射频烧灼兔眼巩膜对眼压的影响 ,为射频治疗的安全性评价提供依据。方法　选取 6只健康新西兰纯种大白兔 ( 12眼 ) ,用射频治疗仪射频头直接烧灼兔眼巩膜 10s ,以烧灼前情况做自身对照 ,烧灼后 ,右眼用氯霉素和醋酸可的松滴眼液滴眼 ,左眼滴生理盐水对照。非接触式眼压计测量烧灼前及烧灼后 2h、2 4h、3d、14d的眼压 ,进行对比分析。结果　烧灼后各时段眼压与烧灼前相比 ,差异均无显著意义 (P >0 0 5 )。结论　射频烧灼巩膜后 14天内对眼压无明显影响。     

葡萄膜巩膜房水引流途径的研究进展

房水经葡萄膜巩膜途径排出是房水引流的重要组成部分,随着影响葡萄膜巩膜途径的药物在青光眼治疗中的应用,其临床重要性越来越受到人们的关注.本文通过介绍最新发现的葡萄膜淋巴管通道,一些药物和手术以及相关因素对房水从葡萄膜巩膜途径排出的影响,对近年来葡萄膜巩膜房水流出途径的研究进展作一综述.     

FITC-BSA与FI在葡萄膜巩膜模型中分布的对比研究

目的:从形态学方面观察比较FITC-BSA(异硫氰酸荧光素牛血清白蛋白)与FI(荧光素钠)在葡萄膜巩膜途径中的分布状况,探求FITC-BSA作为示踪剂的优点与可行性。方法:10只家兔,右眼前房内注入FITC-BSA为A组(n =10),左眼注入等量的FI为B组(n =10)。分别于术后2,4,6,8,10h,各处死家兔2只,摘除双侧眼球作冰冻切片,荧光显微镜下观察睫状体、脉络膜上腔、前、后巩膜和脉络膜部位的荧光强度并确定其等级。结果:A组葡萄膜巩膜途径各部位的荧光强度均比B组增强。结论:FITC-BSA示踪法是一种较为理想的研究葡萄膜巩膜途径的方法。     

Occurrence of cholinergic nerve fibers in the human uveoscleral tissue

We have studied the cholinergic nerve fibers (CNF) of human uveoscleral tissue in normal and pathological conditions (intraocular pressure: (IOP) of various degrees ) and have performed a quantitative image analysis of CNF with the aim of studying an hypothetical association between IOP and the uveoscleral level of cholinergic neurotransmitter in nerve fiber of the enucleated human eyes. Eleven patients, previously enrolled in our medical protocols are affected by an increase of IOP of various degrees, were subjected to surgical enucleation of one eyeball for traumatic or neoplastic reasons and were the donors of samples of the uveoscleral tissue for CNF demonstration. The samples were also submitted to quantitative image analysis. An enzymatic activity, Acetylcholinesterase (AChe), is present in nerve fibers that innervate the human uveoscleral tissue. The AChe-positive nerve fibers represent about 7.2% of the observed area in normal conditions, while in patients with elevated IOP ACheactivity is about 20.3% of the total observed area. The increase of AChe activity in our experiments, all performed under the same conditions, and therefore, with comparable results, may be related with the increase of IOP. This revised version was published online in July 2006 with corrections to the Cover Date.     

Occurrence of catecholaminergic nerve fibers in the human uveoscleral tissue in conditions of normal and raised intraocular pressure

The distribution of catecholaminergic nerve fibers (CNF) in human uveoscleral tissue was studied in six human eyes with normal intraocular pressure and in five eyes with increased pressure. The eyes with increased pressure had no visual field alterations and the patients did not have anyglaucoma-related opticneuropathies. The amount of norepinephrine in these structures was also analysed. Catecholaminergic nerve fibers were detected by means of fluorescence microscopy and were counted using the quantitative analysis of images. Our results demonstrate that the occurrence of catecholaminergic nerve fibers (expressed in Conventional Units = C.U.) in human uveoscleral tissue is 15.4 ± 1.6 C.U. in eyes with normal intraocular pressure. In eyes with increased intraocular pressure, these values were 12.2 ± 1.2 C.U. Moreover, the amount of norepinephrine in tissue homogenates of the same eyes was evaluated and found to be 21.7 ± 1.3 g/gr tissue fresh weight of the human uveoscleral tissue in eyes with normal intraocular pressure. This value decreased to 18.8 ± 1.1 g/gr tissue fresh weight in the same tissue in conditions of raised intraocular pressure. In these experiments, the small number of eyes examined made it difficult to draw general conclusions. However, the role of human uveoscleral tissue was emphasized by the rich catecholaminergic innervation. A decrease of catecholaminergic nerve fibers and norepinephrine occurs when intraocular pressure is elevated. The modifications of these parameters, involved in the sympathetic control of aqueous humor outflow, may support the hypothesis of a possible relevant role for the human uveoscleral tissue in different pathological conditions.     

兔眼非穿透性小梁切除术后早期葡萄膜巩膜途径的组织病理学改变

目的:观察兔眼非穿透性小梁切除术(nonpenetratingtabecularsurgery,NPTS)后房水葡萄膜巩膜引流途径的组织病理学改变,进一步阐明其降压机制。方法:8只家兔,随机选1眼作NPTS即A组(n=8),另1眼为正常对照即B组(n=8)。术后观察眼压,1wk后处死家兔摘除眼球分别行HE染色、SMA免疫组化染色,光镜下观察葡萄膜巩膜途径的各组织结构改变。结果:A组术前、术后1wk时眼压差别有显著性(P<0.01);光镜观察见A组房水池底部巩膜纤维间隙疏松、睫状体微小脱离,SMA免疫组化显示睫状肌细胞间隙无明显改变。结论:NPTS后房水池底部巩膜纤维间隙增大和/或睫状体微小脱离是葡萄膜巩膜途径引流量增强的组织解剖基础。     

非穿透性小梁手术对葡萄膜巩膜房水流出量的影响

目的探讨非穿透性小梁手术（nonpenetrating trabecular surgery，NPTS）对葡萄膜巩膜房水流出量的影响，从房水动力学的角度揭示NPTS降眼压的机制。方法用示踪剂异硫氰酸荧光素牛血清白蛋白（fluoresceinisothiocyanate—bovine serum albumin：FITC—BSA）于术后7d分别对手术后的兔眼模型组和正常兔眼组进行前房持续灌注30min，灌注毕处死家兔，摘除双侧眼球，并将组织分离为前巩膜、后巩膜、前葡萄膜、后葡萄膜、视网膜和残余液体等6种组织。测定每种组织的荧光强度，计算葡萄膜巩膜流出量（uveoscleral outflow，Fu）。结果实验组葡萄膜巩膜流出量明显高于正常组，两组前房水再现量均以前葡萄膜、前巩膜和残余液体为多，实验组术后葡萄膜巩膜通道各组织房水再现量与正常组相比差异有统计学意义（p〈0．001）。结论非穿透性小梁手术能增加葡萄膜巩膜途径房水流出量，房水主要由前巩膜排出。