丝裂霉素C在眼科领域的应用

丝裂霉素С(Ｍｉｔｏｍｙｃｉｎ -Ｃ ,ＭＭＣ)是一种抗代谢药物 ,是由头状链霉菌产生的乙撑亚胺类抗生素混合物的一种成份 (Ｃ15Ｈ18Ｎ4 Ｏ5) ,具有烷化作用 ;与ＤＮＡ分子的双螺旋形成交联 ,破坏ＤＮＡ的结构和功能 ,抑制增殖期　ＤＮＡ的复制 ,对增殖各期中的细胞均有杀伤作用 ,同时也作用于静止期细胞[1] 。ＭＭＣ是抑制成纤维细胞增殖的强力抑制剂 ,其作用强度是 5-Ｆｕ的 10 0倍[2 ] 。组织瘢痕形成主要是由于成纤维细胞增殖所致 ,因此 ,应用ＭＭＣ可有效抑制瘢痕形成。目前 ,ＭＭＣ在眼科领域的应用范围越来越广 ,其主要理论依据正是…     

丝裂霉素C在翼状胬肉切除术中的应用

翼状胬肉是眼科常见病、多发病。对进展明显者 ,采用手术切除胬肉组织为较常用的治疗方法 ,但术后复发是较常见的并发症。近年来 ,在翼状胬肉切除术中应用丝裂霉素Ｃ(ＭＭＣ) ,取得了较满意的效果。报告如下。1　临床资料1 1　一般资料　共 3 7例 3 9眼。男 2 2例 ,2 4眼。女 15例 ,15眼。年龄 3 6～ 73岁。农民 2 4例 ,工人 11例 ,干部 2例。患病时间 5～ 2 1年。静止期 6例 ,进展期 3 1例 ,复发 3例 ,有 1例眼球运动受限。1 2　手术方法　 0 5 %丁卡因表面麻醉后常规消毒铺巾 ,开睑器开睑 ,2 %利多卡因作局部浸润麻醉。在翼状胬肉头部前 …     

翼状胬术后滴用0.01%丝裂霉素C的疗效

目的观察0.01%丝裂霉素C对翼状胬肉切除加带蒂结膜瓣移位术后预防胬肉复发的作用及安全性。方法采用随机分组对照法，对72例（77眼）原发性和复发性翼状胬肉随机分成2组，对照组35例（37眼），治疗组37例（40眼），两组均施行胬肉切除加带蒂结膜瓣移位术。治疗组术后滴用0.01%丝裂霉素C，每天2次，共6日，随访11-20个月，平均13个月。结果3例（3眼）失访。对照组复发率28.57%，治疗组复发率2.56%，P〈0.01。治疗组角膜创面愈合延迟，5例有浅层点状角膜炎。结论翼状胬肉切除加带蒂结膜瓣移位术后滴用0.01%丝裂霉素C能安全、有效地预防翼状胬肉复发。     

术中应用丝裂霉素C预防翼状胬肉复发

为减少翼状胬肉术后的复发率，１９９２年以来我们在进行翼状胬肉手术中，将含０２ｇ／Ｌ丝裂霉素Ｃ溶液的明胶海绵片贴敷巩膜创面，８分钟后去除海绵片再用生理盐水２０ｍｌ冲洗巩膜面。行此法治疗４４例、６８只眼，随访时间最长４年，最短为３个月，翼状胬肉无一例复发，且无严重并发症。     

丝裂霉素C在翼状胬肉手术中的应用

目的观察丝裂霉素C在翼状胬肉手术切除中的应用效果。方法对32例32眼患者进行切除,术中将0．02％丝裂霉素C棉片浸敷于暴露的巩膜面3-5rain,然后用生理盐水50-100ml彻底冲洗创面及结膜囊。结果随访观察6个月-2年．治愈29例,复发3例,治愈率93．75％,复发率6．25％。结论用丝裂霉素C联合翼状胬肉切除,可降低术后复发率。     

丝裂霉素C在翼状胬肉手术中的应用

目的探讨丝裂霉素C在翼状胬肉手术中的应用。方法将一块约4×5mm浸有丝裂霉素C（0．2mg·mL^-1）的手术海绵置于胬肉结膜瓣下的巩膜上约3-5min。弃掉海绵后用生理盐水或平衡盐液至少50mL彻底冲洗。结果丝裂霉素C治疗组复发率（6％）明显低于单纯翼状胬肉切除对照组复发率（28％）。结论丝裂霉素C是目前手术治疗翼状胬肉的一种较为理想有效的药物。     

丝裂霉素C在眼科的应用及并发症

目的 总结丝裂霉素C在眼科领域的应用现状。方法 查阅近年来国内外相关文献,归纳丝裂霉素C在翼状胬肉切除术、青光眼滤过性手术、角膜屈光术等眼科多方面的应用及出现的并发症。结果与结论 丝裂霉素C在眼科多方面均取得较好的疗效,但也存在较多的并发症。把握丝裂霉素C给药的途径、浓度及接触时间,可降低术后复发率,减少并发症。     

翼状胬肉切除术中丝裂霉素C的应用

翼状胬肉是眼科的常见、多发病,以纤维血管组织增生为其特征,术后复发率高达 ２０％－７０％[１］。防止其术后复发一直是眼科临床的研究课题。近1０年来丝裂霉素Ｃ（ＭＭＣ）降低翼状胬肉术后复发在国内外均已应用[２］。我科自 １９９７年以来对５４例,6２眼翼状胬肉行单纯切除术并术中应用丝裂霉素Ｃ来防止胬肉的复发,现报告如下。1 临床资料1．１ 一般资料５４例,６２眼,年龄２４－６８岁,平均4６．５岁。其中女性４８例,５６眼,男性６例,６眼。均为原发性翼状胬肉,活动期５６眼,静止期６眼,胬肉进入角膜２ｍｍ以上,排除…     

翼状胬肉手术中应用丝裂霉素C对角膜内皮的影响

目的评价翼状胬肉手术中应用0.2g/L丝裂霉素C于巩膜上5min,术后角膜内皮密度的变化。方法从2009年5月至2010年5月,共计43例患者纳入研究（18男、25女）,所有患者均接受巩膜暴露法翼状胬肉切除术,术中进行到胬肉头颈部切除后,给予0.2g/L丝裂霉素C于巩膜上5min,然后给予注射用生理盐水冲洗。术前、术后患眼角膜中央进行内皮计数,取3次平均值。结果在丝裂霉素C应用组,术前平均角膜内皮细胞密度为（2254±128）cells/mm2,术后1周、1个月、3个月分别为（1775±63）cells/mm2、（1707±41）cells/mm2、（1780±72）cells/mm2。各时间点和术前比较均有统计学意义（P〈0.02）。对照组术前平均角膜内皮细胞密度（2352±118）cells/mm2,术后1周、1个月、3个月分别为（2345±120）cells/mm2、（2260±162）cells/mm2、（2230±144）cells/mm2。各时间点和术前比较没有有统计学意义。术后没有观察到药物副作用和手术并发症。结论巩膜暴露法翼状胬肉切除术中,给予0.2g/L丝裂霉素C于巩膜上5min,对术眼的角膜内皮细胞密度有一定影响。需要进一步观察丝裂霉素C的不同浓度和持续时间,找到该药物最佳治疗效果和最小副作用。     

丝裂霉素C在翼状胬肉手术中应用的临床研究

目的:探讨丝裂霉素C(MMC)在预防翼状胬肉术后复发与术中应用的关系。方法:治疗组30例37眼翼状胬肉患者采用0.5mg/ml MMC一次性局部敷贴(≤5min),对照组30例38眼翼状胬肉患者不用MMC。结果:随访6mo～24mo(平均16.5mo),治疗组治愈29例36眼,无效1例1眼,复发率为3.3％,治愈率为96.7％;对照组治愈22例30眼,复发8例8眼,复发率为26.67％,治愈率为73.33％。经统计学处理,X~2=4.71,P<0.05。两组比较,术后复发率差异具有显著性意义。结论:0.5mg/mlMMC一次性局部敷贴在翼状胬肉手术中的应用较传统的治疗方法明显降低术后复发率,且避免了对角膜和其他正常眼组织的损伤,具有重要的临床实用价值。     

Uses and complications of mitomycin C in ophthalmology

Mitomycin C is a chemotherapeutic agent that acts by inhibiting DNA synthesis. Its use and application in ophthalmology has been increasing in recent years because of its modulatory effects on wound healing. Current applications include pterygium surgery, glaucoma surgery, corneal refractive surgery, cicatricial eye disease, conjunctival neoplasia and allergic eye disease. Although it has been used successfully in these conditions, it has also been associated with significant complications. This article reviews the current trends and uses of mitomycin C in the eye and its reported complications.     

Uses and complications of mitomycin C in ophthalmology

Mitomycin C is a chemotherapeutic agent that acts by inhibiting DNA synthesis. Its use and application in ophthalmology has been increasing in recent years because of its modulatory effects on wound healing. Current applications include pterygium surgery, glaucoma surgery, corneal refractive surgery, cicatricial eye disease, conjunctival neoplasia and allergic eye disease. Although it has been used successfully in these conditions, it has also been associated with significant complications. This article reviews the current trends and uses of mitomycin C in the eye and its reported complications.     

丝裂霉素C在小梁切除术治疗青光眼中的应用

目的评价丝裂霉素C在复合式小梁切除术治疗青光眼中的作用。方法选择2008年1月-2010年1月在我院眼科行MMC联合小梁切除术36例45眼和小梁切除术33例40眼的两组患者,年龄和性别基本匹配,进行回顾性比较分析。结果 MMC组出院时成功率97.8%,术后3、6、12个月成功率分别为93.3%、90.5%、82.5%。对照组出院时成功率95.0%,术后3、6、12个月成功率分别为71.8%、69.2%、67.6%。经过χ2检验,两组成功率比较差异有统计学意义(P<0.05)。结论小梁切除术联合丝裂霉素C能安全、有效地治疗青光眼。     

HPLC法测定丝裂霉素C聚氰基丙烯酸正丁酯纳米粒中丝裂霉素C的含量

目的:建立高效液相色谱法测定丝裂霉素 C 聚氰基丙烯酸正丁酯纳米粒(MMC-PBCA-NP)中药物含量。方法:采用C_(18)柱(4.6 mm×150 mm,5 μm),以混合磷酸盐缓冲液-乙腈(85:15)为流动相,流速为1 mL·min~(-1),紫外检测器,检测波长为365 nm。结果:丝裂霉素 C(MMC)浓度在5～250 μg·mL~(-1)范围内与峰面积呈良好的线性关系,r=0.9998;平均回收率(n=6)为98.15%。结论:本法专属性强,操作简便,结果准确。适用于 MMC-PBCA-NP 的质量控制。     

丝裂霉素C的心肌毒性作用

丝裂霉素C对心肌细胞有明显毒性作用,电子显微镜观察显示小鼠在体心肌细胞肌丝集合体断裂、溶解,细胞核染色质集聚、核膜皱缩等;对体外培养心肌细胞可引起搏动频率减慢、节律失常,乳酸脱氢酶释放增加,严重者细胞停搏甚至固缩或脱落,对心肌细胞的DNA合成也有明显抑制作用。     

Structure-activity relationships for mitomycin C and mitomycin A analogues

A set of 30 mitomycin C and mitomycin A analogues, including five new compounds, was screened against three different solid human tumor cell lines using the MTT tetrazolium dye assay. A statistically significant correlation among antitumor activity, quinone reduction potential (E1/2), and the logarithm of the partition coefficient (log P) was obtained, with the most easily reduced and the most lipophilic compounds being the most potent. When these analogues were separated into mitomycin C and mitomycin A subsets, the former gave a correlation only with E1/2, whereas the latter (which differ little in their E1/2 values) gave a correlation only with log P. These correlations are in contrast to those made in the P388 leukemia assay in mice wherein the most active mitomycin C and mitomycin A analogues were the most hydrophilic ones. When the same compounds were tested against P388 leukemia cells in the MTT assay, the results were the same as those of the solid tumor assays. Thus, the substantial differences in relative potencies of mitomycins are related not to the kind of tumor cell, but to the type of assay performed, cell culture versus whole animal. No correlation was found between antitumor potency in the cell culture systems and calculated relative DNA binding strengths, probably because the limiting factors in antitumor potency of mitomycins appear to be tumor cell uptake (log P) and/or bioreductive activation (E1/2).     

Characterization of liposomes and an emulsion containing mitomycin C or lipophilic mitomycin C prodrugs

The characteristics of liposomes and an oil-water emulsion containing either mitomycin C (MMC) or its lipophilic prodrugs were investigated. Prodrugs were incorporated into liposomes and oil droplets of an oil-water emulsion, and this incorporation was dependent on the lipid content of the liposomes and droplets. A good correlation was observed between the calculated lipid:water partition ratios and partition coefficients in chloroform:water. The prodrugs were rapidly distributed between the lipid and aqueous phases when they were injected into the dispersion medium of empty liposomes and an oil-water emulsion, or when the formulations incorporating prodrugs were diluted with water. Addition of prodrugs to liposomes containing perylene resulted in a decrease of fluorescence. Based on these findings, prodrugs were concluded to be incorporated into lipidic dispersion formulations based on their partitioning behavior. N1a-[(Nonyloxy)carbonyl]MMC (7) showed the highest incorporation into lipidic formulations, while prodrugs with moderate lipophilicities were rapidly released from lipid particles. Liposomes incorporating 7 maintained their multilamellar vesicular form as shown by electron microscopy and by examining their entrapping capacity for water soluble marker dyes. The release of prodrug 7 from both formulations was slow in a buffer solution, but considerable release and conversion to the parent drug were observed when rat plasma was added to the same system. These results suggest that the stability of MMC could be improved by incorporation into lipidic formulations and that a suitable release rate in vivo could be accomplished by use of a prodrug.     

丝裂霉素C磁性纳米微球的制备

目的:以丝裂霉素C为药物模型,研究磁性纳米抗肿瘤药物的制备工艺及方法。方法:采用正交设计优化工艺并筛选,以纳米级Fe_3O_4为磁性核心,人血清白蛋白为膜材,利用乳液固化法制备包载丝裂霉素C 的磁性纳米微球,并借助透射、扫描电镜观察微球形态,通过激光粒度分析仪作粒度分析,利用高效液相色谱(HPLC)测量载药量及包封率,以磁性测试仪进行体外磁响应性测定。结果:该优化的磁性纳米微球在电镜下呈表面光滑的核壳样球型微粒,平均粒径为217.7nm,微球载药量为7.89%,包封率为90.5%,体外饱和磁化强度为21.85emu·g~(-1)。结论:磁性纳米载药微球为肿瘤的主动靶向治疗提供了一种可能的新剂型,有较好的临床应用前景。     

HPLC测定组织中丝裂霉素C的浓度

目的:建立了测定组织中的丝裂霉素C的反相高效液相色谱法。方法:组织匀浆用乙酸乙酯提取。以Shim-Pack CLC-ODS(150mm×6mm,10pm)为色谱柱,甲醇-水(35:65)为流动相,检测波长为365nm,外标法定量。结果:丝裂霉素C组组织浓度线性范围为0.1～2.0pg/g(r=0.9991,方法回收率为97.10％。日内、日间RSD％为4.00％～8.42％,最低检测浓度为0.05eg/g。结论:该法简便,适用于丝裂霉素C组织浓度的测定