雷公藤甲素抗兔眼外滤过术切口瘢痕化的机制研究

目的探讨祛风湿类中药提取物雷公藤甲素（TP）对兔眼外滤过术后切口部位成纤维细胞及其相关细胞因子的影响。方法将48只实验兔随机分为4组，分别为生理盐水（NS）组，丝裂霉素（MMC）组，0．2mg／mlTP组，0．4mg／mlTP组。每组12只，均行单眼造模。术中按不同组别局部浸润不同药物2min，生理盐水组中未造模眼（12眼）作为正常对照。于术后1d、6d、14d进行眼压测量及眼前节观察，并分别于术后6d及14d各组随机处死6只实验兔。制备眼球标本并行HE染色、免疫组化染色切片观察。结果兔眼外滤过术造模后1、6、14d均能有效维持眼压低水平（P〈0．05），其中术后6dTP两浓度组均优于MMC组及NS组（P〈0．05），术后14d高浓度TP组优于其它3组（P〈0．05），而低浓度TP组优于NS组（P〈0．05）；两TP组于兔眼外滤过术后1、6、14d均能有效维持滤过泡形态和功能；并能于术后6、14d有效抑制切口部位成纤维细胞增殖，且优于NS组（P〈0．01）及MMC组（P〈0．05）；而高浓度组优于低浓度组（P〈0．01）；两TP组及MMC组均能有效降低兔眼滤过道成纤维细胞胞浆中细胞因子TGF—β1的表达。术后6d，各用药组滤过道成纤维细胞胞浆TGF—β1染色阳性颗粒少于NS组，呈棕黄色颞粒，而NS组呈深棕色颗粒；术后14d，各用药组阳性颗粒与NS组大体相近，均呈棕黄色颗粒，数量较6d组减少。结论雷公藤甲素对兔眼外滤过术切口部位瘢痕形成具有明显抑制作用。

Research on machanism of Triptolide anti-scarring about filtration surgery incision site on rabbit eyes

OBJECTIVE To investigate the mechanism of antirheumatic herbal extracts TP impacting on postoperative incision site about fibroblast proliferation and related cytokines. METHODS Forty-eight New Zealand white rabbits were randomly divided into 4 groups, saline group, MMC group, 0.2 mg/mlTP group and 0.4 mg/mlTP group. Twelve rabbits in each group （24 eyes） accepted filtration and different drug with single eye. Took other eyes in normal saline group as control. Killed 6 rabbits randomly from each drug group on the 6~ and the 14~ day after surgery. Prepared eyeball specimens and observed pathological section for HE staining and immunohistochemical staining. At the same time, observed IOP and anterior segment performance of eyes after 1 day, 6 days and 14 days. RESULTS On the 1st, 6th, 14th day after external filtration , the IOP of rabbit eyes could effectively maintain lower level（P〈0.05）. Six days after filtration, two concentrations of TP groups were superior to MMC group and NS group （P〈0.05）; 14 days after filtration, the high concentration TP group was better than the other three groups （P〈 0.05 ）, while the low concentration TP group was better than that of NS group （P〈0.05）. On the 1st, 6th, 14th day after external fihration, two TP groups could maintain filtering bleb＇ s morphology and function effectively. After 6 and 14 days after fihration, the two TP groups could effectively inhibit the fibroblast proliferation of filtration incision site, which was better than that of NS group （P〈0.01） and MMC group （P〈0.05）; High concentration group was superior to the low concentration group （P〈0.01） Both TP and MMC groups could effectively reduce the expression of cytokine TGF-beta 1 which was in fibroblasts cytoplasm within filter passage on rabbit eyes. After 6 days： In each treatment group, TGF-β1 staining positive particles of the filtration path fibroblasts cytoplasm were less than the normal saline group. The normal saline group showed dark brown particles, the treatment groups showed pale brown particles. After 14 days： In each treatment group, TGF-β1 staining positive particles of the filtration path fibroblasts cytoplasm showed pale brown particles which were broadly similar with the normal saline group. The numbers of the positive particles were less than the 6-days groups. CON- CLUSIONS TP had obvious inhibitory effect on filtration surgery incision site scarring of rabbit eyes, which was helpful to maintain filtration function.