纤溶酶对兔晶状体摘除术后前房炎症及晶状体上皮细胞的抑制作用

目的探讨纤溶酶对兔晶状体摘除术后前房炎症反应及晶状体上皮细胞（LECs）的抑制作用机制。方法将健康4月龄新西兰大白兔20只随机分为对照组和实验组,每组10只。2组均行晶状体超声乳化摘除术,术毕对照组给予0.2ml 0.9%氯化钠注射液前房内注射,实验组给予注射用纤溶酶1U前房注射。分别于术后1、3、7、14、30、60d进行眼部裂隙灯检查,观察前房炎症反应及后囊膜混浊（PCO）的发生时间、程度及发生率。60d时眼球标本HE染色,光镜下观察后囊膜上的LECs的形态及角膜、视网膜形态。结果前房炎症：术后1d 2组所有术眼出现前房炎症;术后3d和7d实验组前房炎症发生率较对照组低（P〈0.05）;术后7d对照组6眼存在前房炎症实验组术眼前房炎性反应消失（P〈0.01）。2组前房炎性反应消退时间差异有统计学意义（P〈0.05）。PCO程度及发生率：实验组术后14d,对照组术后7d出现PCO。术后60d时PCO发生率差异有统计学意义（P〈0.01）。PCO的混浊程度评分差异有统计学意义（P〈0.01）。HE染色：实验组后囊膜中央区上LECs稀少,呈单层排列。对照组后囊膜中央区和赤道部均可见多层增生的LECs以及大量的胶原纤维附着。2组角膜、视网膜各层结构完整。结论纤溶酶可以有减轻前房炎症反应,纤溶酶可以抑制晶状体上皮细胞增殖。

The inhibitory effect of plasmin on the inflammation in anterior chamber and lens epithelial cells after lens extraction in rabbits

Objective To investigate the inhibitory effects of plasmin on the inflammation in anterior chamber(AC)and lens epithelial cells(LECs)after lens extraction in rabbits.Methods 20 New Zealand white rabbits(4-month age)weighted 2.5～3.0kg were randomly divided into control group and experimental group,with 10 rabbits in each group.All the rabbits underwent phacoemulsification under general anesthesia.At the end of the surgery,the rabbits in experimental group were injected with plasmin 1U(0.2ml)in the anterior chamber,however,the rabbits in control group were injected with 0.9% sodium chloride injection 0.2ml.The slit lamp examination in ocular region was performed to observe inflammation reaction in anterior chamber and the onset time,degree and incidence of posterior capsule opacification(PCO)at 1,3,7,14,30,60 days after the operation.At 60 days after operation,the rabbits’ eyeball specimens were stained with HE,then the morphous of LECs in posterior capsule and the morphous of cornea and retina were observed under light microscope.Results The inflammation in AC: at 1 day after operation,all the eyes in both groups showed inflammation reaction in AC;at 3 days and 7 days after operation the incidence of inflammation reaction in experimental group was significantly lower than that in control group(P<0.05);The regression time of inflammation reaction in AC:had a significant difference between two groups(P<0.05).The incidence and degree of PCO in PC:the PCO appeared at 2 weeks after operation in experimental group,however,which appeared at 7 days after operation in control group.The incidence of PCO at 60 days after operation had a significant difference between two groups(P<0.01).The scoring of turbidity degree of PCO a significant difference between two groups(P<0.01).HE staining results:lens epithelial cell was rare in experimental group and arranged in a single membrane,however,a lot of fibroblasts could be seen in the posterior capsule.The structure of corner and retina in both group was complete.Conclusion The plasmincan relieve inflammation reaction in AC,furthermore,which can inhibit the proliferation of lens epithelium cells.