透明质酸酶对外伤性玻璃体积血转归的影响

目的探讨透明质酸酶对兔眼外伤性玻璃体积血转归的影响。方法28只新西兰白兔，右眼为外伤性玻璃体积血模型，左眼为空白对照眼。1d后随机分为实验组和阳性对照组，每组14只兔（14只眼）。实验组玻璃体腔注射透明质酸酶0．002umol／（min·L），阳性对照组玻璃体腔注射0．1mL BSS。分别于给药后1、3、7、14、21、28d测量眼压，行裂隙灯及眼底检查。每组抽取2只实验兔行眼球摘除，抽取玻璃体液测定碱性成纤维细胞生长因子（bFGF）的质量浓度，取眼球壁行组织病理学检查。结果给药14d后，实验组的玻璃体混浊程度明显低于阳性对照组，各组间比较差异有统计学意义（P〈0．05）。给药后1d、3d，实验组眼压和空白对照组眼压比较差异均有统计学意义（P〈0．05），与阳性对照组比较差异均有统计学意义（P〈0．05）。随着时间推移，玻璃体中bFGF的质量浓度均增高，阳性对照组增高更明显。组织病理学检查见实验组和阳性对照组视网膜均出现了水肿和神经节细胞空泡样变、内界膜增厚等改变，但实验组较阳性对照组形成增生膜少。结论透明质酸酶20IU于兔眼玻璃体腔内注射对视网膜无毒性作用，可加速外伤性玻璃体积血的消散，造成眼压一过性降低。

Influence of hyaluronidase on turnover of traumatic vitreous hemorrhage

Objective Many clinical researches have determined the clinical effectiveness of hyaluronidase on vitreous hemorrhage. However, the data of relevant experimental study is lack. The aim of this study was to investigate the effect of hyaluronidase on traumatic vitreous hemorrhage turnover. Methods The animal model of traumatic vitreous hemorrhage was established in 28 right eyes of 28 New Zealand pigmented rabbits. 0. 002 umol/（min·L） hyaluronidase was injected intravitreously in 14 model eyes 1 day after operation, and the same amount of balance salt solution （BSS） was injected at the same way in other 14 model eyes. The fellow eyes were as blank controls. The clinical ocular examinations were performed under the slim-lamp and ophthalomoseope, and intraocular pressure was detected using indentation tonometers at the 1 st,3rd,7th, 14th, 21st and 28th day. Then two rabbits from each group were sacrificed and vitreous sample was drawn respectively in the time points above for the detect of basic fibroblast growth factors（bFGF）. The histological changes of retina were evaluated under the light microscopy and scan electron microscopy＇. Results No the inflammatory reaction was seen in ocular anterior segment in model eyes. The grade of vitreous opacity based on Forrester criteria was lower in hyaluronidase injection group than BSS injection group in the 14th,21st and 28th day （P 〈 0.05）. The intraocular pressure was significantly declined in the 1st and 3rd day after injection in hyaluronidase injection group compared with BSS injection group and normal group （ P 〈 0.05 ）. The bFGF level in vitreous was elevated in hyaluronidase injection group and BSS injection group with the increase of time and showed a more dominant enhance in BSS injection group. Edema of retina and vacuolar degeneration of retinal ganglion cells,thickness of inner limiting membrane were found under the light microscopy in hyaluronidase injection group and BSS injection group, but the proliferative membrane was less in hy