苦参碱聚乳酸微球防治增生性玻璃体视网膜病变的研究

目的评价苦参碱聚乳酸微球防治实验性增生性玻璃体视网膜病变（PVR）的效果。方法30只新西兰白兔玻璃体腔注入成纤维细胞悬液制备PVR模型。随机分为3组,玻璃体腔分别注入载药微球（含苦参碱4mg）、游离苦参碱（2mg）、生理盐水和空白聚乳酸微球。玻璃体腔手术操作后第1、3、7、14、21、28、35天观察眼前节炎症反应情况、玻璃体混浊程度、玻璃体腔内微球分解过程、玻璃体内增生情况及视网膜是否脱离以及脱离的程度。结果所有动物1周内前房有轻～中度的炎症反应,1周后消失。各组均有不同比例的动物在不同时间点发展为PVRⅠ～Ⅲ级。视网膜脱离的发生率：游离药物组与对照组比较,除35d外,其余各时间点差异均有统计学意义（P〈0.05）;载药微球组与对照组相比,各时间点差异均有统计学意义（P〈0.05）;载药微球组与游离药物组比较,28d和35d时差异均有统计学意义（P〈0.05）。结论苦参碱聚乳酸微球兔眼玻璃体腔注射能够有效防治实验性PVR。

Preventive effect of matrine polyactic acid microsphere on proliferative vitreoretinopathy

Objective To establish a matrine delivery system in vitreous is very important for the dynamic treatment of proliferative vitreoretinopathy(PVR) . Present study was to evaluate the efficacy of matrine polyactic acid microsphere(MAT-PLA-MS) in prevention of PVR. Methods The suspension of cultured fibroblasts was injected into vitreous cavity of 30 healthy adult New Zealand albino rabbits to induce PVR. Then the experimental rabbits were divided into 3 groups and 10 rabbits for each. The animals received intravitreal injection of 0.3 mL MAT-PLA-MS(4 mg) matrine in MAT-PLA-MS group. Free matrine normal sodium solution 0.3 mL(containing 2mg matrine) was injected in vitreous cavity in free matrine group. 0. 3 mL normal saline solution was injected into the vitreous of the left eyes and the equivalent volume of blank polyaetic acid microsphere(blank-PLA-MS) into the right eyes in control group. The changes of cornea, aqueous humor, lens, vitreous and fundus were examined and recorded by slit lamp biomicroscope, indirect ophthalmoscope, fundus color camera and B ultrasonogram on the 1st, 3rd, 7th, 14th, 21st, 28th and 35th day following injection of drug. The inhibition effect of matrine on PVR was evaluated according to Ryan' s grading criteria of PVR. Results On the 14th days after implantation of MAT-PLA-MS, the rate of retinal detachment was 60%, 10%, 5% and 60% in normal saline group, free matrine group, MAT-PLA-MS group and blank-PLA-MS group respectively. Statistically significant difference was found among normal saline group, blank-PLA-MS group, MAT-PLA-MS group and free matrine group(P ＜0. 05). On the 21st day after injection of fibroblasts, the morbidity of retinal detachment was 80%, 30%, 10% and 80% in normal saline group, free matrine group, MAT-PLA-MS group and blank-PLA-MS group respectively, showing a significant difference among different groups. On the 28th day, the incidence rate of retinal detachment was 90%, 50%, 15% and 90% respectively, presenting statistical difference among various groups (P ＜ 0. 05) as well as between free matrine group and MAT-PLA-MS group (P＜0. 05). On the 35th day, considerably difference also was seen in the morbidity of retinal detachment among various groups (90%, 60%, 15% and 90% respectively) (P＜0.05). Conclusion Implantation of MAT-PLA-M S into vitreous cavity can effectively inhibit the development of PVR induced by fibroblasts in rabbit model.