青光安对抗青光眼术后滤过道瘢痕组织中弹性纤维、MMP-7、TIMP-1的实验研究

目的:通过观察4种青光安有效组份和青光安颗粒剂对抗青光眼术后滤过道瘢痕瘢痕组织中弹性纤维、MMP-7、TIMP-1的影响,来探讨青光安的有效组份和青光安颗粒剂对抗滤过道瘢痕化的作用机制,并对比青光安有效组份与青光安颗粒剂对抗瘢痕化作用的优劣。方法:将青光安4种有效组份与青光安颗粒剂中药混悬液作用于滤过手术后D、E、F、G、H组,通过与A组空白对照组、B组模型组和C组丝裂霉素C组进行比较,观察青光安4种有效组份与青光安中药混悬液对青光眼术后滤过道瘢痕组织中弹性纤维、MMP-7、TIMP-1的影响。结果:C组、E组和H组术前基础眼压与术后第2d;1,2,4wk的眼压比较,现眼压较其他组回升缓慢,第28d时仍然是最小值,与其余A、B、D、F、G组比较差异具有统计学意义。弹性纤维面积密度比较:手术组与空白对照组比较,差异均有统计学意义(P<0.05),C组与H组、C组与E组比较,差异无明显统计学意义(P>0.05),H组与E组比较,差异无统计学意义(P>0.05)。其他各组间比较,差异有显著统计学意义(P<0.01)。结论:青光眼术后滤过道瘢痕化,是导致滤过性手术失败的重要原因;青光安有效组份2、青光安混悬液和丝裂霉素C可通过增加MMP-7的表达和抑制弹性纤维、TIMP-1的表达而减少瘢痕组织增生,具有明显的抗青光眼术后滤过道瘢痕化的作用;通过实验观察可初步说明青光安有效组份2与青光安混悬液都具有明显的抑制滤过道瘢痕化的作用,且二者效果持平,青光安中药组略优于青光安有效组份2组。

Effect of Qingguang'an on elastic fiber, MMP-7, TIMP-1 in scarring area of filtration canal after glaucoma surgery

AIM: To observe the effect of Qingguang'an on elastic fiber, MMP-7, TIMP-1 in scarring area of filtration canal after glaucoma surgery through the four Qingguang'an effective groups and Qingguang'an granules, to discuss and compare their mechanism of action on scarring area of filtration canal.

METHODS:Four effective components of Qingguang'an were used in groups D, E, F, G and H after glaucoma surgery, compared with group A(blank), group B(model)and group C(MMC)to observe the effect of elastic fiber, MMP-7, TIMP-1 in scarring filtration canal.

RESULTS:Compared with the preoperative basic IOP and 2d, 1, 2, 4wk postoperative IOP of groups C, E and H, the IOP of three group rose up slower than other groups, and kept the lowest data at 28d. There was significant difference compared with the rest of A, B, D, F, G groups(P<0.05). The area and density of elastic fiber in surgery group were significantly different with that of black control group(P<0.05), but there were no statistical differences between groups C and H, groups C and F, groups H and E(P>0.05). The difference was statistically significant among other groups(P<0.01).

CONCLUSION:The scarring area of filtration canal after glaucoma surgery is the major reason which lead to the failure of surgery. Qingguang'an effective group 2, Qingguang'an granules and MMC could reduced the scar tissue by restrained the elastic fiber, TIMP-1 and increased the MMP-7. By observing the experimental results that both Qingguang'an effective group 2 and Qingguang'an granules could restrained the scarring area of filtration canal, the effects were unbiased, Qingguang'an granules group is better than effective group 2.