应用不同浓度的克拉霉素眼用凝胶治疗兔金黄色葡萄球菌性角膜溃疡

目的：通过观察对金黄色葡萄球菌性角膜溃疡的疗效，筛选克拉霉素眼用凝胶的合适浓度。方法：角膜实质层接种法建立40只家兔右眼金黄色葡萄球菌性角膜溃疡模型。将模型随机分成5组，每组8只兔（8只眼），各组分别给予空白基质、0．1％克拉霉素眼用凝胶、0．25％克拉霉素眼用凝胶、左氧氟沙星凝胶、0．25％克拉霉素眼用凝胶联合重组牛碱性成纤维细胞生长因子（Recombinantbovinebasicfibroblastgrowthfactor，Rb—bFGF），每天4次，每次2滴，分别在第1、3、5、7、10、14天观察角膜病变情况及溃疡面积大小。结果：在相同的给药方法下，0．1％克拉霉素眼用凝胶、0．25％克拉霉素眼用凝胶、左氧氟沙星凝胶、0．25％克拉霉素眼用凝胶联合Rb—bFGF均能使金黄色葡萄球菌性角膜溃疡面积缩小、角膜病变好转，与空白基质组相比有统计学差异（P〈0．05）；0．25％克拉霉素眼用凝胶组疗效明显优于0．1％克拉霉素眼用凝胶组（P〈0．05）。结论：制备的0．25％克拉霉素眼用凝胶对金黄色葡萄球菌性角膜溃疡疗效肯定，可以进一步开发应用于临床。

Different concentrations of clarithromycin ophthalmic gel for rabbits corneal ulcers induced by staphylococcus aureus

PURPOSE: To screen proper concentration of clarithromycin ophthalmic gel by observing the efficacy of different concentrations of clarithromycin ophthalmic gel for treating staphylococcal corneal ulcers. METHODS: Corneal ulcer was induced in the right eye of 40 rabbits, 3.0 x 10(9) CFU/ml staphylococcus aureus suspension was injected midstromally into the central cornel. These rabbits were divided randomly into 5 groups, each group received respectively topical blank matrix, clarithromycin ophthalmic gel 0.1%, clarithromycin ophthalmic gel 0.25%, levofloxacin ophthalmic gel, clarithromycin ophthalmic gel 0.25% and recombinant bovine basic fibroblast growth factor (Rb-bFGF), 4 times every day, 2 drops each time. The eyes were examined respectively with the slit lamp before treatment (day 0), on day 3, day 5, day 7, day 10, day 14 to observe the progression of corneal ulceration, including the area of the corneal ulcer and mark of keratitis. RESULTS: Under the same way of giving medicine, experimental corneal ulcer studies showed a statistically significant decrease in all treatment groups on measurements of the area of the corneal ulcer and mark of keratitis (P < 0.05), and clarithromycin ophthalmic gel 0.25% had a better action than clarithromycin ophthalmic gel 0.1% against staphylococcus aureus corneal ulcer. CONCLUSION: Clarithromycin ophthalmic gel 0.25% was proved to be an effective ocular medication for the therapy of gram-positive bacterial corneal ulcer.