局部应用两性霉素B脂质体滴眼治疗兔曲霉菌性角膜溃疡的效果_临床医学论文.docVIP

局部应用两性霉素B脂质体滴眼治疗兔曲霉菌性角膜溃疡的效果_临床医学论文 局部应用两性霉素B脂质体滴眼治疗兔曲霉菌性角膜溃疡的效果_临床医学论文 作者：王亮，张林，吴洁，刘先宁 【摘要】 　　目的：探讨两性霉素B脂质体(AmBL)对兔实验性曲霉菌性角膜溃疡的治疗作用。方法：用40只新西兰白兔,采用角膜”#”形划痕法制作实验性曲霉菌性角膜溃疡模型，随机分为4组，每组10眼。A组应用5g/L AmBL滴眼液点眼,B组应用2.5g/L AmBL滴眼液点眼，C组应用5g/L两性霉素B滴眼液（AmBS）点眼，D组应用生理盐水点眼作对照。造模后第3d每15min点眼1次,共点眼4次,后改为每天点眼6次,并于造模后3,5,7,10,15d,用裂隙灯显微镜观察结膜充血,角膜水肿,角膜浸润的范围,角膜新生血管,房水闪辉,前方积脓的水平作为得分,并进行角膜刮片,角膜共焦纤维镜,角膜组织病理切片及培养观察真菌的生长程度。结果：A，B组造模后3，5d角膜水肿，角膜浸润范围，前房积脓，结膜充血均与其它组无明显差别，造模后7，10d，较其它组显著减轻,造模后15d,各组间无明显差异。A组，B组，与C组，D组在造模后7d角膜新生血管存在明显差异,造模后10d,15d无明显差异。4组间在造模后7,10d角膜刮片及角膜病理学检查存在明显差异,造模后15d无明显差异。结论：AmBL眼液能有效抑制曲霉菌性角膜溃疡的进展, 5g/L AmBL及2.5g/L AmBL均有良好的耐受性，治疗效果无显著差异。 【关键词】 曲霉菌；角膜溃疡；两性霉素B；脂质体 　　Abstract：To evaluate the efficacy of topical amphotericin B limposome(AmBL) injection in the management of keratomycosis in a rabbit model.METHODS: Forty New Zealand White rabbits model of aspergillus keratitis were randomized into four groups (groups A, B, C and D), with 10 eyes in each group. Group A were treated with 5g/L AmBL, group B 2.5g/L AmBL, group C were treated with 5g/L amphotericin B eye drop (AmBS), group D were treated with normal saline as the control group. After 3 days, treatments were performed every 15 minutes, totally for 4 times, then it changed to six times per day. Eye examinations were performed after 3, 5, 7, 10, 15 days. Quantitation of fungi in the cornea was achieved by culturing homogenates and counting colonyforming units.RESULTS: Corneal edema, corneal infiltration range, hypopyon, and conjunctival hyperemia revealed that after 7, 10 days treatment, group A, B was significantly different compared to the other groups (0.01), but not at day 3,5. Corneal new vessels in groups A, B were significantly different compared to groups C, D after 7 days treatment but not different after 10, 15 days. Quantitative cultures in groups A, B were significantly different compared to groups C, D after 7, 10 days treatment.CONCLUSION: Intracameral AmBL injection can effectively inhibit the progre