妥布霉素联合地塞米松治疗兔角膜碱烧伤的实验研究Studyof.PDF

妥布霉素联合地塞米松治疗兔角膜碱烧伤 的实验研究 Study of tobramycin combined with dexamethasone in treating alkali burn of rabbits 摘要 目的：研究妥布霉素联合地塞米松对兔角膜碱烧伤新生血管的抑制作用和对角膜组织以 及角膜上皮的修复作用，初步探讨该方法治疗角膜碱烧伤的机制。方法：新西兰标准白兔 18 只，随机分成3 组（每组6 只）：正常组、模型组和治疗组。除正常组外，采用1mol/L NaoH 眼内烧伤造模，并给予相应干预，分别于治疗后第1、3、7 d 观察角膜新生血管的生长情况， 通过荧光素钠染色观察角膜上皮的修复情况，H-E 染色法观察角膜病理形态学变化。结果： 治疗后1 d，模型组新生血管生长旺盛，并存在严重的充血现象，新生血管数量与正常组差 异显著（P0.05）；治疗组角膜充血现象有所缓解，新生血管管腔细小但数量与模型组差异 不显著。治疗后3 d，模型组仍有大量新生血管存在，新生血管数量与正常组相比差异显著 （P0.05）；治疗组仍存在少量充血情况但新生血管生长基本停滞，数量与模型组相比差异 显著（P0.05）与正常组相比差异不显著（P0.05）。治疗后7 d，模型组新生血管数量有 所减少但部分新生血管长度增加、管腔粗大；治疗组新生血管长度明显变短、管腔缩小，经 统计学分析发现三组新生血管数量差异均不显著（P0.05）。碱烧伤后兔角膜中央可见致密 灰白色浑浊区，随着治疗时间的增加上皮细胞愈合率逐渐增加，治疗后第3 天，治疗组中央 缺损区基本恢复，仅在角膜边缘可见小面积着色区；治疗后第7 天，治疗组中央缺损区完全 修复。碱烧伤后，角膜上皮严重脱落，细胞形状不规则，基质层胶原纤维排列不齐，基质水 肿明显，治疗后角膜上皮基本修复，炎性细胞数量明显减少，基质水肿减轻。结论：妥布霉 素与地塞米松联合应用能有效得抑制兔角膜新生血管的生长，促进角膜上皮细胞的修复，治 疗效果显著。 关键词：角膜碱烧伤；地塞米松；妥布霉素；新生血管 ABSTRACT Objective: To study the inhibitory and effect of tobramycin dexamethasone on rabbit corneal neovascularization after corneal alkali burn and the repairment effect on corneal tissue and corneal epithelium, The mechanism of this method using in the treatment of alkali burn of cornea was preliminarily discussed. Methods: 18 New Zealand white rabbits were randomly divided into 3 groups: normal group, model group and treatment group. Except the normal group, 1mol/L NaoH was used to create the intraocular burn model. Meanwhile the corresponding intervention was giving, The corneal neovascularization was observed day after 1, 3 and 7 day treatment. The repairment effect of corneal epithelium was observed by fluorescein sodium staining. The pathological changes of cornea were observed by H-E staining. Results: After 1 day trentment, the neovascularization of model group was vigorous and had severe congestion. The neovascul