摘要
目的探讨双氯芬酸钠、妥布霉素地塞米松、普拉洛芬、溴芬酸钠滴眼液频繁点眼对兔角膜上皮的副作用,并观察其常规使用对兔角膜上皮创伤愈合的影响。设计实验性研究。研究对象80只新西兰大白兔。方法将兔分为2组,每组40只,一组为频点组(点滴眼液每小时1次);另一组行直径6 mm的角膜上皮刮除模型并予点滴眼液每日4次。每组兔再随机分为5组,每组8只,分别给予生理盐水、双氯芬酸钠、妥布霉素地塞米松、普拉洛芬、溴芬酸钠滴眼液。选择右眼为观察眼。在角膜上皮损伤前、损伤后12、24、48、72、96小时及第5、6、7天进行观察,并在观察结束后摘除眼球行组织病理学检查。主要指标眼表刺激症状、角膜上皮损伤、愈合情况和角膜上皮厚度。结果与生理盐水组比较,四种滴眼液频繁点滴兔眼均未出现明显刺激症状且未见上皮缺损形成,但荧光素染色均可见角膜上皮点染,以第3天明显,且双氯芬酸钠组角膜上皮损伤的积分(9分)明显高于对照组(0分)和溴芬酸钠组(1分)(P<0.05);病理学检查显示点药5天后,妥布霉素地塞米松组角膜上皮细胞层数(3.67±0.52层)少于对照组(4.17±0.41层)(P<0.05),其余各用药组与对照组的角膜上皮细胞层数未见明显差异。创伤后兔角膜上皮的平均修复时间在双氯芬酸钠组和妥布霉素地塞米松组分别为(75.0±27.0)小时和(75.0±8.5)小时,而生理盐水、普拉诺芬和溴酚酸钠组分别为(66.0±11.1)小时、(69.0±15.4)小时和(66.0±11.1)小时,各组比较差异无统计学意义(P>0.05),但角膜上皮愈合后妥布霉素地塞米松组(2.00±0.00层)和双氯芬酸钠组(2.50±0.55层)上皮细胞的层数少于对照组(5.00±0.00层)(P<0.05)。结论频繁滴用抗炎滴眼液可导致兔角膜上皮细胞潜在的损伤;双氯芬酸钠和妥布霉素地塞米松滴眼液抑制兔角膜上皮创伤的愈合作用略强于普拉洛芬和溴芬酸钠。
Objective To investigate side actions of some anti-inflammatory＂ eye drops applied thequently on corneal eplthelium and to observe the effects on healing of corneal epithelium using these eye drops routinely. Design Experimental study. Participants 80 New Zealand rabbits. Method Rabbits were divided randomly into two groups （40 rabbits per group）, the rabbits of one group had the healthy cornea and were given the eye drops every one hour in their right eyes for 5 days; and the rabbits of the other group had de-epithelium cornea （ethyl alcohol to make a 6 mm epithelium defect in the center） and were given the eye drops four times per day in their right eyes for 7 days. Each group was divided randomly into five subgroups in which the right eye were given topical sodium choloride, pranoprofen, diclofenac sodium, bromfeuac sodium and tobramycin-dexamethasone, respectively. The signs were observed with slit lamp at an interval time （before epithelium injury, 12, 24, 48, 72, 96 hours and 5, 6, 7 days after epithelium injury）. The histopathologic examination of rabbit corneas was performed for the epithelium thickness at the end of experiment. Main Outcome Measures conjunctival congestion, secretions in the conjunctival sac, the injury and healing time of the corneal epithelium. Results Compared with the sodium choloride subgroup, all the four subgroups with frequent anti-inflammatory eye drops showed none obvious local excitation, but the corneal epithelium defects were existed partly, which was more serious in the dielofenac sodium subgroup （9 points）, which was significantly higher than the sodium choloride subgroup （0 point） and the bromfenac sodium subgroup （1 point） （P〈0.05）, while at the 5th day the epithelial cell layers of cornea in tobramycin-dexamethasone subgroup （3.67±0.52 layers） are less than that of the control group （4.17± 0.41 layers）（P〈0.05）. As for the de-epithelium group, when compared with the sodium choloride subgroup（66.0±11.1 hours）, the avera
出处
《眼科》
CAS
2012年第3期166-171,共6页
Ophthalmology in China
关键词
滴眼液
角膜
副作用
上皮愈合
兔
anti-inflammatory drop
cornea
side actions
epithelial healing
rabbit
