本文選題：增生性玻璃體視網(wǎng)膜病變　切入點：氟尿嘧啶注射液　出處：《山西醫(yī)科大學》2011年碩士論文　論文類型：學位論文

【摘要】：目的：觀察干擾素-r和氟尿嘧啶單獨及聯(lián)合應用對兔眼增殖性玻璃體視網(wǎng)膜病變(Proliferative Vitreoretinopathy, PVR)的療效。 方法：將24只有色家兔隨機分為A、B、C、D四組。每組以左眼為實驗眼，玻璃體腔注射富含血小板的血漿，建立PVR動物模型。建模后第2天，A組玻璃體腔注射0.2ml平衡鹽溶液；B組玻璃體腔注射0.2ml104干擾素-r, C組玻璃體腔注射0.1ml 0.5mg的氟尿嘧啶注射液和0.1ml104的干擾素-r注射液[28],D組玻璃體腔注射0.2ml 0.5mg的氟尿嘧啶注射液。每日常規(guī)對實驗眼行裂隙燈、眼底檢查，并分別于7、14、30天[14]行閃光視網(wǎng)膜電圖（F-ERG）、眼B超及視網(wǎng)膜組織病理學檢查。 結(jié)果：⑴裂隙燈檢查：不同檢查時間點，四組實驗眼眼前節(jié)均未發(fā)現(xiàn)明顯異常。注藥后1天，A組玻璃體內(nèi)未見混濁。其余各組玻璃體內(nèi)均可見輕度混濁，但隨時間延長混濁均逐漸減輕。 ⑵眼底檢查：隨時間的推移，各實驗組PVR級別均有所進展，以C組發(fā)展較慢。注藥后7d、14d、21d，各組間在同一時間點比較差別無統(tǒng)計學意義（P0.05）；30d時，C組PVR級別明顯低于其他各組，且差別有統(tǒng)計學意義（P0.05），B、D與A組間比較有統(tǒng)計學意義（P0.05）,B、D組間比較無統(tǒng)計學差別（P0.05）。 ⑶F-ERG檢查：各組建模前F-ERG檢查結(jié)果顯示：b波波幅平均值為148.00±6.89μV。建模后，各組b波波幅均比造模前低。注藥后14、30d，B、C、D組與A組間差別有統(tǒng)計學意義（p0.05）。其余各檢查點組間比較無統(tǒng)計學差別（p0.05）。 ⑷眼B超檢查：14d時，A組玻璃體混濁，視網(wǎng)膜前出現(xiàn)纖維增殖膜，有2眼出現(xiàn)視網(wǎng)膜脫離；B、D組出現(xiàn)不同程度的玻璃體增殖條索，但無視網(wǎng)膜脫離。C組未見明顯異常。30d時A組視網(wǎng)膜增厚明顯，有5眼出現(xiàn)視網(wǎng)膜脫離；B、D組均有不同程度的玻璃體混濁、視網(wǎng)膜增厚，B組2眼、D組3眼出現(xiàn)視網(wǎng)膜脫離。C組玻璃體稍混濁，少許增殖條索，未見視網(wǎng)膜脫離。 ⑸視網(wǎng)膜組織病理學檢查：正常兔眼的視網(wǎng)膜各層結(jié)構(gòu)排列整齊、清晰，內(nèi)界膜連續(xù)且光滑。注藥后14d，A組視網(wǎng)膜表面出現(xiàn)增殖膜，且各層結(jié)構(gòu)排列紊亂；B、D組視網(wǎng)膜增厚，但各層結(jié)構(gòu)基本正常；C組視網(wǎng)膜未見明顯異常，各層結(jié)構(gòu)基本正常。注藥后30d，，A組脫離的視網(wǎng)膜形成皺襞，表面纖維血管膜增生；C組視網(wǎng)膜表面輕度纖維增殖；B和D組視網(wǎng)膜纖維增殖膜較C組明顯。 結(jié)論：0.1ml 0.5mg氟尿嘧啶聯(lián)合0.1ml 104干擾素-r玻璃體腔注射對兔眼增生性玻璃體視網(wǎng)膜病變有一定治療作用，其療效優(yōu)于單獨應用0.2ml 0.5mg氟尿嘧啶或0.2ml104干擾素-r。
[Abstract]:Aim: to observe the efficacy of interferon-r and fluorouracil in the treatment of proliferative vitreoretinopathy (PVR) in rabbits with proliferative vitreoretinopathy (PVR). Methods: Twenty-four colored rabbits were randomly divided into four groups: the left eyes were used as experimental eyes and platelet-rich plasma was injected into the vitreous body. PVR animal model was established on the second day after modeling, 0.2 ml of equilibrium salt solution was injected into vitreous body cavity of group A and 0.2 ml of interferon -r was injected into vitreous of group B, 0.1 ml 0.5 mg fluorouracil injection and 0.1 ml interferon-r injection of 0.1 ml 104 were injected into vitreous cavity of group C. Group A was injected with 0.2ml 0.5 mg fluorouracil into the vitreous cavity. Fundus examination was performed on 1430 days (14 days) with flash electroretinogram (ERG), B-ultrasound and histopathology. Results: at different time points, there was no obvious abnormality in the anterior segment of the experimental eyes in the four groups, but no turbidity was found in the vitreous body of group A one day after injection, and slight opacification was found in the other groups. However, the turbidity gradually decreased with the prolongation of time. 2 fundus examination: with the passage of time, the progress of PVR grade in each experimental group was relatively slow, especially in group C. the PVR grade of group C was significantly lower than that of other groups at the same time point at the same time point at the same time point (P 0.05) and the level of PVR in group C was significantly lower than that in other groups. The difference was statistically significant (P 0.05). There was no significant difference between group A and group A (P 0.05). 3F-ERG examination: before modeling, the average value of the ratio b wave amplitude was 148.00 鹵6.89 渭 V. after modeling, the B wave amplitude in each group was lower than that before modeling. There was a significant difference between group A and group D at 1430d after injection, and there was no significant difference between the other check point groups (p 0.05). In 4 eyes, vitreous opacification and fibroproliferative membrane appeared before retina in group A, and proliferative bands of vitreous body in group B were found in group B: 2 eyes. However, no obvious abnormality was found in group C. 30 days after retinal detachment, retinal thickening was observed in group A, and vitreous opacification was found in 5 eyes of group B (retinal detachment), and vitreous opacity was found in group B (n = 5). Retinal thickening group B (2 eyes) and D group (3 eyes) had retinal detachment. Group C had a little vitreous opacity, a little proliferative line, and no retinal detachment. 5Retinal histopathological examination: the retinal layers of normal rabbit eyes were arranged neatly and clearly, the inner boundary membrane was continuous and smooth, the proliferative membrane appeared on the surface of retina of group A 14 days after injection, and the retinal thickening of group B _ (D) with the disorder of the structure of each layer was observed. However, no obvious abnormality was found in the retina of group C, and the structure of each layer was basically normal in group C. the retinal folds were formed in group A 30 days after injection. The proliferative membrane of retinal fibers in group B and D was significantly higher than that in group C. Conclusion 0.1 ml 0.5 mg fluorouracil combined with 0.1 ml 10 4 interferon-r intravitreal injection has a certain therapeutic effect on proliferative vitreoretinopathy in rabbits. The therapeutic effect is better than that of 0.2 ml 0.5 mg fluorouracil or 0.2 ml interferon-r.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R774.1

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