發(fā)布時間：2019-01-24 12:12

【摘要】： 背景和目的在抑制后發(fā)性白內(nèi)障方面,抗代謝藥物發(fā)揮了重要的作用。其中,5-氟尿嘧啶因其特異性高,抑制作用強,對眼內(nèi)組織毒性小而倍受重視。本實驗在國內(nèi)外大量翔實的動物實驗和臨床實驗的基礎(chǔ)上,利用自制的微量進樣器將5-氟尿嘧啶注入到囊袋內(nèi),觀察其對后發(fā)性白內(nèi)障的抑制作用,為進一步探討后囊膜混濁的機理打下基礎(chǔ),為臨床防治后發(fā)性白內(nèi)障的提供快捷、有效的給藥途徑。 材料和方法本次實驗的研究對象為2009年3月-2009年9月期間在我科就診的白內(nèi)障患者。納入標準為老年性白內(nèi)障患者,無其他潛在的干擾實驗結(jié)果的眼部疾病以及全身疾病。將符合上述標準的來自97名患者的107只眼編號,利用隨機數(shù)字表隨機分到四組,分別為實驗組A1,A2,A3和對照組B。實驗組A1,A2,A3在術(shù)中利用自制的微量進樣器在囊袋內(nèi)注入濃度為分別為0.25mg/ml,0.3mg/ml,0.35mg/ml的5-氟尿嘧啶50μl,存留時間約3分鐘。對照組則不進行此步驟。實驗的觀察指標包括術(shù)后1月,3月和7月的后囊膜渾濁的Odrich評分,術(shù)前術(shù)后的眼壓值,術(shù)前術(shù)后的角膜內(nèi)皮細胞密度以及《受試對象主觀感覺調(diào)查問卷》。統(tǒng)計學(xué)處理：對上述觀察指標的結(jié)果采用t檢驗和F檢驗,全部資料應(yīng)用SPSS15.0統(tǒng)計軟件包進行統(tǒng)計學(xué)處理。 結(jié)果1.在術(shù)后第三個月和第六個月,實驗組和對照組之間的Odrich評分之間的差異具有統(tǒng)計學(xué)意義；同時,每組都出現(xiàn)了Odrich評分的陽性評分,即5-氟尿嘧啶對晶狀體上皮細胞的增殖和移行僅限于抑制作用。2.實驗組和對照組的術(shù)前和術(shù)后眼壓值之間的差異無統(tǒng)計學(xué)意義3.實驗組和對照組術(shù)前和術(shù)后的角膜內(nèi)皮細胞密度之間的差異無統(tǒng)計學(xué)意義4.實驗組和對照組之間患者術(shù)后的不適感的陽性率和術(shù)后視力滿意率的差異具有統(tǒng)計學(xué)差異。 結(jié)論1,白內(nèi)障超聲乳化術(shù)中,在囊袋內(nèi)直接利用微量計量器注入5-氟尿嘧啶是簡單方便,行之有效的給藥方式。2,5-氟尿嘧啶對晶狀體上皮細胞的抑制作用具有濃度依賴性,同時5-氟尿嘧啶的眼毒性也是具有濃度依賴性；0.35mg/ml是在二者之間達到平衡的濃度。3,5-氟尿嘧啶對晶狀體上皮細胞僅存在抑制作用,并不能完全阻止晶狀體上皮細胞的增殖和移行。
[Abstract]:Background and objective antimetabolic drugs play an important role in the suppression of post-cataract. Among them, 5-fluorouracil has attracted much attention because of its high specificity, strong inhibitory effect and low toxicity to intraocular tissue. Based on a large number of animal and clinical experiments at home and abroad, 5-fluorouracil (5-FU) was injected into the capsule by using a self-made micro sampler to observe the inhibitory effect of 5-fluorouracil on post-cataract. In order to further explore the mechanism of posterior capsule opacification, and provide a quick and effective way for clinical prevention and treatment of posterior cataract. Materials and methods Cataract patients in our department from March 2009 to September 2009 were studied. Inclusion criteria for senile cataract patients, no other potential interference with experimental results of eye disease, as well as systemic disease. 107 eyes from 97 patients who met the above criteria were randomly divided into four groups by random number table: experimental group A1A2A3 and control group B3. In the experimental group, the concentration of 5-fluorouracil was 0.25 mg / ml 0.35 mg / ml, 0.35 mg / ml, respectively, and the retention time was about 3 minutes. The control group did not take this step. The experimental parameters included the Odrich score of posterior capsule opacification, intraocular pressure (IOP), corneal endothelial cell density (ECC) and subjective perception questionnaire of the subjects at 1 month, 3 months and 7 months after operation. Statistical processing: t test and F test were used for the results of the above observation indexes. All the data were statistically processed by SPSS15.0 statistical software package. Result 1. At the third month and the sixth month after operation, the difference of Odrich score between the experimental group and the control group was statistically significant. At the same time, each group showed a positive score of Odrich score, that is, 5-fluorouracil on the proliferation and migration of lens epithelial cells was limited to the inhibitory effect of 2. 2. There was no significant difference in IOP between the experimental group and the control group before and after operation. There was no significant difference in corneal endothelial cell density between experimental group and control group before and after operation. There were significant differences in the positive rate of postoperative discomfort and the rate of visual acuity satisfaction between the experimental group and the control group. Conclusion 1. During phacoemulsification of cataract, it is simple and convenient to inject 5-fluorouracil directly into the capsule by micrometer. The inhibitory effect of 2-fluorouracil on lens epithelial cells was concentration-dependent, and the eye toxicity of 5-fluorouracil was also concentration-dependent. The concentration of 0.35mg/ml reached a balance between them. 3FU had only inhibitory effect on lens epithelial cells and could not completely prevent the proliferation and migration of lens epithelial cells.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R779.66

【參考文獻】

相關(guān)期刊論文 前10條

1 司維柯,高利宏,劉斌,陳安,李鵬,姚婕;苦參堿誘導(dǎo)人肝癌細胞分化、凋亡時對G_1細胞周期調(diào)節(jié)因子的調(diào)控[J];癌癥;2001年08期

2 蔡季平,周浩,魏銳利,周韻秋,朱莉,朱煌,李由;Nd:YAG激光治療白內(nèi)障術(shù)后晶體后囊膜混濁[J];第二軍醫(yī)大學(xué)學(xué)報;2002年01期

3 江琳,張素華,錢軍,劉杰為,侯建萍,劉瑾,張云燕;晶狀體半脫位白內(nèi)障超聲乳化術(shù)中植入囊袋張力環(huán)的臨床觀察[J];國際眼科雜志;2005年05期

4 顧錚;;后囊膜連續(xù)環(huán)形撕囊聯(lián)合或不聯(lián)合前部玻璃體切除對兒童后發(fā)性白內(nèi)障影響的Meta分析[J];國際眼科雜志;2007年06期

5 劉建偉,趙強,萬昌秀;醫(yī)用聚乳酸體內(nèi)降解機理及應(yīng)用研究進展[J];航天醫(yī)學(xué)與醫(yī)學(xué)工程;2001年04期

6 高潮,王志立,戴曉東;地塞米松緩釋劑在白內(nèi)障超聲乳化摘除人工晶狀體植入術(shù)中的臨床應(yīng)用[J];臨床眼科雜志;2005年01期

7 李學(xué)民,梅明,王薇;白內(nèi)障患者手術(shù)前后色覺的變化[J];食品與藥品;2005年05期

8 鄧小艷;蔡小軍;柯治生;;IL-1β,IL-6反義寡核苷酸脂質(zhì)體抑制兔后發(fā)性白內(nèi)障[J];眼科新進展;2006年05期

9 鄭丹瑩,劉奕志,黃晶晶,鄭湖玲;晶體囊袋內(nèi)應(yīng)用絲裂霉素防治兔后發(fā)性白內(nèi)障的實驗研究[J];眼科學(xué)報;2001年02期

10 孫巖秀,李筱榮,張曉紅,孫慧敏,袁佳琴;5-氟尿嘧啶抑制兔晶狀體上皮細胞增殖及眼內(nèi)毒性的研究[J];眼科研究;2000年03期

，

本文編號：2414465