摘要
目的探讨低分子肝素钠抑制后发性白内障的发生机制。方法实验性研究。将30只4月龄健康新西兰白兔随机分为A、B、C三组,每组各10只,雌雄各半。A组为单纯手术组,行右眼晶状体超声乳化术;B组为手术+低分子肝素钠点眼组,行右眼晶状体超声乳化术,术后予12.5 g/L低分子肝素钠眼液点眼;C组为手术+低分子肝素钠灌注组,行右眼晶状体超声乳化术,术中前房灌注5000 IU低分子肝素钠。分别于术后3、14、28及60 d用ABC-ELISA法检测各组房水中血小板源性生长因子(PDGF)和表皮生长因子(EGF)的含量。术后60 d对各组晶状体后囊行光镜下观察并应用免疫组化半定量法检测晶状体上皮细胞增殖细胞核抗原(PCNA)的表达情况。多样本均数比较采用单因素方差分析,组间均数比较采用LSD-t检验。结果术后3 d,A组PDGF的含量为(48.25±1.37)μg/L,B组PDGF的含量为(41.16±0.97)μg/L,C组PDGF的含量为(32.35±0.27)μg/L,三组之间差异具有统计学意义(F=860.85,P<0.05);术后3 d,A、B、C组EGF的含量分别为(39.27±1.45)ng/L、(31.25±1.28)ng/L、(20.63±1.46)ng/L,三组间差异具有统计学意义(F=131.86,P<0.05)。术后14 d,三组之间EGF含量差异有统计学意义(F=70.14,P<0.05)。EGF含量A组为(35.09±0.70)ng/L,B组为(21.34±0.47)ng/L,C组为(21.18±0.98)ng/L,三组中PDGF含量差异无统计学意义(F=2.176,P=0.145)。术后28 d,三组PDGF和EGF含量差异无统计学意义(F=2.079,P=0.123;F=2.273,P=0.134);术后60 d,三组PDGF和EGF含量差异无统计学意义(F=3.83,P=0.082;F=2.779,P=0.139)。光镜下,三组后囊膜上均可见晶状体上皮细胞,A组和B组细胞数目明显增多,细胞重叠,形态大致正常,A组中还出现了晶状体纤维增生。C组囊膜上只有单层上皮细胞覆盖。PCNA在三组均有阳性表达,三组之间差异有统计学意义(F=127.59,P<0.05)。吸光度(A值)A组为59.5±5.0,B组为23.1±2.6,C组8.6±0.7。结论低分子肝素钠显著抑制了白内障模型兔超乳术后晶状体后囊的混浊以及术后房水中PDGF、EGF的表达;低分子肝素钠术中灌注效果优于术后局部点药。
Objective To discuss the inhibitory mechanism of low molecular weight heparin sodium on posterior capsular opacification in rabbit. Methods It was an experimental study. Thirty New Zealand white rabbits that weighted 1. 5-2. 0 kg without eye diseases were randomly divided into three groups,each group of ten,half male and half female. Group A was surgery group,undertook phacoemulsification in right eye without low molecular weight heparin; Group B,surgery + low molecular weight heparin eyedropping group,undertook phacoemulsification in right eye,then dropped eyes by 12. 5 g/L low molecular weight heparin; Group C,surgery + low molecular weight heparin perfusing group,undertook phacoemulsification in right eye and perfused the anterior chamber by 5000 IU low molecular weight heparin injection in surgery.The concentrations of PDGF and EGF in aqueous 3,14,28,60 days after the surgery were measured respectively. Cell morphological changes were observed under the light microscope,and the expression of PCNA in the lens epithelial cells were detected by immunohistochemical SP method 60 days after surgery.Data were analyzed by SPSS 13. 0 software. Measurement data were given by( ± s) and tested by One-Way ANOVA and LSD-t test. Results Both PDGF and EGF concentrations in aqueous in three groups had significant difference 3 days after surgery(F = 860. 85,P < 0. 05; F = 131. 86,P < 0. 05). The PDGF concentration was(48. 25 ± 1. 37) ng/L in group A,(41. 16 ± 0. 97) ng/L in group B and(32. 35 ± 0. 27)ng/L in group C. The EGF concentration was(39. 27 ± 1. 45) pg/L in group A,(31. 25 ± 1. 28) pg/L in group B and(20. 63 ± 1. 46) pg/L in group C. 14 days after surgery,EGF concentrations in aqueous in three groups had significant difference(F = 127. 59,P < 0. 05). The EGF concentration in aqueous in group A was significantly higher than that in group B and group C(P < 0. 05),while no significant difference had been found between group B and group C. No significant difference of PDGF concentration had been found in these three groups 14 days after surgery(F = 2. 176,P = 0. 145). No significant difference of both PDGF and EGF concentration had been found in these three groups 28 days after surgery(F = 2. 079,P = 0. 123; F =2. 273,P = 0. 134). and no significant difference had been found 60 days after either(F = 3. 83,P = 0. 082;F = 2. 779,P = 0. 139). Under the light microscope,lens epithelial cells were found in all the three groups,the number of cells in group A and group B had increased,while the cells had general normal morphology.Fibroplasia had been found in group A while group C was only covered by simple epithelium. Significant difference in PCNA was detected in three groups(F = 127. 59,P < 0. 05),the IOD was 59. 5 ± 5. 0 in group A,23. 1 ± 2. 6 in group B,and 8. 6 ± 0. 7 in group C,group C was significantly lower than group A and group B(P < 0. 05). Conclusions Low molecular weight heparin significantly inhibited the posterior capsular opacification and the expression of PDGF,EGF after cataract surgery in rabbit. Perfusing low molecular weight heparin during surgery was more dffective than partial applications after surgery.
出处
《中华眼科医学杂志（电子版）》
2012年第2期19-23,共5页
Chinese Journal of Ophthalmologic Medicine(Electronic Edition)
基金
河北省2011年医学科学研究重点课题计划(20110109)
关键词
低分子肝素钠
后发性白内障
血小板源性生长因子
表皮生长因子
Low molecular weight heparin
Posterior capsular opacification
Platelet-derived growth factor
Epidermal growth factor
