摘要目的:比较兔眼跨巩膜持续给药、静脉给药与结膜下注射治疗实验性表皮葡萄球菌性眼内炎的效果。方法:纳入研究30只成年新西兰大白兔，雌雄不限，体质量2.0~2.5 kg，随机分成3组：静脉给药组、结膜下注药组及跨巩膜持续给药组，每组各10只。均在兔右眼接种0.1 mL 100 CFU表皮葡萄球菌后24 h开始进行治疗。静脉给药组每天静脉滴注20 mg去甲万古霉素，平均滴注持续时间1 h以上；结膜下注药组隔天一次结膜下注射浓度为20 mg/mL的去甲万古霉素0.3 mL；跨巩膜持续给药组每天以流速0.1 mL/h，浓度20 mg/mL在眼球筋膜囊下持续给药7 h。接种后每天行裂隙灯显微镜眼前段检查及眼底镜检查，并记录炎症评分。第8天处死动物摘除眼球，做石蜡包埋及组织切片观察。结果:三组症状炎症评分比较差异有统计学意义( F时间＝93.53， P<0.001； F组别＝4.07， P＝0.028)，跨巩膜持续给药组症状炎症峰值为(19.8±4.3)分与静脉给药组(24.3±4.08)分，结膜下注射组(24.3±6.77)分相比，炎症评分明显降低( t＝4.81, 5.00; P＝0.022, 0.018)。病理炎症评分比较，3组总体差异有统计学意义( F＝41.43, P<0.001)，跨巩膜给药组较其它两组眼球各部位病理炎症评分均显著降低(均 P<0.001)。 结论:跨巩膜持续给药方式治疗实验性表皮葡萄球菌性眼内炎较静脉给药及结膜下注药更有效。

abstractsObjective:To compare the therapeutic efficacy of transscleral continuous drug delivery, intravenous administration and subconjunctival injection in the treatment of experimental Staphylococcus epidermidis endophthalmitis in rabbit eyes.Methods:Thirty adult New Zealand white rabbits, without gender preferences, weighting 2.5-3.0 kg, were randomly divided into 3 groups with 10 rabbits in each group. There were the transscleral drug delivery group, the intravenous administration group and the subconjunctival injection group. Right eyes of the rabbits received the intraocular injection of 100 colony-forming units (CFU) of Staphylococcus epidermidis. At 24 hours after injection, the intravenous administration group received intravenous administration of 20 mg norvancomycin every day with average drip time more than 1 hour. The subconjunctival injection group received subconjunctival injection of 0.3 mL norvancomycin with concentration of 20 mg/mL once every two days.The transscleral drug delivery group received continuous transscleral norvancomycin infusion with the flow rate of 0.1ml/h with concentration of 20 mg/mL for 7 hours daily through a simply modified auto drug infusion pump. Each eye was observed by slit-lamp examination and funduscopy. Clinic symptom inflammation scores were recorded every day. The eyeballs were enucleated with Paraffin embedding and tissue slice observation. The pathological inflammation scores were recorded.Results:The difference was statistically significant among the three groups ( Ftime=93.53, P<0.001; Fgroup=4.07, P=0.028). The maximum clinic symptom inflammation scores of the transscleral drug delivery group [(19.8±4.13) scores] was obviously lower than those of the intravenous administration group [(24.3±4.08) scores] and the subconjunctival injection group [(24.3±6.77) scores], ( t=4.81, 5.00; P=0.022, 0.018). There were differences in overall pathological inflammation scores among the three groups( F= 41.43, P<0.001). The pathological inflammation scores of different sections in the eyeballs of the transscleral drug delivery group were obviously lower than those of the other two groups(all P<0.001). Conclusion:Transscleral drug delivery is more effective than intravenous administration and subconjunctival injection for the treatment of experimental Staphylococcus epidermidis endophthalmitis.