摘要目的 探讨吡非尼酮滴眼液在兔青光眼小梁切除手术后的应用效果.方法 实验研究.选择新西兰白兔24只(24只眼),制作兔高眼压模型5天后进行小梁切除术,分为两组:实验组使用吡非尼酮滴眼液滴眼,对照组使用PBS眼液滴眼.分别于术后1d(天)、7d、14 d、28 d观察眼压情况、结膜滤过泡、并发症情况,real-time PCR观察比较两组滤过泡区CTGF mRNA表达水平,共焦显微镜比较观察滤过泡微囊泡密度和面积情况.结果 术前及术后1d,7d,比较两组眼压,差异均无统计学意义(P＞0.05);术后14 d,21 d和28 d,两组间眼压比较,差异均有统计学意义(P＜0.05).术后1d,7d,14 d两组的滤过泡评分比较,差异无统计学意义(P＞0.05);比较术后21 d,28 d两组的滤过泡评分,差异有统计学意义(P＜0.05).经过治疗28 d后,实验组结膜上皮下平均微囊密度和平均微囊面积分别为(106±24) cysts/mm2和(29 783±13 604) μm2, 而对照组结膜上皮下平均微囊密度和平均微囊面积分别为(23±12) cysts/mm2和(4 754±2 536) μm2,两组比较差异均有统计学意义(P＜0.05).两组结膜滤过泡区CTGF mRNA表达在各时间点比较差异有统计学意义(P＜0.05).结论 吡非尼酮滴眼液应用于兔青光眼小梁切除手术后,降低眼压持久,滤过泡形成良好,有明显的抗瘢痕作用.

abstractsObjective To investigate the efficacy of pirfenidone eye drops for trabeculectomy in rabbit glaucoma model.Methods Totally 24 rabbits (24 eyes) with high intraocular pressure (IOP) were randomly divided into 2 groups: the experimental group (ocular trabeculectomy in combination with pirfenidone) and the control group (ocular trabeculectomy surgery in combination with PBS).Clinical observations (including IOP, filtering blebs and complications), real-time quantitative reverse transcription-polymerase chain reaction (real-time PCR) were performed on different time points (D1, D7, D14, D21 and D28) after the surgery.The conjunctiva area of filtering blebs was scanned with Confoscan 4.0.The images of conjunctiva filtering blebs were analyzed.Results There was no significant difference on IOP before and after ld, 7d preoperation (P ＜0.05).After PD 21, there were statistically significant differences in the IOP and filtering bleb scores in both group (P ＜0.05), whereas no statistically difference on that at PD1, 7 and 14 (P ＞0.05).On postoperative D28, the mean density of microcyst (106±24) cysts/mm2 and mean microcyst area (29783±13604)μm2 in the experimental group was significantly higher compared to those in the control group [(23±12) cysts/mm2 and (4754±2536) μm2, P ＜0.05, respectively].Compared to that in control group, the level of CTGF expression in operation areas was reduced in the experimental on mRNA level (P ＜0.05).Conclusions The trabeculectory surgery with pirfenidone eye drops can control IOP, sustain the functional filtration bleb, inhibit the proliferation of fibroblasts and open the filtrating pathway on the rabbit glaucoma models.