本文選題：加替沙星膠聯(lián)羊膜藥膜　切入點(diǎn)：細(xì)菌性角膜炎　出處：《中國(guó)老年學(xué)雜志》2017年15期 　論文類型：期刊論文

【摘要】：目的探討加替沙星膠聯(lián)羊膜藥膜治療細(xì)菌性角膜炎兔模型的效果。方法參照常規(guī)方法制作加替沙星膠聯(lián)羊膜藥膜。新西蘭大白兔25只中隨機(jī)取5只,左眼為對(duì)照眼,右為實(shí)驗(yàn)眼。待動(dòng)物完全麻醉后,將制成的藥膜片覆蓋于眼球表面后揭去表層的硝酸濾紙,并用尼龍縫線間斷縫合固定于角膜緣淺層鞏膜。對(duì)照眼結(jié)膜囊內(nèi)滴入配制的3 mg/ml加替沙星溶液50μl,并于12 h后重復(fù)滴眼一次。分別于術(shù)后和首次滴眼后1 d、2 d、3 d、4 d、5 d雙眼同時(shí)抽取房水。利用高效液相色譜法檢測(cè)實(shí)驗(yàn)眼和對(duì)照眼房水中加替沙星濃度。制作金葡球菌性角膜潰瘍動(dòng)物模型,將潰瘍形成后的動(dòng)物分為4組,每組4只,分別為A組:生理鹽水組,B組:加替沙星滴眼液組,C組:加替沙星膠聯(lián)羊膜藥膜組,D組:單層羊膜組。取各組潰瘍愈合的兔眼作細(xì)菌培養(yǎng),檢查各組金葡球菌性角膜潰瘍的細(xì)菌陰轉(zhuǎn)情況。取潰瘍組織石蠟包埋、切片,HE染色。同時(shí)對(duì)各組角膜潰瘍動(dòng)物的療效進(jìn)行判定。結(jié)果實(shí)驗(yàn)眼各時(shí)間點(diǎn)房水中均可測(cè)出加替沙星,濃度0.036~0.274μg/ml,實(shí)驗(yàn)組第1、2、3天房水中加替沙星濃度與第4、5天相比明顯較高;對(duì)照眼僅在第1天和第2天檢測(cè)出加替沙星,且濃度顯著低于實(shí)驗(yàn)眼(P0.05)。角膜潰瘍,加替沙星滴眼液和藥膜均療效顯著,且藥膜在干預(yù)3 d和7 d后評(píng)分均顯著低于加替沙星滴眼液干預(yù)(P0.05);加替沙星滴眼液和藥膜在干預(yù)后細(xì)菌培養(yǎng)情況均出現(xiàn)一定程度的陰轉(zhuǎn),而另外兩組僅生理鹽水干預(yù)7 d后出現(xiàn)1例陰轉(zhuǎn)。角膜切片HE染色觀察加替沙星滴眼液和藥膜干預(yù)角膜上皮及基質(zhì)有輕微水腫,炎癥細(xì)胞浸潤(rùn)大量減少;加替沙星滴眼液和藥膜均療效顯著,痊愈率及好轉(zhuǎn)率分別為(75.00%vs 87.50%)和(100.00%vs 100.00%)。結(jié)論加替沙星膠聯(lián)羊膜藥膜對(duì)金葡球菌性角膜潰瘍具有良好的治療作用,開辟了治療細(xì)菌性角膜潰瘍的另一途徑。
[Abstract]:Objective to investigate the effect of gatifloxacin gel combined with amniotic membrane on the treatment of rabbit model of bacterial keratitis. Methods Gatifloxacin gel combined with amniotic membrane was made in 25 New Zealand white rabbits. When the animal is completely anesthetized, the film is coated on the surface of the eyeball and removed from the surface of the surface of the eye with nitric acid filter paper. Nylon suture was used to fix the superficial limbal sclera. The conjunctival sac of control eyes was treated with 50 渭 l of 3 mg/ml gatifloxacin solution and repeated drops 12 hours later. D simultaneous extraction of aqueous humor with both eyes. The concentrations of gatifloxacin in aqueous humor of experimental eyes and control eyes were determined by HPLC. The animal model of Staphylococcus aureus corneal ulcer was established. The animals with ulcers were divided into 4 groups, 4 animals in each group. Group A: normal saline group: group B: gatifloxacin eye drops group (group C): gatifloxacin gel combined amniotic membrane group (group D): monolayer amniotic membrane group. The bacterial negativity of Staphylococcus aureus corneal ulcer in each group was examined. The ulcer tissue was embedded in paraffin and stained with HE. The curative effect of each group was determined. Results gatifloxacin could be detected in aqueous humor at every time point in experimental eyes. The concentration of gatifloxacin in aqueous humor of the experimental group was significantly higher on the 1st and 2nd day than on the 4th and 5th day, and the concentration of gatifloxacin was significantly lower than that of the experimental eye on the 1st and 2nd day, and the concentration of gatifloxacin in the experimental group was significantly lower than that in the experimental eye on the first day and the second day, and the concentration of gatifloxacin in the experimental group was significantly lower than that in the experimental eye. The efficacy of gatifloxacin eye drops and gatifloxacin eye drops was significant, and the scores of gatifloxacin eye drops and gatifloxacin eye drops were significantly lower than those of gatifloxacin eye drops after 3 and 7 days of intervention (P 0.05). In the other two groups, there was only one negative change after 7 days of intervention with normal saline. The corneal sections were stained with HE to observe the slight edema of corneal epithelium and stroma treated with gatifloxacin eye drops and membrane, and the decrease of inflammatory cell infiltration. The curative effect of gatifloxacin eye drops and gatifloxacin eye drops was significant, the cure rate and improvement rate were 75.00 vs 87.50 and 100.00000 vs 100.000.Conclusion Gatifloxacin gel combined amniotic membrane has a good therapeutic effect on Staphylococcus aureus corneal ulcer. It opens up another way to treat bacterial corneal ulcer.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第一醫(yī)院;
【基金】：重慶市衛(wèi)生局科研資助項(xiàng)目(渝衛(wèi)科教2008-2-114)
【分類號(hào)】：R-332;R772.21
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本文編號(hào)：1566977