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目的 探讨组织型纤溶酶原激活剂 (t -PA)在兔眼青光眼滤过术毕前房小剂量 (2 5μg)注射的有效性。方法 采用前瞻性、盲法对照研究 ,2 0只健康白色家兔双眼行全厚巩膜咬切滤过手术 ,术毕随机选一眼为t-PA治疗眼 ,另一眼为等量生理盐水对照眼 ,术后临床观察结合光电镜检查。结果 生理盐水对照组术后 1日和 3日滤过道及滤泡腔内有纤维蛋白凝块及红细胞栓子阻塞 ,而t-PA治疗组滤过道完全开放 ,炎性细胞及成纤维细胞的数量明显减少 ;术后 7日和 1 4日t-PA治疗组手术区肉芽组织和瘢痕组织的量亦明显少于对照组。与组织学检查相一致 ,术后 1周内治疗组滤过泡比对照组明显增大。两组均未见明显毒副作用。结论 t-PA可有效溶解滤过道及滤泡腔内的纤维蛋白凝块 ,提高青光眼滤过手术的成功率
Objective To investigate the efficacy of tissue-type plasminogen activator (t-PA) in small-dose (25μg) injection of glaucoma in rabbit eyes. Methods A prospective, blinded and controlled study was conducted. Twenty cases of healthy white rabbits underwent full thickness scleral buckthorn surgery. One eye was randomly selected as the t-PA eye for treatment and the other for the same amount of saline control eye. Postoperative clinical observation combined with light microscopy. Results In control group, fibrin clots and erythrocyte embolus were blocked on the 1st and 3rd day after operation in the filtration passage and in the follicular cavity. The number of inflammatory cells and fibroblasts in the t-PA treatment group was completely open The number of granulation tissue and scar tissue in operation area of t-PA treatment group was also significantly less than that of control group on the 7th and 14th day after operation. Consistent with the histological examination, within 1 week after treatment, the filtration rate of the treatment group was significantly higher than that of the control group. No obvious side effects in both groups. Conclusion t-PA can effectively dissolve fibrin clots in the filter tract and the follicular cavity and improve the success rate of glaucoma filtration surgery