摘要
目的研究单剂量丝裂霉素C(MMC)局部注射对翼状胬肉组织中血管和成纤维细胞的影响,探讨MMC对翼状胬肉治疗作用的机制。方法翼状胬肉患者随机分为二组:A组直接切除胬肉组织,留标本作病理检查;B组于翼状胬肉颈部进针,向翼状胬肉组织内局部注射MMC0.1ml(0.4mg/ml),注射药物后3～10周手术切除翼状胬肉,留标本。C组为患其它眼病而无翼状胬肉者的球结膜。各标本做HE染色,观察组织中血管和成纤维细胞的变化。结果光镜下,B组翼状胬肉头、体部可见血管减少,基底膜附近小血管萎缩;成纤维细胞减少,且胞体小,核深染,核形态不规则,胞浆欠清晰。A、B组标本血管数量明显较正常结膜多,呈散在分布。A组头、体部的血管、成纤维细胞数分别与B、C组相比较均有显著差异(P<0.05)。患者在注射MMC后1个月内有结膜水肿、充血,但逐渐减轻,部分患者注射MMC后,有眼痛症状,经治疗后减轻。使用MMC的B组未出现因使用MMC而出现的严重并发症。结论MMC对翼状胬肉组织中的血管和成纤细胞有抑制作用;MMC在低浓度、低剂量下使用未出现眼部严重并发症。
Objective To study the impact of single dose mitomycin C on vessel and fibroblasts in pterygium,and to study its treatment mechanism on pterygium. Methods 1. The pterygium cases were divided into two groups ： group A, group B. In group A, pterygiums were directly cut and specimens of pterygiums were kept for pathological study. In group B, single dose MMC, which is 0. 1ml from 0.4mg/ml , was injected into pterygiums through their necks preoperatively. Pterygium resections were done 3 to 10 weeks after injection and specimens were kept for pathological study as well. Group C, 5 eyes were observed from normal balbar conjunctiva with other eye diseases but without pterygium. 2. specimens from group A, B and N were made into paraffin sections respectively with HE staining to observe changes of vessel and fibroblasts. Results 1. Vascular disappeared or became thinner, congestion of the pterygiam body decreased with different degrees of vascular contraction in pterygium after using MMC. 2. The number of blood,vessels reduced in the head and body of the pterygium in group B under optical microscope. Small blood vessels shrank near the basement membrane. Fibroblasts reduced and the cell body wane with deep staining and irregular shape nuclear, less clear cytoplasm. More blood vessels were found in group A and B with pterygiums compared with Group C, and these blood vessels scattered. The mimber of blood vessels in the head and body of pterygium in group A was significantly different （ P 〈 0.05 ） compared with group B as well. Some patients outset the symptom of eye pain after using MMC, and the symptoms relieved one week after using Indomethacin orally or by eye drops. There were no complications because of MMC in MMC using group . Conclusion 1. The number of blood vessels and fibroblasts increased significantly in pterygium than that in normal conjunctiva. 2. MMC can depress blood vessels and fibroblasts in pterygium. There were no serious eye complications with using low concentration and low dose of MMC.
出处
《临床眼科杂志》
2009年第2期163-166,共4页
Journal of Clinical Ophthalmology
