摘要
目的探讨外源性胰岛素样生长因子Ⅰ（IGF-Ⅰ）对外斜视猫模型内直肌肌分化因子5（Myf5）、转化生长因子β1（TGF-β1）表达变化的影响。方法实验研究。选择处于视觉发育敏感期内幼猫（4-6周）27只，采用随机数字表法分为实验组、无菌水对照组和空白对照组，各组再根据药物干预时间分为4周亚组、8周亚组、12周亚组，每亚组3只。通过缩短外直肌并前徙制作右眼外斜视幼猫模型后，实验组将外源性IGF-Ⅰ 0.05 ml（0.1 g/L）注射到右眼内直肌建立外斜视治疗模型；无菌水对照组注射等量无菌水；空白对照组未进行注射。各组分别于药物干预后4、8、12周取完整右眼内直肌，采用免疫组织化学染色法检测内直肌Myf5和TGF-β1平均吸光度（A）值。采用Kruskal-Wallis、Bonferroni检验方法分析Myf5和TGF-β1表达的变化，采用简单线性回归等方法分析Myf5和TGF-β1表达与药物干预时间的相关性。结果（1）药物干预4周时，实验组内直肌Myf5的A值（33.34±17.16）与无菌水对照组（21.30±7.44）和空白对照组（18.95±6.59）比较，差异无统计学意义（χ2=4.646，P〉0.05）；药物干预8、12周时，实验组内直肌Myf5的A值分别为39.24±15.25和47.70±19.39，高于同时间点的无菌水对照组（19.43±4.75、4.82±2.66）和空白对照组（18.00±7.29、5.86±2.61），差异均有统计学意义（χ2=21.864、31.814，均P〈0.01）。实验组内直肌Myf5的A值随着IGF-Ⅰ干预时间的延长呈增加趋势（R2=0.99，P〈0.05）；无菌水对照组及空白对照组内直肌Myf5的A值随时间延长呈降低趋势（R2=0.81、0.80，均P〈0.05）。（2）药物干预4、8、12周时，实验组内直肌TGF-β1的A值分别为0.80±0.12、0.53±0.09和0.42±0.08，均低于同时间点的无菌水对照组（1.91±0.23、2.30±1.03、1.82±0.72）及空白对照组（2.01±0.31、2.62±1.11、1.83±0.67），差异均有统计学意义（χ2=30.801、40.278、35.177，均P〈0.01）。实验组内直肌TGF-β1的A值随着IGF-Ⅰ干预时间延长呈降低趋势（R2=0.83，P〈0.05）；无菌水对照组及空白对照组内直肌TGF-β1A值与时间无相关性趋势（R2=0.04、0.06）。结论外源性IGF-Ⅰ对外斜视猫模型内直肌中Myf5的表达具有增强作用，对TGF-β1的表达具有抑制作用。重复注射外源性IGF-Ⅰ可使Myf5持续增强表达，TGF-β1持续减弱表达。
ObjectiveTo analyze the relationship between optical coherence tomography（OCT） performance and visual acuity of patients with acute retinal necrosis （ARN）.MethodsRetrospective analysis was performed on the patients diagnosed with ARN at the ophthalmology department of Peking union hospital during October 2011 and May 2016. Fourteen patients （15 eyes）, 9 males and 5 females, whose anterior and posterior inflammation disappeared and the retinal necrosis lesion in the fundus of the eye subsided were included. The mean age was （41.6±12.2） years. All patients underwent careful examinations including best corrected visual acuity （BCVA）, slit-lamp microscope, indirect ophthalmoscope, color fundus picture, fundus fluorescein angiography （FFA） and OCT （results of their last consultations）.ResultsBCVA： 8 eyes were increased, 2 eyes were unchanged and 5 eyes were decreased at the last visit; light perception （LP） 1 eye, finger count （FC） 1 eye, 3 eyes of 0.01 to 0.1, 6 eyes of 0.15 to 0.25. The inflammatory reaction in the anterior segment of 14 eyes disappeared, while the inflammatory reaction of the remaining 1 eye was relieved. The fundus lesions of all 15 eyes disappeared. According to OCT results： five eyes （5/15） exhibited normal macula area, among the 5 eyes, 4 eyes are of 0.15 to 0.25 visual acuity, and 1 eye is of 0.5 visual acuity;macular epiretinal membrane is present in three eyes （3/15）, of which the visual acuity is 0.02, 0.25 and 0.3 respectively macula edema is present in three eyes （3/15）, among the 3 eyes, 1 eye （visual acuity of 0.01）showed thickening of neurosensory retina, cystoid change of fovea and several fluid dark areas, the other 2 eyes （visual acuity of 0.02 and 0.5 respectively） showed small diffuse fluid dark area in the neurosensory retina;atrophy of neurosensory retina and absence of IS/OS was found in four eyes （4/15）, among the 4 eyes, the visual acuity of 3 is below 0.01, and the other 1 eye is of 0.08 visual acuity.ConclusionsThe OCT performance of stationary phase of ARN tends to be positively correlated with the visual acuity of patients. The prognosis of visual acuity of the patients whose OCT results showed atrophy of neurosensory retina and absence of IS/OS is poor.
作者
狄宇
叶俊杰
李东辉
Di Yu, Ye Junjie, Li Donghui(Department of Ophthalmology, Peking Union Medical Academy of Medical Sciences, Beijing 100730, Chin)
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2018年第5期369-374,共6页
Chinese Journal of Ophthalmology
关键词
视网膜坏死综合征
急性
体层摄影术
相干光
视敏度
治疗结果
Retinal necrosis syndrome
acute
Tomography
optical coherence
Visual acuity
Treatment outcome
