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目的:探讨视盘内注射组织凝血酶原激活剂的电生理学安全性。方法:首先将记录VEP的电极植入兔颅骨内。经兔睫状体扁平部将25μg tPA,12.5μg tPA及BSS注入视神经内0.1mL,并与第四组正常眼作比较(n=6)。注入后1,3,7,14和24d行裂隙灯及间接眼底镜检查,记录VEP及ERG。结果:检查未发现视神经内注射tPA对视神经和视网膜有明显的毒性作用和其它损伤。各组VEP第1个波峰的潜伏期分别是24.6±1.5, 24.1±1.9, 24.0±2.0和24.6±1.3mS(P=0.4112);振幅分别是124±42, 145±41, 132±48和117±29μV(P=0.0649)。各组ERG的a波的潜伏期分别是6.0±0.4, 5.9±0.4, 5.9±0.5和5.8±0.3mS(P=0.6279);振幅分别是110±14, 112±15, 110±16和108±11μV(P=0.7248)。b波的振幅分别是151±12,148±14, 144±16和141±20μV(P=0.0957)。结论:经睫状体扁平部向兔视神经内注射tPA,安全可行。
Objective: To investigate the electrophysiological safety of intrapleural injections of tissue prothrombin activator. Methods: First, the electrode recording VEP was implanted into the rabbit skull. Twenty-five micrograms of tPA, 12.5 micrograms of tPA, and BSS were injected into the optic nerve at 0.1 mL through the flattened rabbit ciliary body and compared to the fourth group of normal eyes (n = 6). Slit lamp and indirect ophthalmoscopy were performed at 1, 3, 7, 14 and 24 days after injection. VEP and ERG were recorded. RESULTS: No intra-optic tPA injection was found to have significant toxic effects on the optic nerve and retina and other injuries. The latency of the first peak of VEP in each group was 24.6 ± 1.5, 24.1 ± 1.9, 24.0 ± 2.0 and 24.6 ± 1.3 mS, respectively (P = 0.4112); the amplitudes were 124 ± 42, 145 ± 41, 132 ± 48 and 117 ± 29μV (P = 0.0649). The latency of a wave of ERG in each group was 6.0 ± 0.4, 5.9 ± 0.4, 5.9 ± 0.5 and 5.8 ± 0.3 mS, respectively (P = 0.6279); the amplitudes were 110 ± 14, 112 ± 15, 110 ± 16 and 108 ± 11 μV (P = 0.7248). The amplitudes of b wave were 151 ± 12, 148 ± 14, 144 ± 16 and 141 ± 20 μV, respectively (P = 0.0957). Conclusion: It is safe and feasible to inject tPA into the optic nerve of the rabbit through the flattened ciliary body.