Wentworth J S, Paterson C A, Gray R D
Department of Ophthalmology and Visual Sciences, University of Louisville School of Medicine, Kentucky.
Invest Ophthalmol Vis Sci. 1992 Jun;33(7):2174-9.
Proteinase inhibitors have been shown to prevent corneal ulceration and perforation when used immediately after an experimental alkali burn injury. To evaluate the clinical efficacy of a synthetic metalloproteinase inhibitor, HSCH2CH[CH2CH(CH3)2]CO-Phe-Ala-NH2(SIMP), treatment with inhibitor was withheld until corneal ulceration ensued after a standard alkali injury to the rabbit eye. When topical therapy with a 1 mmol/l solution of SIMP was initiated after corneal ulceration had progressed to a mid-stromal level (clinical score of 2), there was no significant difference in the progression of corneal ulceration between the treated vs. control group after 6 d of therapy. In the second study in which treatment was initiated earlier at the onset of superficial ulceration (clinical score of 1), there was a significant difference in clinical scores between the two groups after 1 day of treatment until termination of the experiment at 21 d (P less than 0.005). In the inhibitor-treated group, 88.9% of the corneas showed a reversal or cessation of progression of the ulceration process. Eighty-seven-and-a-half percent of the control corneas progressed to descemetocele formation or perforation by day 14 of treatment. This study suggests that SIMP may be used for effective treatment of corneal ulcers resulting from an alkali burn injury in the human eye. It also shows that early and aggressive initiation of therapy is critical.
蛋白酶抑制剂已被证明在实验性碱烧伤后立即使用时可预防角膜溃疡和穿孔。为了评估一种合成金属蛋白酶抑制剂HSCH2CH[CH2CH(CH3)2]CO-Phe-Ala-NH2（SIMP）的临床疗效，在对兔眼进行标准碱损伤后，直到角膜溃疡出现才开始用抑制剂治疗。当角膜溃疡发展到基质中层水平（临床评分为2）后开始用1 mmol/l的SIMP溶液进行局部治疗时，治疗6天后治疗组与对照组之间角膜溃疡的进展没有显著差异。在第二项研究中，在浅表溃疡开始时（临床评分为1）更早开始治疗，治疗1天后直到21天实验结束，两组之间的临床评分有显著差异（P小于0.005）。在抑制剂治疗组中，88.9%的角膜显示溃疡进展过程逆转或停止。到治疗第14天时，87.5%的对照角膜发展为后弹力层膨出或穿孔。这项研究表明，SIMP可用于有效治疗人眼碱烧伤引起的角膜溃疡。它还表明早期积极开始治疗至关重要。
