Nasir M A, Toth C A, Mittra R A
Department of Ophthalmology, Duke University Medical Center, Durham, NC 27710, USA.
Am J Ophthalmol. 1996 May;121(5):554-60. doi: 10.1016/s0002-9394(14)75430-3.
To determine the efficacy of a specific antithrombin agent (recombinant desulphatohirudin variant 1 [Revasc, Ciba-Geigy, Ltd., Basel, Switzerland]) administered in the infusion fluid to prevent early postoperative fibrin formation in a rabbit lensectomy and vitrectomy model.
Standard fragmatome lensectomies and core vitrectomies were performed prospectively in a masked fashion on ten control eyes with lactated Ringer's infusion and on ten eyes treated with 10 microgram of recombinant hirudin/ml in the infusate. The amounts of fibrin and hemorrhage were graded in a masked fashion by using slit-lamp examination and indirect ophthalmoscopy on postoperative days 1 through 5 and on day 7.
The difference in the mean grade of fibrin formed on the first postoperative day in the eyes treated with recombinant hirudin (mean, 0.9) in relation to the mean grade of fibrin in the control eyes (mean, 3.5) was statistically significant (P = .004). This difference was also significant on the second postoperative day (P = .01). None of the treated eyes developed intraoperative or postoperative hemorrhage.
Recombinant desulphatohirudin variant 1 is an effective inhibitor of postoperative fibrin formation in a rabbit model and is not associated with an increased risk of intraoperative or postoperative bleeding at the tested dose. This drug may be a useful adjunct in vitreous surgery for both proliferative vitreoretinopathy and the complications of proliferative diabetic retinopathy.
确定在输液中给予一种特定抗凝血酶药物（重组去硫酸水蛭素变体1 [瑞伐沙，瑞士巴塞尔汽巴 - 嘉基有限公司]）在兔晶状体切除和玻璃体切除模型中预防术后早期纤维蛋白形成的疗效。
对10只接受乳酸林格氏液输注的对照眼和10只在输注液中使用10微克/毫升重组水蛭素治疗的眼，以盲法前瞻性地进行标准晶状体切碎切除术和核心玻璃体切除术。通过裂隙灯检查和间接检眼镜检查，在术后第1天至第5天以及第7天以盲法对纤维蛋白和出血的量进行分级。
用重组水蛭素治疗的眼（平均0.9）术后第一天形成的纤维蛋白平均分级与对照眼（平均3.5）的纤维蛋白平均分级之间的差异具有统计学意义（P = 0.004）。在术后第二天这种差异也具有显著性（P = 0.01）。所有治疗眼均未发生术中或术后出血。
重组去硫酸水蛭素变体1在兔模型中是术后纤维蛋白形成的有效抑制剂，并且在所测试的剂量下与术中或术后出血风险增加无关。这种药物可能是玻璃体手术治疗增殖性玻璃体视网膜病变和增殖性糖尿病视网膜病变并发症的有用辅助药物。
