目的：研究银杏内酯B联合干细胞移植对青光眼大鼠的影响及相关机制。

方法：实验共分为五组：正常对照组(Control)、青光眼模型组(GLA)、干细胞组(RSCs)、银杏内酯B组(GKB)与混合组(RSCs+ GKB)。眼球组织进行HE染色，TUNEL染色检测视网膜神经节细胞的凋亡，免疫印迹法(Western blot)检测Bcl-2、Bax以及Cleaved caspase-3和Cleaved caspase-9的蛋白表达水平，实时荧光定量PCR(RT-qPCR)分别检测各组组织中Bcl-2、Bax mRNA表达水平。

结果：HE染色结果显示，给予干细胞或银杏内酯B处理，减少纤维间质水肿与空泡的出现，混合组纤维间质少见水肿与空泡； 银杏内酯B联合干细胞处理后显著减少视网膜神经节细胞的凋亡，上调Bcl-2的蛋白与mRNA表达水平，并下调Bax的蛋白与mRNA表达水平、Cleaved caspase-3和Cleaved caspase-9的蛋白表达水平。

结论：银杏内酯B联合干细胞能够抑制青光眼大鼠视网膜神经节细胞的凋亡，改善青光眼，其作用机制可能与调控Bcl-2、Bax、Cleaved caspase-3和Cleaved caspase-9因子的表达有关。

METHODS: Rats were divided randomly into five groups: control group, glaucoma group, RSCs group, GKB group and RSCs combination therapy group. A chronic glaucoma model was established in rats, accordingly. The morphological changes in ocular tissues were analyzed by HE staining. Retinal ganglion cells apoptosis were analyzed by TUNEL staining. The protein expressions of Bcl-2, Bax, Cleaved caspase-3 and Cleaved caspase-9 were determined by Western blot. The mRNA levels of Bcl-2 and Bax were determined by qPCR.

RESULTS: HE staining revealed that RSCs transplantation or GKB treatment decreased fiber interstitial edema and vacuole, as compared to glaucoma group. Furthermore, this improvement was more pronounced in combination therapy group than in single treatment alone. Combination therapy significantly inhibited retinal ganglion cells apoptosis, increased Bcl-2 mRNA and protein expression,but decreased Bax mRNA and protein expression. Moreover, the protein expression of Cleaved caspase-3 and Cleaved caspase-9 expression were decreased after combination therapy.

CONCLUSION: Our data demonstrate that combination of Ginkgobalide B and retinal stem cells transplantation can inhibit retinal ganglion cells apoptosis and protect against glaucoma. These effects may be associated with the regulation of Bcl-2, Bax, Cleaved caspase-3 and Cleaved caspase-9 expression.