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[板层角膜移植时间对角膜碱烧伤血清特异性抗体产生的影响]

[Effect of lamellar keratoplasty time on the production of serum specific antibody in corneal alkali burns].

作者信息

Zheng Xiao-Fen, Feng Ke-Xiao, Li Bing, Yang Ji-Zhong, Ge Jing-Jing

机构信息

Shanxi Eye Hospital, Taiyuan 030002, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2004 Mar;40(3):160-4.

Abstract

OBJECTIVE

To observe the production of serum specific anti-denatured corneal antibody and the effects of lamellar keratoplasty on changes of corneal histopathology in different stages after alkali burns.

METHODS

20 male New Zealand rabbits, with alkali burns in right eye were randomly divided into 5 groups including: burned group; 2 early lamellar keratoplasty group (operation at 3 or 7 days post alkali burns respectively); 2 middle and later lamellar keratoplasty groups (operation at 2 or 5 weeks after alkali burns respectively). The level of serum specific antibody in each group was detected by ELISA and the corneal structure was evaluated by light and electron microscopy in different stages after alkali burns.

RESULTS

The anti-denatured corneal antibody was induced after corneal alkali burns. The level of antibody significantly increased at 2th week post, peaking burn at 5 or 6th week, then decreasing. More antibodies were detected when contralateral eye was burn at 8 week post first burn. However, only slight increasing antibody was detected in early lamellar keratoplasty group. Furthermore, no significant changes of antibody production were observed in middle and later lamellar keratoplasty group. The light and electron microscopic analysis showed that, the corneal epithelium recovered better, the fibre of corneal stroma arranged better, inflammatory cells infiltrated less and neovascularization formed less in lamellar keratoplasty groups comparing to the burned group. The early lamellar keratoplasty groups recovered better than in middle and later lamellar keratoplasty groups.

CONCLUSION

Early lamellar keratoplasty after corneal alkali burns can significantly decrease the immune response. Histopathological data also indicate that early lamellar keratoplasty can improve the tissue regeneration and recovery, prevent topical inflammatory reaction, and abate corneal neovascularization. This study suggests that early lamellar keratoplasty is more effective than the conservative treatment.

摘要

目的

观察碱烧伤后不同阶段血清特异性抗变性角膜抗体的产生情况以及板层角膜移植术对角膜组织病理学变化的影响。

方法

将20只右眼碱烧伤的雄性新西兰兔随机分为5组,包括:烧伤组;2个早期板层角膜移植组(分别在碱烧伤后3天或7天手术);2个中晚期板层角膜移植组(分别在碱烧伤后2周或5周手术)。采用ELISA法检测每组血清特异性抗体水平,通过光镜和电镜评估碱烧伤后不同阶段的角膜结构。

结果

角膜碱烧伤后可诱导产生抗变性角膜抗体。烧伤后第2周抗体水平显著升高,在第5或6周达到峰值,随后下降。首次烧伤后8周对侧眼烧伤时检测到更多抗体。然而,早期板层角膜移植组仅检测到抗体略有增加。此外,中晚期板层角膜移植组抗体产生无明显变化。光镜和电镜分析显示,与烧伤组相比,板层角膜移植组角膜上皮恢复更好,角膜基质纤维排列更整齐,炎症细胞浸润更少,新生血管形成更少。早期板层角膜移植组比中晚期板层角膜移植组恢复更好。

结论

角膜碱烧伤后早期板层角膜移植可显著降低免疫反应。组织病理学数据也表明早期板层角膜移植可促进组织再生和恢复,预防局部炎症反应,减轻角膜新生血管形成。本研究表明早期板层角膜移植比保守治疗更有效。

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