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[角膜移植排斥反应的免疫学方面及本人在高危患者免疫抑制治疗中的经验]

[Immunological aspects of corneal graft rejection and own experience in immunosuppressive therapy in high risk patients].

作者信息

Kamińska Anna, Szaflik Jerzy, Minkiewicz-Timler Grazyna, Sybilska Małgorzata, Pawluczyk-Dyjecińska Martyna, Smolarek Monika

机构信息

Z Katedry i Kliniki Okulistyk II Wydziału Lekarskiego Akademii Medycznej w Warszawie.

出版信息

Klin Oczna. 2004;106(3 Suppl):485-8.

Abstract

The aim of the study was to present factors responsible for immune privilege of corneal graft, pathogenesis of immunological corneal graft rejection, and the influence of immunosuppressive therapy on keeping clarity of corneal graft. We also present retrospective evaluation of prophylactic immunosuppressive therapy in high-risk patients and in cases of graft rejection, in group of patients after corneal transplantation performed in Department of Ophthalmology in years 2001-2003. 349 cases of penetrating keratoplasty, lamellar or penetrating with limbal transplantation were analyzed. Condition requiring keratoplasty, surgical procedures, profile of immunosuppressive therapy, number of recurrences of corneal graft rejection and changes of visual acuity were evaluated. Immunosuppressive therapy with oral corticosteroids and systemic Cyclosporine allow to keep clarity of corneal graft and useful visual acuity in 60% cases of high-risk patients.

摘要

本研究的目的是阐述角膜移植免疫赦免的相关因素、免疫性角膜移植排斥反应的发病机制以及免疫抑制治疗对维持角膜移植透明性的影响。我们还对2001 - 2003年在眼科进行角膜移植的高危患者及移植排斥病例的预防性免疫抑制治疗进行了回顾性评估。分析了349例穿透性角膜移植术、板层角膜移植术或带角膜缘的穿透性角膜移植术病例。评估了角膜移植的需求状况、手术方式、免疫抑制治疗方案、角膜移植排斥反应的复发次数以及视力变化。口服皮质类固醇和全身性环孢素的免疫抑制治疗可使60%的高危患者维持角膜移植的透明性和有用视力。

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