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穿透性角膜移植术后内皮免疫排斥反应的临床研究

[Clinical study on the endothelial immune rejection after penetrating keratoplasty].

作者信息

Shi Wei-yun, Wang Xu, Xie Li-xin

机构信息

Shandong Eye Institute and Hospital, Qingdao 266071, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2005 Feb;41(2):145-9.

Abstract

OBJECTIVE

To study the relationship between the grafts transparency and the endothelial immune rejection at different periods after penetrating keratoplasty (PKP).

METHODS

A following-up was performed on patients received PKP in Shandong Eye Institute and Hospital between January 1994 and December 1998. A total of 648 cases (648 eyes) were involved in this study, including 444 males (444 eyes) and 204 females (204 eyes). The incidence of endothelial immune rejection and grafts opacification at the time point of 0.5, 1, 3, 6, 9, 12, 18, 24, 36 and 48 months postoperatively was collected. We made two curves to study the relationship between transparence of grafts and endothelial rejection. Relationship between the endothelial immune rejection and the types of corneal diseases before the operation was also analyzed.

RESULTS

There was a significant relationship between grafts opacification and the endothelial immune rejection (linear regression and simple correlation, P < 0.01). The rate of rejection decreased after 3 years postoperatively. Inflammatory background was an important factor for the occurrence of endothelial immune rejection and graft opacification.

CONCLUSIONS

After PKP, endothelial immune rejection is the critical factor for affecting the grafts transparency. Long-term follow-up of the patients is important for the maintaining of transparency of grafts and to obtain a successful result of the operation.

摘要

目的

研究穿透性角膜移植术(PKP)后不同时期移植物透明度与内皮免疫排斥反应之间的关系。

方法

对1994年1月至1998年12月在山东眼科研究所及医院接受PKP的患者进行随访。本研究共纳入648例(648眼),其中男性444例(444眼),女性204例(204眼)。收集术后0.5、1、3、6、9、12、18、24、36和48个月时内皮免疫排斥反应及移植物混浊的发生率。绘制两条曲线以研究移植物透明度与内皮排斥反应之间的关系。还分析了内皮免疫排斥反应与术前角膜疾病类型之间的关系。

结果

移植物混浊与内皮免疫排斥反应之间存在显著关系(线性回归和简单相关性,P<0.01)。术后3年后排斥率下降。炎症背景是内皮免疫排斥反应和移植物混浊发生的重要因素。

结论

PKP术后,内皮免疫排斥反应是影响移植物透明度的关键因素。对患者进行长期随访对于维持移植物透明度及获得手术成功结果很重要。

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