角结膜干燥症自体颌下腺移植术后角膜植片存活情况的实验研究

Corneal graft survival status after autolgous salivary gland transplantation in the treatment of keratoconjunctivitis sicca

目的探讨自体颌下腺移植治疗角结膜干燥症后同种异体板层角膜移植术后植片存活情况和CD25+细胞在角膜排斥植片的表达情况。设计实验研究。研究对象健康成年新西兰兔20只。方法 20只实验动物用摘除泪腺和Harder腺的方法制成干眼模型,随机分两组:实验组行自体颌下腺移植;对照组不处理。移植腺体成活后两组都行同种异体板层角膜移植术。主要指标角膜植片存活时间和CD25+细胞在角膜植片表达情况。结果实验组角膜植片存活时间(37.0±5.4天)明显长于对照组(21.3±4.3天)(t=6.495,P<0.001),两组植片CD25表达情况(实验组:22.80±1.61个/5个倍视野;对照组:23.05±1.87个/5个高倍视),无显著差异(t=0.287,P>0.05)。结论颌下腺移植术后角膜植片失败主要原因是免疫排斥反应、血管化高危植床及泪液分泌不稳定。唾液泪液对角膜植片无明显不良影响。

Objective To explore corneal graft survival time and CD25＋ cell expression profile in rejected corneal graft after allogenous lamellar corneal transplantation following autogenous salivary gland transplantation in treatment of keratoconjunetivitis sieca. Design Experimental research. Participants 20 healthy adult New-Zealand rabbits. Methods Dry eye models were established in twenty laboratory animals by removing their lacrimal gland and Harder＇s gland, which were then randomly divided into two groups, experiment group and control group. Experiment group received autogenous salivary gland transplantation, while control group received no treatment. After the transplantation were proved to be successful, both groups undertook allogenous lameUar corneal transplantation. Main Outcome Measures Corneal grafts survival time and CD25＋ cell expression profile in corneal graft. Results Corneal graft survival time was longer in experiment group （37.0±5.4 days） than in control group （21.3±4.3 days）, and CD25＋ cell expression of the two groups was not significantly different （（22.80±1.61） in experiment group and （23.05±1.87） in control group）. Conclusion The main reason underlying corneal graft failure following salivary gland transplantation were immune rejection reaction, vascularized high-risk graft bed, and unstable lacrimal secretion. No prominent adversaary effect that might happened to corneal graft could be attributed to salivary, gland derived tear.