胎儿角膜缘干细胞在假性胬肉治疗中的应用

Application of fetal limbal stem cell in the treatment of pseudopterygium

目的探讨应用胎儿角膜缘干细胞治疗假性胬肉的临床效果。方法16例（16眼）接受假性胬肉切除联合胎儿角膜缘组织移植术治疗，术中应用胎龄28周以上新鲜的人胎儿角膜缘组织供体，术后给予抗排斥药物治疗，定期复诊观察角、结膜的愈合，免疫排斥反应，胬肉复发等情况。结果随访时间平均（9．4±2．4）月，术后角膜上皮愈合的平均时间为（3．8±1．3）d，13例（81．3％）角膜上皮持续完整，1例（6．3％）出现假性胬肉的复发。术后1、3、6个月和最后随访时发生上皮排斥的例数分别为7例（43．8％）、3例（18．8％）、0例、0例，通过抗排斥药物治疗均得以控制，平均药物治疗时间为（3．9±1．3）d。术后1、3、6个月和最后随访时的植片排斥反应的评分均值依次为：0．6±0．9、1．0±1、0．3±0．8、0．3±0．8。术后6个月内，共有3例（18．8％）出现植片的溶解，其中2例经抗排斥药物治疗后明显好转，另外1例则持续出现植片的溶解。结论应用胎儿角膜缘干细胞治疗理化损伤后假性胬肉的初步结果令人满意，为临床治疗此类疾病提供了新的思路。

Objective To study the chnical effect of fetal limbal stem cell in the treatment of pseu- dopterygium. Methods 16 eyes of 16 patients had been peformed the operation of pseudopterygium excision combined with fetal limbal stem cell transplantation. Fresh human fetal limbal stem cell with donors＇ gesta- tional age of 28 weeks or more were used intraoperatively. The medicine preventing immune rejection were used after operation. Corneo-conjunctival healing, immune rejection, palindromia of pterygium and intraocu- lar pressure were observed in the follow-up. Results The patients were followed up for （9.4±2.4） months. The average time for the corneal epithelial healing was （3.8 ± 1.3） d. In the follow-up, 13 cases （81.3 % ） of corneal epithelial continued complete, 1 case （6.3 % ） recurred pseudoperygium. The number of epithelial rejection were 7 cases, 3 cases, 0 case and 0 case at 1 m, 3 ms, 6 ms and at the last follow-up time after operation, but the rejection was controlled through medication, the average time of medicine treat- merit was （3.9 ± 1.3） d. At 1,3, and 6 months after surgery and the last follow-up, the mean rating value of graft rejection were 0.6 ± 0.9, 1.0 ±1.1,0.3 ± 0.8, 0.3 ± 0.8. Six months after operation, there were 3 cases of graft dissolution. Two cases were significantly improved by anti-rejection medication, another one had continued dissolution and the graft failed to survive. Conclusion Preliminary results are satisfactory for the treatment of pseudopterygium caused by physic and chemical damage through transplanting fetal lira- hal stem cell, it provides a new idea for the clinical treatment of those diseases.