高危角膜移植术后免疫排斥反应规律的临床研究

Clinical investigation of allograft rejection in high risk keratop lasty

目的探讨不同病因的高危移植患者行穿透性角膜移植术后免疫排斥反应发生的规律。方法对680例行穿透性角膜移植术中的124例134只眼高危移植患者术后排斥反应时间、排斥反应发生率及反应类型进行观察。结果134只眼高危角膜移植术后免疫排斥反应发生率在12%～75%不等,其中角膜植床严重新生血管化者的排斥率最高。排斥发生时间最早为术后13天,术后3～6个月为排斥反应发生高峰。排斥反应类型以内皮型和上皮型最多。结论不同高危因素的穿透性角膜移植术后排斥反应发生率不同,排斥反应发生的时间和类型也不同。

ObjectiveTo investigate the rule of occurrence of allograft rejec tion in different kinds of high risk ker atoplasty.MethodsThe time,rate and type of allograft rejection were reviewed i n 124 cases(134 eyes)of high risk kerato plasty.ResultsAllograft rejection rate was between 12%～75% in all of the 134 e yes,the earliest rejection occurred in 13 days after transplantation and the peak of rejection was in 3～6 months after op eration.The highest rate of rejection(75 %) occurred in the severely vascularized corneal bed group(chemical and thermal burn)during 3～6 months after penetrating keratoplasty(PKP).The onset of allograft rejection occurred at 13d～3 month after surgery in the fungal keratitis large g raft group and cases with previous skin transplantation history.Endothelial and Epithelial rejection were two major types of allograft rejection in high risk keratop lasty.ConclusionThe time,rate and type of rejection are different in high risk keratoplasty caused by different high r isk factors.