低浓度丝裂霉素C联合自体游离角膜缘干细胞移植治疗原发性翼状胬肉的研究  

The Study of Low-dose Mitomycin C in the Corneal Limbal Stem Cell Autografting for Prevention of Primary Pterygium

作　　者：廖洪斐[1] 肖卫[1] 刘静[2] 张向荣[1] 

机构地区：[1]南昌大学第一附属医院眼科,南昌330006 [2]西安市第四人民医院眼科,西安710004

出　　处：《江西医学院学报》2009年第1期107-109,112,共4页Acta Academiae Medicinae Jiangxi

摘　　要：目的观察低浓度丝裂霉素C(MMC)在自体游离角膜缘干细胞移植术治疗原发性翼状胬肉的临床疗效。方法140例行翼状胬肉切除的原发性翼状胬肉患者140只眼,随机分为3组。A组40例患者40只眼,翼状胬肉切除术中用0.2 mg/mL的MMC 3 min。B组50例患者50只眼,翼状胬肉切除术中采用自体游离角膜缘干细胞移植。C组50例患者50只眼翼状胬肉切除术中接受自体游离角膜缘干细胞移植联合应用0.2 mg/mL MMC1 min。随访13～62个月,术后观察3组的复发率和并发症。结果复发率:A组4例(10.0%),B组3例(6.0%),C组2例(4.0%)。A组与B、C组复发率比较差异有统计学意义(P<0.05)、B与C组复发率差别无统计学意义(P>0.05)。创面上皮完全形成在术后14 d内。并发症:结膜肉芽肿A组2例,B、C组无;巩膜软化溶解A组1例。未发现角膜穿孔、虹膜炎、青光眼等其他严重并发症。结论自体游离角膜缘干细胞移植联合术中应用低浓度MMC(0.02%1 min)无明显降低原发性翼状胬肉复发作用。Objective To investigate the clinical effect of low-dose mitomycin C （MMC） in the corneal limbal stem cell autografting for prevention of primary pterygium recurrence. Methods A total of 140 patients （140 eyes） with primary pterygium after pterygium excision were divided randomly into three groups （groups A, B, and C ）. All of cases were accepted operation, 40 eyes of the 40 patients of group A was treated with pterygium excision on base of MMC （0.2 mg/mL, 3 min）. Fifty eyes of the 50 patients of group B was treated with the corneal limbal stem cell autografting in pterygium excision. 50 eyes of the 50 patients of group C was treated with the corneal limbal stem ceil autografting on base of MMC（0.2 mg/mL,1 min） in pterygium excision. All patients had been followed up for 13-62 months, observed the rate of recurrence and complications of three groups. Results The recurrent rates of the patients in groups A,B,C were 10. 0%, 6.0 %, 4.0 %, respectively. There were statistical significances between groups A and B as well as between groups A and C（P〈0.05）. There was no statistical significance between groups 13 and C （P〈0.05）. Epithelialization of the wounds was completed within 14 days of surgery. Conjunctive granuloma：2 cases in group A, no case in groups B and C;Scleromalacia：l case in group A no case in groups B and C. No serious complications such as corneal perforation,iritis and glaucoma were demonstrated in any of the study groups. Conclusion The low-dose mitomycin C in the corneal limbal stem cell autografting have not decreased the recurrence rate of pterygium.

关 键 词：丝裂霉素C 角膜缘干细胞 自体移植 原发性翼状胬肉 复发 

分 类 号：R777.33[医药卫生—眼科]