环孢霉素A滴眼治疗角膜移植排斥反应  

Treatment of corneal allograft rejection with cyclosporin A eyedrops

作　　者：赵京城[1] 金秀英[1] 

机构地区：[1]北京市眼科研究所

出　　处：《眼科》1993年第3期131-134,188,共5页Ophthalmology in China

摘　　要：应用0.5％环孢霉素A(cyclosporin A,CsA)滴眼治疗穿透性角膜移植术后发生免疫排斥患者16例(16只眼),治愈9只眼,好转6只眼,无效1只眼。随访5～24个月,其中2只眼因停药复发,1只眼于拆线后复发,继续用药或增加给药次数后治愈。研究表明0.5％CsA滴眼剂治疗术前移植床条件较好,角膜移植术后发生免疫排斥的病例可得到良好疗效;而对术前移植床条件较差,角膜移植术后发生免疫排斥的病例有一定的疗效。作者对眼局部应用CsA治疗角膜移植排斥的疗效和作用机理进行了讨论。16 eyes with corneal allograft rejection after penetrating keratoplasty were treated with 0.5％ cyclosporin A (CsA) eyedrops, 9 eyes were completely cured, 6 eyes markedly improved, and one eye ineffective. Follow-up for 5～24 months found that 3 of the 9 cured eyes recurred, 2 eyes after suspension of CsA and one eye after removal sutures. The recurrence was cured with resumed or increased application of the drug. The study indicated that treatment with CsA eyedrops yielded good curative rerults, particularly in eyes of satisfactory preoperative transplantation bed. The authors suggested that CsA should be used and then tapered slowly over a long period of time, especially in the cases with corneal vascularization or other significant risk factors of rejection. In the cases with poor preoperative corneal transplantation beds, increased concentration of CsA or combination with other immunosuppressants should be considered. The efficacy of CsA and its mechanism of action on corneal graft rejection were discussed.

关 键 词：环孢霉素类/治疗应用 角膜移植 移植物生存/药物作用 

分 类 号：R77[医药卫生—眼科]