环孢素A联合地塞米松长期滴眼对高危角膜移植术后免疫排斥反应的影响(英文)  

Effects of topical cyclosporin A and cyclosporin A com bined dethmathason for long-term on immune rejection of high risk orneal trans plantation

作　　者：席兴华[1] 秦波[1] 姜德咏[1] 唐罗生[1] 曹燕娜[1] 

机构地区：[1]中南大学湘雅二医院眼科,湖南长沙410011

出　　处：《中国现代医学杂志》2004年第6期30-33,36,共5页China Journal of Modern Medicine

基　　金：SupportedbyScienceFundantionofHunanProvince (No .2 0 0 0 45 )

摘　　要：目的　探讨长期应用环孢素A(CyclosporinA ,CsA)联合地塞米松滴眼液对高危穿透性角膜移植术后免疫排斥反应的防治效果及其安全性。方法　 4 2例 (42眼 )高危穿透性角膜移植术后患者 ,术后 3个月随机分为二组 :Ⅰ组为实验组 2 3例 2 3眼 ,应用 1%CsA和 0 .1%地塞米松溶液滴眼 ,每日各 2～ 3次 ,交替用药 ,术后 6个月后地塞米松浓度改为 0 .0 5 % ,每日各 2次 ,交替用药 ,直至术后 1年 ;Ⅱ组为对照组 19例 19眼在术后 3月改为单纯 1%CsA滴眼 ,每日 3次 ,直至术后 1年。所有病例随访观察 1年以上。结果　 4 2眼PKP术后发生角膜植片免疫排斥反应 11眼 (2 6 .19% ) ,其中I组 4眼 (17.39% ) ,Ⅱ组 7眼 (36 .84 % ) ,差异具有显著性(P <0 .0 5 )。其它并发症的发生率两组间无显著性差异。术后患者视力均较术前明显提高 ,差异具有显著性(P <0 .0 5 )。结论　较长期应用 1%CsA联合地塞米松滴眼 ,可以安全、有效地降低高危PKP术后植片免疫排斥反应发生率 ,从而提高穿透性角膜移植的成功率。Objective:To evaluate the efficacy and security of long-term topical use of 1%CsA combine d with 0.1% dexmethasone (DXM) drops to prevent immunological rejection after h igh-risk penetrating keratoplasty (PKP).Methods:42 eyes of 42 ca ses with high-risk PKP were randomly divided into 2 groups 3 months after operat ions. Group I(experimental group): 23 eyes were treated with 1%CsA and DXM for 1 2 months. Group Ⅱ(control group): 19 eyes were treated with 1%CsA only for 12 m onths;All cases were followed up for 12～24 months. Results:The re was a statistical difference between the two groups in postoperative immunolo gical rejection that occurred in 7 out of 19 (36.84%) eyes in Group Ⅱ,and 4 o ut of 23 (17.39%) in Group Ⅰ. There was no significant difference between the t wo groups in other postoperative complications. Conclusion:The r esult shows that long-term topical use of CsA combined with DXM is more effectiv e than that of CsA alone in decreasing the rejection rate with no significant increasing of the complications.

关 键 词：穿透性角膜移植 免疫排斥环 孢霉素A 地塞米松 

分 类 号：R772[医药卫生—眼科]