板层角膜移植时间对角膜碱烧伤后血清特异性抗体的影响  

Effect of lamellar keratoplasty time on the production of serum specific antibody in corneal alkali burns

作　　者：郑晓汾[1] 冯克孝[1] 李冰[1] 杨纪忠[1] 葛京京[1] 

机构地区：[1]山西省眼科医院

出　　处：《中华眼科杂志》2004年第3期160-164,共5页Chinese Journal of Ophthalmology

摘　　要：目的　通过动物角膜碱烧伤模型 ,观察烧伤后不同时期和烧伤后不同时间行板层角膜移植手术的新西兰白兔血清特异性抗体水平与组织病理的变化。方法　新西兰白兔 2 0只 ,制作单侧眼角膜中央部中度碱烧伤模型并完全随机分为 5组 :烧伤组、早期移植组两组 (即 3d移植组、7d移植组 )、中晚期移植组两组 (即 2周移植组、5周移植组 )。制备正常及碱烧伤角膜蛋白提取液 ,用酶联免疫吸附试验 (ELISA)检测每组兔不同时期血清抗角膜变性蛋白抗体水平 ,并取不同时期的角膜做光镜、电镜观察。结果　角膜碱烧伤后机体产生特异性抗体 ,2周时升高明显 ,5～ 6周达高峰 ,之后下降 ,8周时再次烧伤对侧眼角膜 ,抗体生成明显。早期移植组抗体升高不显著 ,而中晚期移植组抗体变化趋势与烧伤组基本相似。光、电镜结果显示 :移植组与烧伤组比较 ,上皮愈合好 ,基质纤维排列整齐 ,炎细胞浸润轻 ,新生血管少 ;早期移植组比晚期移植组恢复更好。结论　早期板层角膜移植治疗角膜碱烧伤可阻断机体针对碱烧伤后角膜变性蛋白的体液免疫反应过程。Objective To observe the production of serum specific anti-denatured corneal antibody and the effects of lamellar keratoplasty on changes of corneal histopathology in different stages after alkali burns. Methods 20 male New Zealand rabbits, with alkali burns in right eye were randomly divided into 5 groups including: burned group; 2 early lamellar keratoplasty group (operation at 3 or 7 days post alkali burns respectively); 2 middle and later lamellar keratoplasty groups(operation at 2 or 5 weeks after alkali burns respectively). The level of serum specific antibody in each group was detected by ELISA and the corneal structure was evaluated by light and electron microscopy in different stages after alkali burns. Results The anti-denatured corneal antibody was induced after corneal alkali burns. The level of antibody significantly increased at 2 th week post, peaking burn at 5 or 6 th week, then decreasing. More antibodies were detected when contralateral eye was burn at 8 week post first burn. However, only slight increasing antibody was detected in early lamellar keratoplasty group. Furthermore, no significant changes of antibody production were observed in middle and later lamellar keratoplasty group. The light and electron microscopic analysis showed that, the corneal epithelium recovered better, the fibre of corneal stroma arranged better, inflammatory cells infiltrated less and neovascularization formed less in lamellar keratoplasty groups comparing to the burned group .The early lamellar keratoplasty groups recovered better than in middle and later lamellar keratoplasty groups. Conclusion Early lamellar keratoplasty after corneal alkali burns can significantly decrease the immune response. Histopathological data also indicate that early lamellar keratoplasty can improve the tissue regeneration and recovery, prevent topical inflammatory reaction, and abate corneal neovascularization. This study suggests that early lamellar keratoplasty is more effective than the conservative treatment.

关 键 词：板层角膜移植 角膜碱烧伤 血清 特异性抗体 移植时间 动物模型 

分 类 号：R772.2[医药卫生—眼科]