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目的:探讨颈淋巴结切除术对碱烧伤后角膜移植免疫排斥反应的抑制作用.方法:建立大鼠同种异体角膜移植模型,SD鼠为受体,Wistar鼠为供体,受体鼠再随机分为A,B,C,D四组,A组为对照组,B组为颈淋巴结切除组,C组为碱烧伤后角膜移植组,D组为碱烧伤后角膜移植合并颈浅淋巴结切除组。每组均为6只,其中1只于术后14d行植片的巨噬细胞免疫组化染色。其余5只通过裂隙灯观察角膜免疫排斥的状况,检测并比较各组植片平均存活时间(mean survival time,MST)。结果:各组MST分别是10.40±1.14d;46.30±9.46d;7.00±1.58d和15.00±3.39d。B组MST较A组明显延长(P<0.05),而D组MST较C组明显延长,差异具有显著性意义(P<0.05)。角膜移植后14d,B组植片中无CD68阳性细胞出现,A组和D组植片中有不同程度的CD68阳性的巨噬细胞浸润,而C组植片中CD68呈强阳性表达。结论:颈淋巴结切除术能有效抑制正常及碱烧伤后角膜移植术后的免疫排斥反应。
Objective: To investigate the inhibitory effect of cervical lymphadenectomy on the rejection of corneal allograft after alkali burns.Methods: The rat model of allograft keratoplasty was established, the SD rat was the recipient, the Wistar mouse was the donor, and the recipient mice were randomized A, B, C, D four groups, A group as control group, B group for cervical lymph node resection group, C group for alkali burn corneal transplantation group, D group for alkali burn after corneal transplantation combined with cervical lymph node dissection group. Each group was 6, one of which was stained with macrophages 14 days after the operation. The other 5 rabbits were observed by slit lamp for the status of corneal immune rejection. The mean survival time (MST) of each group was detected and compared. Results: The MST in each group was 10.40 ± 1.14d, 46.30 ± 9.46d, 7.00 ± 1.58d and 15.00 ± 3.39d, respectively. The MST in group B was significantly longer than that in group A (P <0.05), while the MST in group D was significantly longer than that in group C (P <0.05). On the 14th day after corneal transplantation, there were no CD68 positive cells in group B, CD68 positive macrophages infiltrated in group A and group D, while CD68 in group C was strongly positive. Conclusion: Cervical lymph node dissection can effectively inhibit the immune rejection after corneal transplantation in normal and alkali burn patients.