DCD角膜移植术后角膜内皮细胞与排斥反应的相关性分析

目的：探讨心脏死亡供体器官捐献(donation after cardiac death，DCD)来源角膜植片术后排斥反应与角膜内皮细胞的相关性。

方法：用角膜内皮显微镜对心脏死亡供体来源角膜植片行穿透性角膜移植术后发生排斥反应的28例28眼角膜植片分别于术后<1、2～3、4～6、7～12mo行角膜内皮镜检查。

结果： 28例患者术后<1、2～3、4～6、7～12mo的角膜内皮细胞变异系数分别为38.23%、49.56%、57.18%、65.04%； 角膜内皮细胞密度分别为2071.15±311.47、1771.33±348.18、1626.59±353.92、1553.14±307.31个/mm²； 角膜内皮细胞变异系数与排斥反应呈正相关关系(r=0.95，P<0.05)； 术后角膜内皮细胞密度与排斥反应呈负相关关系(r=-0.93，P<0.05)。

结论：DCD穿透性角膜移植术后发生排斥反应时有角膜内皮细胞变异系数逐步增高，角膜内皮细胞密度逐步降低的趋势； 角膜内皮细胞变异系数、角膜内皮细胞密度可作为早期检测术后排斥反应的指标。

Correlation analysis of reject reaction and corneal endothelial cells after penetrating keratoplasty from donation after cardiac death

AIM: To study the relativity between reject reaction from donation after cardiac death(DCD)and corneal endothelial cell source of corneal graft after penetrating keratoplasty.

METHODS:Totally 28 cases of corneal graft rejection after penetrating keratoplasty with cardiac death donor cornea were analyzed using corneal endothelial microscope at less than 1mo, 2-3mo, 4-6mo, 7-12mo after operation.

RESULTS:Coefficient variation of corneal endothelial cell of the 28 cases at less than 1mo,2-3mo, 4-6mo and 7-12mo were 38.23%, 49.56%, 57.18%, 65.04%. Corneal endothelial cell density were 2071.15±311.47, 1771.33±348.18, 1626.59±353.92, 1553.14±307.31. The coefficient variation of corneal endothelial cells was positively correlated with rejection(r=0.95, P<0.05). The postoperative corneal endothelial cell density was negatively correlated with rejection(r=-0.93, P<0.05).

CONCLUSION: The corneal endothelial cell coefficient variation increased gradually and the corneal endothelial cell density decreased gradually after DCD corneal allograft rejection. Corneal endothelial cell coefficient variation and corneal endothelial cell density can be used as indicators of early detection of postoperative rejection.