穿透性角膜移植术后排斥反应的危险因素分析

目的探讨导致穿透性角膜移植术后排斥反应的危险因素。方法对168眼穿透性角膜移植术后排斥反应发生情况进行回顾性分析，总结免疫排斥反应发生的时间、次数，原因以及预后等。结果168眼中发生免疫排斥反应46眼，总发生率27．38％。各病种排斥反应发生率不同，圆锥角膜3．85％（1／26）；角膜内皮营养不良9．09％（1／11）；单纯疱疹性角膜炎29．55％（13／44）；真菌性角膜炎34．48％（20／58）；细菌性角膜炎40％（6／15）；角膜内皮细胞功能失代偿40％（2／5）；热、化学伤33．33％（3／9）。结论免疫排斥反应的发生是角膜移植手术失败的主要原因，其发生的时间与发生率同角膜疾病的种、角膜植片的位置及大小密切相关。

Risk factors of graft rejection in penetrating keratoplasty

Objective To discuss risk factors of corneal graft rejection after penetrating keratoplasty (PK).Methods We retrospectively studied the graft rejection of 168 patients who had accepted PK surgery.The time,rate,causes and prognosis of rejection were analyzed.Results The graft rejection was occurred in 46 eyes of the 168 eyes.The total rate was 27.38％.The rate of rejection in keratoconus was 3.85％ ( 1/26),corneal endothelial dystrophy 9.09％ ( 1/11 ),herpes simplex keratitis 29.55％ ( 13/44),fungal keratitis 34.48％ (20/58),bacterial keratitis 40％ (6/15),bullous keratopathy 40％ (2/5),corneal chemical and hot burn 33.33％ (3/9).Conclusion Graft rejection is the critical reason of graft failure.High risk of graft rejection was associated with the corneal diseases,the position and size of graft.