颈淋巴结切除术抑制碱烧伤后角膜移植免疫排斥反应的实验研究

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。

Experimental study on cervical lymph nodes removal enhance allograft survival in alkali-burned cornea

AIM:To explore the inhibitive effects of cervical lymphadenectomy on kerstoplasy after alkaline burns.METHODS:The Wistar rats' corneas were transplanted into Sprague-Dawley(SD)rats' eyes which were randomly divided into 4 groups:group A(control group);group B,the cervicallymphadenectomy group;group C,corneal transplantation after the alkali burn injury;group D,cervical lymphadenectomy following group C.Out of 6 rats in each group,the cornea of one rat Was used for mawophage immunohistochemistry at day 14 after the transplantstion,and the remaining 5 rats were used for studying corneal immune rejection with a slit lamp.The time when allograft rejection occurred was recorded and mean survival times(MST)were compared among the groups.RESULTS:Compared with the MST of group A(10.40±1.14 days),the MST of group B(46.30±9.46 days)Was significantly longer(P＜0.05).MST of grafts between group C(7.00± 1.58 days)and group D(15.00±3.39 days)was also significant (P＜0.05).At 14th day after the transplantation,there was no CD68 immunoreactivity in the graft of group B,and CD68 proteins were expressed to some extent in the grafts of group A and D.However,in the graft of group C,the expression of proteins Was dramatically up-regulated.CONCLUSION:Cervical lymphadenectomy therapy has a significant effect in preventing corneal allograft rejection in normal and alkali burned oorneai beds.