白内障囊外摘除联合人工晶体植入术后体液免疫的变化(英文)

目的：观察白内障囊外摘除＋人工晶体植入（ＥＣＣＥ＋ＩＯＬ）术后体液免疫反应的变化以及全身应用地塞米松对该反应的影响。方法：将患者随机分为二组（行标准ＥＣＣＥ＋ＩＯＬ术），第１组术后全身应用地塞米松，第２组全身不用地塞米松。分别对其手术前后血清ＩｇＧ、ＩｇＭ、ＩｇＡ、ＣＨ５０、Ｃ３、Ｃ４含量的改变、以及循环免疫复合物（ＣＩＣ）、抗核抗体、类风湿因子、血沉、抗“Ｏ”、Ｃ反应蛋白进行测定，并观察临床指标——睫状充血、房水混浊程度的变化。结果：第２组病人术后血清ＩｇＧ、ＩｇＭ升高，补体ＣＨ５０、Ｃ３、Ｃ４含量降低，而血清特异性晶体蛋白抗体水平升高。第１组病人ＩｇＧ、ＩｇＭ、ＩｇＡ则无变化，ＣＨ５０、Ｃ４含量升高，临床体征明显较第２组轻。结论：ＥＣＣＥ＋ＩＯＬ可引起体液免疫的明显改变，地塞米松对该反应具有良好的治疗效果。

changes following ECCE+IOL operation

Objectives: : To observe changes of humoral immunereactions in patients before and after ECCE+ IOL operation,and to study the effects of dexamethasone on the reactions. Methods: Thirtysix patients were equally divided into 2 groups,among which dexamethasone was given to the first group after the operation while the second group was not given. Serum IgG, IgM,IgA, CH50 , C3, C4, circulating immune complex, antinuclear antibody,rheumatoid factor,erythrocyte sedimentation rate(ESR),antistreptolysin O and Creactive protein were determined, the degree of congestion of the ciliary body and aqueous flare were evaluated. Results:]After the operation,serum IgG and IgM were elevated, complement CH 50, C3, C4 were reduced and the levels of antibodies specifically against the lens antigens rose markedly after the surgery in the second group. In contrast,serum IgG, IgM and IgA remained unchanged, complement CH50 and C4 were elevated in the first group,and the clinical signs were mild. Conclusions: Significant, harmful humoral immunological changes happened in patients receiving ECCE+ IOL surgery,and dexamethasone treatment could effectively prevent the changes.