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回顾性总结穿透性角膜移植术 ( penetratingkeratoplasty ,PKP)后急性内皮型免疫排斥反应发生的时间规律。方法 :对我院 6年来实施的PKP病例进行回顾性分析 ,对发生过急性内皮型免疫排斥反应的 2 5 6例病例 ,详细总结免疫排斥反应发生的时间、次数 ,以及发生的原因、预后等。结果 :76 5 3 % ( 196 /2 5 6 )的首次排斥反应发生在术后 1年内 ,19 14 % ( 4 9/2 5 6 )发生在术后 2年内 ,只有 11例发生在 2年以后。二次排斥距首次排斥的时间 1～ 16 5个月 ,平均 4 8个月。真菌性角膜炎病例的排斥发生时间相对较提前 ,73 8% ( 6 2 /84)集中在术后 8个月内。其中全角膜移植者多发生在术后 2周内。HSK病例在术后 6～ 9个月份和 13～ 17个月各有一个高峰。细菌性角膜溃疡病例发生的较分散 ,但是主要集中在 3～ 11个月之间。结论 :掌握这些规律对临床治疗和研究具有重要指导意义。
A retrospective review of the time course of acute endothelium-derived immune rejection after penetrating keratoplasty (PKP) was performed. Methods: A retrospective analysis was performed on PKP cases in our hospital over the past 6 years. A total of 256 cases of acute rejection after acute endoderm were considered, and the time and number of immunological rejection reactions, prognosis and so on were summarized in detail . RESULTS: The first rejection of 76 5 3% (196/265) occurred within 1 year after operation, 19 14% (49/2 56) occurred within 2 years after operation, and only 11 cases occurred after 2 years . Secondary exclusion from the time of first rejection 1 ~ 165 months, an average of 48 months. The incidence of fungal keratitis cases was relatively earlier, 73 8% (62/84) concentrated within 8 months after surgery. The whole corneal graft occurred more than 2 weeks after surgery. HSK cases in the postoperative 6 to 9 months and 13 to 17 months have a peak. Bacterial corneal ulcer cases occurred more dispersed, but mainly concentrated in 3 to 11 months. Conclusion: To master these rules has important guiding significance for clinical treatment and research.