标题：生物工程角膜移植治疗病毒性角膜炎疗效观察

      作者：曲晓瑜，储昭节，马强，高伟，王小东    西安市第一医院陕西省眼科研究所，陕西 西安 710002

      卷次： 2019年30卷21期

      【摘要】 目的 探讨生物工程角膜移植在病毒性角膜炎治疗中的有效性、安全性和可靠性。方法 收集2017年9月至2018年8月西安市第一医院角膜病区开展的生物工程角膜移植手术73例，根据术前疾病分为病毒性角膜炎组7例和非病毒性角膜炎组66例。术后定期规律随访3个月以上，观察移植供体的排斥、水肿、溶解、混浊等角膜植片存活的情况，以角膜供体溶解、混浊和不可逆排斥定为移植失败。结果 病毒性角膜炎组患者的移植失败率为85.71%，明显高于非病毒性角膜炎组的13.63%，差异有显著统计学意义(P<0.01)。结论 病毒性角膜炎的发病中有很多免疫机制参与，生物工程角膜的胶原没有细胞结构，免疫因子和免疫细胞的参与可以加速胶原的溶解，因此，生物工程角膜移植治疗病毒性角膜炎的有效性、安全性及可靠性欠佳，临床适应证选择应谨慎。
      【关键词】 生物工程角膜；病毒性角膜炎；板层角膜移植；排斥反应；水肿；溶解
      【中图分类号】 R772.21 【文献标识码】 A 【文章编号】 1003—6350（2019）21—2805—03

Effect of bioengineered corneal transplant for treatment of herpes simplex keratitis.
QU Xiao-yu, CHU Zhao-jie,MA Qiang, GAO Wei, WANG Xiao-dong. Xi'an No.1 Hospital, Shaanxi Institute of Ophthalmology, Xi’an 710002, Shaanxi,CHINA
【Abstract】 Objective To investigate the validity, safety, and reliability of bioengineered corneal transplant fortreatment of herpes simplex keratitis (HSK). Methods From September 2017 to August 2018, 73 patients undergoingbioengineered corneal transplant were collected from Xi'an No.1 Hospital. According to the preoperative diseases, theywere divided into viral keratitis group (HSK group, 7 cases) and non-viral keratitis group (non-HSK group, 66 cases).Regular follow-up for more than 3 months was carried out to observe the survival of corneal grafts, such as rejection,edema, dissolution, and turbidity. The dissolution, turbidity, and irreversible rejection of corneal donors were regarded asfailure of transplantation. Results The rate of transplantation failure in HSK group was 85.71%, which was significant-ly higher than 13.63% in non-HSK group (P<0.01). Conclusion There are many immune mechanisms involved in thepathogenesis of viral keratitis. The collagen of bioengineered cornea has no cell structure, and the involvement of im-mune factors and immune cells can accelerate the dissolution of collagen. Therefore, bioengineered corneal transplantshould be applied cautiously, as it is not doing well in the efficacy, safety, and reliability for the treatment of HSK.
      【Key words】 Bioengineered cornea; Herpes simplex keratitis (HSK); Lamellar keratoplasty; Rejection; Edema;Dissolution·短篇论著·doi:10.3969/j.issn.1003-6350.2019.21.025基金项目：陕西省西安市科技计划项目[编号：2017116SF/YX010(7)]