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全身免疫疾病对角膜移植术预后影响的研究现状
孙悦
张弘 [综述]
作者及单位信息
·
DOI： 10.3760/cma.j.cn115989-20210218-00116
Current research of the impact of systemic immune disorders on keratoplasty prognosis
Sun Yue
Zhang Hong
Authors Info & Affiliations
Sun Yue
Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
Zhang Hong
Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
·
DOI： 10.3760/cma.j.cn115989-20210218-00116
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摘要

全身免疫疾病患者常因角膜穿孔、角膜缘干细胞缺乏、角膜进行性混浊等眼部并发症而进行角膜移植手术，但因此类患者的免疫状态异常，常导致手术预后较差。本研究拟通过对发生眼部并发症的全身免疫疾病患者进行总结，如类风湿性关节炎、系统性红斑狼疮、Stevens-Johnson综合征、黏膜类天疱疮、特应性疾病，阐述该类患者眼部并发症的发病原因、机制以及眼部相关诊断方法，分析其特殊的眼部免疫状态，探讨角膜移植手术预后的相关影响因素，以期在临床中指导手术及用药方案的制定，延长移植物存活时间，提高患者生活质量，为临床工作提供帮助。

全身免疫疾病;免疫相关性角膜炎;角膜移植;角膜移植手术预后;糖皮质激素;生物制剂
ABSTRACT

Patients with systemic immune diseases often undergo keratoplasty due to ocular complications such as corneal perforation, limbal stem cell deficiency and progressive corneal opacity, but the abnormal immune status of these patients often leads to a poor prognosis.The aim of this article is to summarize the patients with systemic immune diseases including rheumatoid arthritis, systemic lupus erythematosus, Stevens-Johnson syndrome, mucous membrane pemphigoid and atopic diseases with ocular complications, explain the etiology, mechanism and ocular diagnostic methods of ocular complications, to analyze their unique ocular immune status and to explore the relevant factors affecting the success rate of the transplantation in patients who underwent corneal transplantation because of ocular complications, in order to prolong the survival time of the graft by formulating a reasonable surgical and medication plan in clinical practice, improve the quality of life of patients, and provide help for clinical work.

Systemic immune diseases;Immune-associated keratitis;Keratoplasty;Prognosis of keratoplasty;Glucocorticoids;Biological agents
Zhang Hong, Email: mocdef.3ab6165450540831
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引用本文

孙悦,张弘. 全身免疫疾病对角膜移植术预后影响的研究现状[J]. 中华实验眼科杂志,2024,42(11)：1048-1052.

DOI:10.3760/cma.j.cn115989-20210218-00116

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近年来，全身免疫疾病的发病率逐年升高，此类患者常伴有眼部并发症，如免疫相关性角膜炎、巩膜炎、葡萄膜炎，甚至眼眶疾病，严重时可出现角膜混浊、穿孔，影响患者视力甚至致盲 [ 1 , 2 , 3 ]。角膜移植手术为目前治疗角膜混浊和修补角膜穿孔的主要方法之一，但此类患者角膜移植手术预后较差。这些患者常存在炎症细胞增殖及促炎细胞因子表达升高等异常的免疫反应，从而引发眼部慢性炎症，破坏前房免疫豁免状态，降低角膜移植手术成功率。对此类患者进行局部及全身的免疫干预治疗，可有效改善其眼部并发症。本文拟通过对伴有眼部并发症的全身免疫疾病患者的疾病特征、发病机制、角膜移植术预后的影响因素及改善方法等方面进行综述，以期提高临床工作者对该类型疾病的认知。
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[56]
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张弘，Email： mocdef.3ab6165450540831
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国家自然科学基金 (U20A20363)
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