CAJ | 학술논문

目的评价自体骨髓间充质干细胞在严重眼表损伤移植后的治疗效果.方法选取了化学烧伤4例,Stevens-Johnson综合征2例.骨髓间充质干细胞取自患者,细胞培养14 d后,经细胞检测鉴定为骨髓间充质干细胞,将细胞种植在羊膜表面,细胞扩增融合达90％后使用.手术切除表面结膜化组织达角膜缘外3 mm,将羊膜上培养的自体骨髓间充质干细胞移植到角膜及角膜缘表面,术后予抗生素、激素、人工泪液点眼治疗；病人定期随访,进行裂隙灯显微镜及印迹细胞学检查.结果 6例患眼均覆盖了含有自体骨髓间充质干细胞的羊膜片,术后1周角膜上皮完整.3例患者视力有改善,2例患者视力保持术前水平,1例患者视力下降.术后所有患者眼表面光滑程度有所改善,但新生血管没有明显减少.术后12周印迹细胞学检查结果,1例患者角膜表面可检测到上皮样细胞及杯状细胞.结论自体骨髓间充质干细胞移植可以改善眼表条件,有潜在应用于治疗角膜缘功能障碍的价值.
목적 평개자체골수간충질간세포재엄중안표손상이식후적치료효과.방법 선취료화학소상4례,Stevens-Johnson종합정2례.골수간충질간세포취자환자,세포배양14 d후,경세포검측감정위골수간충질간세포,장세포충식재양막표면,세포확증융합체90％후사용.수술절제표면결막화조직체각막연외3 mm,장양막상배양적자체골수간충질간세포이식도각막급각막연표면,술후여항생소、격소、인공루액점안치료；병인정기수방,진행렬극등현미경급인적세포학검사.결과 6례환안균복개료함유자체골수간충질간세포적양막편,술후1주각막상피완정.3례환자시력유개선,2례환자시력보지술전수평,1례환자시력하강.술후소유환자안표면광활정도유소개선,단신생혈관몰유명현감소.술후12주인적세포학검사결과,1례환자각막표면가검측도상피양세포급배상세포.결론 자체골수간충질간세포이식가이개선안표조건,유잠재응용우치료각막연공능장애적개치.
Objective To evaluate the effect of autologous bone marrow mesenchymal stem cells (BMSC) in treating severely damaged ocular surface.Methods Four cases of corneal chemical burn and two cases of Stenven-Johnson Syndrome were enrolled in this study.The BMSCs were obtained and cultured in vitro.The cells were harvested afler 14 days and confirmed to be BMSCs.Then the cells were placed on an amniotic membrane (AM) and expanded until 90％ confluence formation before using.After the abnormal conjunctival and corneal tissues were removed from the cornea,the AM coated autologous BMSCs were transplanted onto the corneal surface.Aftersurgery,antibiotics,steroid and lubricant eye drops were used and patients were examined by slit-lamp and impression cytology.Results In all the six treated eyes,the entire corneal epithelium was intact one week after surgery.The visual acuity improved in three eyes,two eyes kept at the same level and decreased in one eye.The ocular surface was smooth,but the new blood vessels didn't show significant reduction.After twelve weeks,the epithelial cells phenotype and goblet cells appeared on corneal surface.Conclusions Autologous BMSCs can improve ocular surface condition in severely damaged patients,which show potential use for treating limbal deficiency.