中华眼科医学杂志（电子版）
中華眼科醫學雜誌（電子版）
중화안과의학잡지（전자판）
CHINESE JOURNAL OF OPHTHALMOLOGIC MEDICINE(ELECTRONIC EDITION)
2014年
1期
1-6
,共6页
眼部移植物抗宿主病%造血干细胞移植%伪膜性结膜炎%治疗%眼表疾病
眼部移植物抗宿主病%造血榦細胞移植%偽膜性結膜炎%治療%眼錶疾病
안부이식물항숙주병%조혈간세포이식%위막성결막염%치료%안표질병
Ocular graft versus host disease%Hematopoietic stem cell transplantation%Pseudo-membranous conjunctivitis%Management%Ocular surface disease
眼部移植物抗宿主病（ GVHD）是造血干细胞移植（ HSCT）术后常见的并发症之一，可影响多达80％的慢性移植物抗宿主病患者，并显著降低其生活质量。眼部GVHD可累及全部眼组织，且最常影响泪腺和结膜等眼表结构，引起难治性干眼症。眼部GVHD与移植术后患者的死亡率和病死率密切相关，其临床表现与其他存在眼部表现的自身免疫性疾病或胶原血管性疾病非常相似。眼部GVHD的评估、诊断和治疗需根据患者的全身情况综合进行，并应采用多途径和多方案联合的方式逐步进行治疗。除了进行常规的人工泪液、眼表糖皮质激素、泪小点栓子及接触软镜等干眼症治疗措施外，抗炎药物环孢素A和自体血清滴眼对眼部GVHD也有较好的疗效。近年来，多数研究者对眼部GVHD的诊断和治疗已达成共识，但对于GVHD的预防和后期随访研究较少。鉴于此，笔者对眼部GVHD的诊断和治疗进行述评，以促进GVHD的临床研究。
眼部移植物抗宿主病（ GVHD）是造血榦細胞移植（ HSCT）術後常見的併髮癥之一，可影響多達80％的慢性移植物抗宿主病患者，併顯著降低其生活質量。眼部GVHD可纍及全部眼組織，且最常影響淚腺和結膜等眼錶結構，引起難治性榦眼癥。眼部GVHD與移植術後患者的死亡率和病死率密切相關，其臨床錶現與其他存在眼部錶現的自身免疫性疾病或膠原血管性疾病非常相似。眼部GVHD的評估、診斷和治療需根據患者的全身情況綜閤進行，併應採用多途徑和多方案聯閤的方式逐步進行治療。除瞭進行常規的人工淚液、眼錶糖皮質激素、淚小點栓子及接觸軟鏡等榦眼癥治療措施外，抗炎藥物環孢素A和自體血清滴眼對眼部GVHD也有較好的療效。近年來，多數研究者對眼部GVHD的診斷和治療已達成共識，但對于GVHD的預防和後期隨訪研究較少。鑒于此，筆者對眼部GVHD的診斷和治療進行述評，以促進GVHD的臨床研究。
안부이식물항숙주병（ GVHD）시조혈간세포이식（ HSCT）술후상견적병발증지일，가영향다체80％적만성이식물항숙주병환자，병현저강저기생활질량。안부GVHD가루급전부안조직，차최상영향루선화결막등안표결구，인기난치성간안증。안부GVHD여이식술후환자적사망솔화병사솔밀절상관，기림상표현여기타존재안부표현적자신면역성질병혹효원혈관성질병비상상사。안부GVHD적평고、진단화치료수근거환자적전신정황종합진행，병응채용다도경화다방안연합적방식축보진행치료。제료진행상규적인공루액、안표당피질격소、루소점전자급접촉연경등간안증치료조시외，항염약물배포소A화자체혈청적안대안부GVHD야유교호적료효。근년래，다수연구자대안부GVHD적진단화치료이체성공식，단대우GVHD적예방화후기수방연구교소。감우차，필자대안부GVHD적진단화치료진행술평，이촉진GVHD적림상연구。
Ocular graft-versus-host disease ( GVHD ) is a common complication of hematopoietic stem cell transplantation ( HSCT ) affecting up to 80% of chronic GVHD patients, which has a negative impact on quality of life. Ocular GVHD nearly affects every part of the eyes, especially in ocular surface structure such as lacrimal gland and conjunctiva,which results in refractory dry eye.The clinical features of ocular GVHD is similar with other autoimmune or collagen vascular disease which may affect ocular surface and is associated with mortality and morbidity after HSCT.The current evaluation,diagnosis and management of ocular GVHD should be approached in a multidisciplinary fashion in the context of patient′s overall GVHD,and treatment should be given step by step from lower to higher.In addition to common treatment such as artificial tears,topical steroids,punctual occlusion and contact lenses,which used to manage dry eye, both of cyclosporine A and autologous serum also show a promising result.In recent years,the treatments of ocular GVHD have been reached consensus,while the investigation of preventive measures and follow-up visit have been seldom reported.The diagnosis and treatment of GVHD were assessed in this paper.
