CAJ | 학술논문

目的通过活体共聚焦显微镜观察、分析树突状细胞在非菌性边缘性角膜炎中的作用机制.方法临床病例应用分析研究.对201 1年1月至2012年10月在北京大学第三医院眼科中心选取21例非菌性边缘性角膜炎患者,记录性别、年龄、发病史,同时实施患眼裂隙灯检查、眼前节像、角膜病灶刮片和活体共聚焦显微镜检查.患眼局部均应用0.1％糖皮质激素和1％环孢霉素A滴眼液.结果 21例非菌性边缘性角膜炎患者19例为单眼,2例为双眼.其中男性13例,女性8例;平均年龄(40.85±11.16)岁,平均发病时间(3.76±1.02)周;所有病变区角膜刮片检查未发现细菌、真菌、棘阿米巴.角膜病灶多呈新月形、荧光素染色呈阳性,部分伴有新生血管侵入.活体共聚焦显微镜下病变区角膜上皮细胞层和浅基质层内见炎性细胞和被激活的成熟树突状细胞侵入,治疗后病变区角膜上皮细胞层和浅基质层内炎性细胞和被激活成熟树突状细胞明显减少或消失;病变角膜逐渐恢复透明或留下斑翳.结论活体共聚焦显微镜下观察边缘角膜炎症区被激活树突状细胞与非菌性边缘性角膜炎的发生和发展有着密切关系.
목적 통과활체공취초현미경관찰、분석수돌상세포재비균성변연성각막염중적작용궤제.방법 림상병례응용분석연구.대201 1년1월지2012년10월재북경대학제삼의원안과중심선취21례비균성변연성각막염환자,기록성별、년령、발병사,동시실시환안렬극등검사、안전절상、각막병조괄편화활체공취초현미경검사.환안국부균응용0.1％당피질격소화1％배포매소A적안액.결과 21례비균성변연성각막염환자19례위단안,2례위쌍안.기중남성13례,녀성8례;평균년령(40.85±11.16)세,평균발병시간(3.76±1.02)주;소유병변구각막괄편검사미발현세균、진균、극아미파.각막병조다정신월형、형광소염색정양성,부분반유신생혈관침입.활체공취초현미경하병변구각막상피세포층화천기질층내견염성세포화피격활적성숙수돌상세포침입,치료후병변구각막상피세포층화천기질층내염성세포화피격활성숙수돌상세포명현감소혹소실;병변각막축점회복투명혹류하반예.결론 활체공취초현미경하관찰변연각막염증구피격활수돌상세포여비균성변연성각막염적발생화발전유착밀절관계.
Objective To investigate the mechanism of dendritic cells in non infectious peripheral keratitis by in vivo confocal microscopy.Methods A case series with 21 consecutive cases of non infectious peripheral keratitis patients was investigated,of the patients' gender,age,disease history were recorded,and at the same time the structure and cellular features of was estimated by anterior segment slit lamp examination,corneal smear and in vivo corneal microscopy.Application of topical 0.1％ cortical steroid and 1％ cyclosporin A eye drops for all cases.Results In the 21 cases of non infectious peripheral keratitis,19 cases were unilateral,2 cases were bilateral;13 cases were male,8 cases were female; mean age was 40.85±11.16岁 years,the average time was 3.76±1.02 weeks,all lesion scraping were not found bacteria,fungi,acanthamoeba.Corneal lesion showed crescent,fluorescein staining was positive,accompanied angiogenesis invasion.In epithelial cell and anterior stromal layer of peripheral corneal lesion was showed inflammatory cells and activated dendritic cell invasion,after treatment,the inflammatory cells and activated dendritic cells was significantly reduced or disappeared; corneal lesions gradually restore transparent or left macula.Conclusions In vivo confocal microscopy can be applied to investigate the cellular histopathological characteristics of non infectious peripheral keratitis,which provide a novel and reliable method to study the dendritic cells of antigen presenting function.