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目的:探讨角膜热烧伤后角膜溃烂溶解穿孔以及眼内炎症的免疫学机制。方法:在大鼠角膜上制作热烧伤模型,在烧伤后的不同阶段,制备角膜,虹膜、脉络膜巩膜复合体以及视网膜平片,采用标准的ABC免疫组化方法,观察眼局部T淋巴细胞亚群,巨噬细胞、树突细胞,MHC Ⅱ类抗原阳性细胞的动态变化。结果:烧伤后早期,角膜及虹膜即有T淋巴细胞浸润,以CD3阳性细胞为主,MHCⅡ类抗原阳性细胞也轻度增多;当角膜溶解穿孔阶段,T淋巴细胞浸润达到高峰,在T淋巴细胞亚群中,CD4明显多于CD8阳性细胞;同时,巨噬细胞、树突细胞、MHCⅡ类抗原阳性细胞也大量出现。细胞密集分布于角膜缘,在溃疡溶解处,可见MHCⅡ类抗原阳性细胞及少至中等量CD3阳性淋巴细胞。Ⅱ类抗原阳性细胞在形态学上也发生了些变化,由初期的园形变为多形性,且大小不一。当烧伤恢复期病变稳定时,各种阳性细胞逐渐减少。结论:免疫反应参与了严重角膜烧伤的发病过程,在角膜溶解穿孔的发生中起重要作用。眼科学报 1997;13:70～74。
Objective: To investigate the immunologic mechanism of corneal ulcer dissolving perforation and intraocular inflammation after corneal thermal burn. Methods: Thermal burn model was made on cornea of rat. Corneal, iris, choroidal scleral complex and retina were prepared at different stages after burns. The local ocular T lymphocyte subsets , Macrophages, dendritic cells, MHC class Ⅱ antigen-positive cells in the dynamic changes. Results: In the early postburn period, infiltration of T lymphocytes was observed in the cornea and iris. CD3-positive cells were predominant in the cornea and iris, and MHC class II antigen-positive cells also slightly increased. T lymphocytes infiltrated peakly during corneal lysis and perforation, Subgroups, CD4 was significantly more than CD8 positive cells; the same time, macrophages, dendritic cells, MHC class II antigen-positive cells also appeared in large numbers. Cell-dense distribution in the limbal limbus, in ulcer lysis, showing MHC Ⅱ antigen-positive cells and as low as moderate CD3-positive lymphocytes. Type II antigen-positive cells in morphological changes have also changed from the initial Park into a pleomorphic, and different sizes. When the lesion during the recovery of burn stability, a variety of positive cells gradually decreased. Conclusion: Immune response is involved in the pathogenesis of severe corneal burns and plays an important role in corneal lysis and perforation. Journal of Ophthalmology 1997; 13: 70 ~ 74.