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目的观察厌氧菌性角膜炎的临床特征及病理改变,探讨其致病机制。设计实验性研究。研究对象健康成年新西兰白兔25只。方法新西兰白兔按每组5只,随机分为5组,每组随机选取1只作为对照。向实验组的兔右眼角膜基质内分别注射痤疮丙酸杆菌悬液,建立动物模型,对照组注射生理盐水。分别于建模后5、8、12、17、23天进行临床表现评分,并取术眼角膜,分别进行角膜厌氧菌培养、组织病理学观察、CD4+/CD8+T淋巴细胞免疫组化染色及ELISA方法测定TNF-α、IL-8含量。主要指标组织病理学改变、CD4+/CD8+T淋巴细胞表达、TNF-α及IL-8含量。结果兔厌氧菌性角膜炎主要表现为局限性角膜基质浸润,伴有周围组织水肿,后期出现角膜新生血管。炎症细胞以嗜酸性粒细胞为主,在第8天和第17天出现两个峰值(500.0±164.3和665.0±28.1);单核细胞及淋巴细胞数量在第17天分别增加至118.0±17.2及60.5±13.0。角膜组织内CD4+、CD8+T淋巴细胞表达呈阳性,CD4+表达持续强于CD8+表达。角膜内TNF-α及IL-8含量在第5、12、17天分别为(21.99±4.56)pg/ml和(22.39±4.20) pg/ml、(9.32±2.89)pg/ml和(8.10±7.24)pg/ml、(20.72±8.20)pg/ml和(22.48±11.33)pg/ml。结论嗜酸性粒细胞及TNF-α、IL-8参与了厌氧菌性角膜炎的炎症反应过程,T淋巴细胞介导的迟发型超敏反应具有重要作用。(眼科,2007,16:357-360)
Objective To observe the clinical features and pathological changes of anaerobic keratitis and explore its pathogenesis. Design experimental research. Twenty-five healthy adult New Zealand white rabbits Methods New Zealand white rabbits were randomly divided into 5 groups randomly with 1 in each group as control. To the experimental group, the rabbits were injected with P. acnes suspension into the right cornea of cornea. The animal model was established and the control group was injected with normal saline. The clinical manifestations were scored on the 5th, 8th, 12th, 17th and 23rd day after modeling respectively. The corneas of the corneas were taken for culture of anaerobic cornea, histopathological observation and immunohistochemical staining of CD4 + / CD8 + T lymphocytes And ELISA method for determination of TNF-α, IL-8 content. The main indicators of histopathological changes, CD4 / CD8 T lymphocyte expression, TNF-α and IL-8 content. Rabbit anaerobic keratitis mainly showed localized corneal stromal infiltration with edema of surrounding tissues and corneal neovascularization at the later stage. Inflammatory cells were mainly eosinophils with two peaks (500.0 ± 164.3 and 665.0 ± 28.1) on day 8 and day 17; the number of monocytes and lymphocytes increased to 118.0 ± 17.2 on day 17 and 60.5 ± 13.0. Corneal tissue CD4 +, CD8 + T lymphocyte positive expression, CD4 + expression continued to be stronger than CD8 + expression. The levels of TNF-α and IL-8 in the cornea were (21.99 ± 4.56) pg / ml and (22.39 ± 4.20) pg / ml on the 5th, 12th and 17th day 7.24) pg / ml, (20.72 ± 8.20) pg / ml and (22.48 ± 11.33) pg / ml. Conclusion Eosinophils, TNF-α and IL-8 are involved in the inflammatory reaction of anaerobic keratitis and T-lymphocyte-mediated delayed-type hypersensitivity plays an important role. (Ophthalmology, 2007,16: 357-360)