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目的对正常人和异种表面角膜镜片术（ｅｐｉｋｅｒａｔｏｐｈａｋｉａ，ＥＫＰ）后患者泪液前列腺素Ｅ２（ＰｒｏｓｔａｇｌａｎｄｉｎＥ２，ＰＧＥ２）含量的变化进行了测定，以评价异种ＥＫＰ与免疫反应之间的关系。方法对９例９眼施行了异种（恒河猴）ＥＫＰ，术前及术后１、３、７、１４、３０和６０天分别对９例患者的泪液ＰＧＥ２含量进行放免测定，随机选择１０名健康志愿者作为对照。结果异种ＥＫＰ术后泪液ＰＧＥ２含量显著增加，术后第２周达最高水平，为２７．２９μｇ／Ｌ，比正常对照组高出３．１倍，随后逐渐下降，但术后２个月仍高于术前水平。结论作者认为异种ＥＰＫ能诱导ＰＧＥ２的释放，进而导致免疫反应。术后ＰＧＥ２含量的早期变化可能是手术炎症与免疫应答的综合结果，而后期则与异种镜片抗原持续刺激单核—巨噬细胞释放ＰＧＥ２有关。术后早期局部应用类固醇激素和环氧酶抑制剂如消炎痛有利于减少ＰＧＥ２的释放从而抑制排斥反应的发生。
Objective To investigate the changes of tear and prostaglandin E2 (Prostaglandin E2, PGE2) levels in normal and epikeratophakial (EKP) patients to evaluate the relationship between different EKP and immune responses. Methods 9 (9 eyes) EKP were administered to 9 eyes. Radioimmunoassay (RIA) was performed on 9 patients before operation and 1, 3, 7, 14, 30 and 60 days after surgery. Healthy volunteers as a control. Results The content of PGE2 in tear fluid after X-ray was significantly increased. The highest level was 27.29μg / L at the second week after operation, which was 3.1 times higher than that of the normal control group, then decreased gradually, but remained high at 2 months Preoperative level. Conclusion The authors believe that heterologous EPK can induce the release of PGE2, which in turn leads to an immune response. The early postoperative changes of PGE2 content may be the result of combined surgery inflammation and immune response, while the latter may be related to the continuous stimulation of monocyte - macrophage release of PGE2 by different lens antigens. Early postoperative local application of steroid hormones and cyclooxygenase inhibitors such as indomethacin is conducive to reduce the release of PGE2 thereby inhibiting the occurrence of rejection.