摘要
目的探究高度近视并发性白内障(HMC)患者白内障术前、术后房水中细胞因子的变化及其与术后并发症的关系。方法选取2020年6月至10月在南通大学附属医院行超声乳化白内障吸除术的患者60例(65眼)为研究对象,其中HMC患者24例(27眼)为HMC组,单纯年龄相关性白内障(ARC)患者36例(38眼)为ARC组。于白内障术前和术后20 h分别抽取100μL房水,采用Luminex液相悬浮芯片检测房水中47种细胞因子含量。术后20 h在裂隙灯显微镜下观察房水闪辉和浮游细胞情况,并与所测因子进行相关性分析。于术前及术后1周、1个月、3个月对入组患眼行OCT检查,将所测的黄斑中心凹厚度(CFT)与差异表达的细胞因子进行相关性分析。结果术后20 h,HMC组患眼房水闪辉和浮游细胞等级分布与ARC组相比差异均有统计学意义(均为P<0.05)。术前,HMC组患眼房水中肝细胞生长因子(HGF)、白细胞介素(IL)-12(P40)、嗜酸性粒细胞趋化因子(Eotaxin)浓度均明显高于ARC组,血管内皮生长因子浓度明显低于ARC组(均为P<0.05)。术后20 h,HMC组患眼房水中14种细胞因子均比ARC组明显增高(均为P<0.05)。HMC组患眼术前CFT明显薄于ARC组(P=0.018),术后1周、1个月、3个月CFT均比术前显著增加(均为P<0.05)。相关性分析结果显示,HMC组患眼术后1个月CFT与术前房水中HGF、IL^(-1)2(P40)浓度均呈正相关,与术后20 h房水中HGF、IL^(-1)2(P40)、干扰素诱导蛋白(IP)-10浓度均呈正相关,与IL^(-1)3浓度呈负相关(均为P<0.05)。多元线性回归分析结果显示,术前房水中IL^(-1)2(P40)浓度,术后房水中IL^(-1)2(P40)、IP-10、IL^(-1)3浓度是HMC患者术后CFT的影响因素。结论HMC患者白内障术后前房炎症反应较重,易发生黄斑水肿等术后并发症。房水中IL^(-1)2(P40)、IP-10、IL^(-1)3浓度有望成为HMC患者白内障术后黄斑水肿的预测指标和治疗靶点。
Objective To explore the changes of cytokines in aqueous humor of patients with high myopia complicated cataract(HMC)before and after cataract surgery and its association with postoperative complications.Methods Sixty-five eyes of sixty patients who had undergone phacoemulsification from June 2020 to October 2020 in the Affiliated Hospital of Nantong University were selected.They were divided into the HMC group(27 eyes of 24 patients)and age-related cataract(ARC)group(38 eyes of 36 patients).100μL aqueous humor was collected before and 20 hours after the cataract surgery.Luminex multiplex assays were used to detect 47 cytokines in the aqueous humor.Aqueous flare and planktonic cells were observed under the slit-lamp microscope 20 hours after surgery,and their correlation with the measured cytokines was analyzed.Additionally,the central foveal thickness(CFT)was measured using optical coherence tomography before surgery,1 week,1 month and 3 months after surgery,and its correlation with differentially expressed cytokines was analyzed.Results Twenty hours after surgery,the aqueous flare and phytoplankton cell distribution of patients in the HMC group were significantly different from those in the ARC group(both P<0.05).Before surgery,the hepatocyte growth factor(HGF),interleukin(IL)-12(P40),and eosinophil chemotactic factor(Eotaxin)in the aqueous humor of patients in the HMC group were significantly higher than those in the ARC group,while the vascular endothelial growth factor(VEGF)was significantly lower than that in the ARC group(all P<0.05).Twenty hours after surgery,14 cytokines in the aqueous humor of patients in the HMC group were significantly higher than those in the ARC group(all P<0.05).The preoperative CFT of patients in the HMC group was significantly lower than that in the ARC group(P=0.018).CFT of the HMC group showed a statistically significant increase at 1 week,1 month,and 3 months after surgery(all P<0.05).Correlation analysis results showed that in the HMC group,1-month postoperative CFT was positively correlated with the preoperative HGF and IL^(-1)2(P40),as well as the 20-hours postoperative HGF,IL^(-1)2(P40),and interferon inducible protein-10,and was negatively correlated with the IL^(-1)3(all P<0.05).Multiple linear regression results showed that the preoperative IL^(-1)2(P40)level as well as the postoperative IL^(-1)2(P40),IP-10,and IL^(-1)3 levels affected the postoperative CFT of patients in the HMC group.Conclusion The inflammatory reaction in the anterior chamber of HMC patients is severe after cataract surgery,and postoperative complications such as macular edema are easy to occur.IL^(-1)2(P40),IP-10,and IL^(-1)3 are expected to become predictors and therapeutic targets of macular edema in HMC patients after cataract surgery.
作者
耿文静
管宇
李鹏飞
季敏
苏舒
宋佩
袁玉蓉
管怀进
GENG Wenjing;GUAN Yu;LI Pengfei;JI Min;SU Shu;SONG Pei;YUAN Yurong;GUAN Huaijin(Department of Ophthalmology,the Affiliated Hospital of Nantong University,Nantong 226001,Jiangsu Province,China)
出处
《眼科新进展》
CAS
北大核心
2021年第11期1031-1036,共6页
Recent Advances in Ophthalmology
基金
国家自然科学基金面上项目(编号81770906,81974129)
江苏省科技计划项目(编号BE2016699)
南通市科技计划项目(编号MS22019012,JC2019078)。
作者简介
第一作者:耿文静(ORCID:0000-0001-7958-0906),女,1996年10月出生,江苏南京人,硕士,研究方向:白内障,E-mail:18360345846@163.com;第一作者:管宇(ORCID:0000-0001-6500-2363),女,1988年10月出生,江苏南通人,研究方向:白内障及眼屈光,E-mail:guanyuleye@126.com;通信作者:管怀进(ORCID:0000-0002-4911-1989),男,1962年1月出生,江苏南通人,硕士,教授,主任医师,博士研究生导师,研究方向:白内障,E-mail:guanhjeye@163.com。
