视网膜脱离行玻璃体切除硅油填充术后继发青光眼患者房水中IL-2、IL-6、MCP-1的表达

Expression of IL-2,IL-6,and MCP-1 in aqueous humor of patients with secondary glaucoma after vitrectomy for retinal detachment and silicone oil filling

目的探讨视网膜脱离行玻璃体切除硅油填充术后继发青光眼患者房水中白细胞介素-2(interleukin-2,IL-2)、白细胞介素-6(interleukin-6,IL-6)、单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)的表达及意义。方法回顾性分析本院2015年6月至2016年12月视网膜脱离行玻璃体切除硅油填充术后继发青光眼患者24例(继发青光眼组)及眼压正常行硅油取出术患者50例(对照组),检测2组患者房水中IL-2、IL-6、MCP-1水平,并分析其相关性及对术后继发青光眼的预测价值。结果继发青光眼组患者房水中IL-2、IL-6和MCP-1水平分别为(0.28±0.04)μg·L-1、(18.21±2.17)ng·L-1、(3.96±0.46)μg·L-1,均显著高于对照组患者[(0.19±0.03)μg·L-1、(10.49±2.32)ng·L-1、(3.07±0.44)μg·L-1](均为P<0.05);继发青光眼组患者房水中IL-2与IL-6呈正相关(r=0.616,P=0.000);IL-2与MCP-1呈正相关(r=0.594,P=0.000);IL-6与MCP-1呈正相关(r=0.608,P=0.000)。房水中IL-2预测视网膜脱离行玻璃体切除硅油填充术后继发青光眼ROC曲线下面积(area under curve,AUC)为0.845,敏感度为75.0%,特异度为90.0%;房水中IL-6预测术后继发青光眼AUC为0.896,敏感度为70.8%,特异度为95.9%;房水中MCP-1预测术后继发青光眼AUC为0.872,敏感度为87.5%,特异度为80.0%;三者联合检测的AUC为0.978,敏感度为91.7%,特异度为96.0%。结论视网膜脱离行玻璃体切除硅油填充术后继发青光眼患者房水中IL-2、IL-6、MCP-1水平升高,三者联合检测对术后继发青光眼预测价值高于三者单独检测,对术后筛查青光眼具有一定的参考价值。

Objective To investigate the levels and significances of interleukin-2(IL-2),interleukin-6(IL-6),and monocyte chemoattractant protein-1(MCP-1)in aqueous humor of patients with secondary glaucoma after vitrectomy for retinal detachment and silicone oil filling.Methods From June 2015 to December 2016,24 patients with secondary glaucoma after vitrectomy for retinal detachment and silicone oil filling(secondary glaucoma group) and patients with normal intraocular pressure who underwent silicone oil removal(control group) were retrospectively analyzed,and the levels of IL-2,IL-6,and MCP-1 in aqueous humor of the two groups were measured,and the correlation and their predictive values for secondary glaucoma after operation were analyzed.Results The levels of IL-2,IL-6,and MCP-1 in aqueous humor of secondary glaucoma patients were(0.28±0.04)μg· L-1,(18.21±2.17)ng·L-1,(3.96±0.46)μg·L-1,respectively,which were significantly higher than those of the control group [(0.19±0.03)μg· L-1,(10.49±2.32)ng·L-1,(3.07±0.44)μg·L-1](all P<0.05);there was a positive correlation between IL-2 and IL-6 in aqueous humor of secondary glaucoma patients(r=0.616,P=0.000);IL-2 and IL-6 was positively correlated with MCP-1(r=0.594,0.608,both P=0.000);the area under the ROC curve(ACU) of IL-2 in aqueous humor for predicting secondary glaucoma after vitrectomy for retinal detachment and silicone oil filling was 0.845,sensitivity was 75.0%,specificity was 90.0%;the ACU of IL-6 in aqueous humor for predicting secondary glaucoma after operation was 0.896,sensitivity was 70.80%,specificity was 95.9%;the ACU of MCP-1 in aqueous humor for predicting secondary glaucoma after operation was 0.872,sensitivity was 87.5%,specificity was 80.0%;the ACU of combined detection in aqueous humor for predicting secondary glaucoma after operation was 0.978,the sensitivity was 91.70%,and the specificity was 96.0%.Conclusion The levels of IL-2,IL-6 and MCP-1 increase in aqueous humor of patients with secondary glaucoma after vitrectomy for retinal detachment and silicone oil filling,and the predictive value of combined detection for secondary glaucoma after operation is higher than that of single detection,and it has reference value for screening glaucoma after operation.