曲安奈德对老年性白内障患者术后炎性反应的影响

Study on the effect of triamcinolone acetonide on inflammatory response after cataract surgery in elderly patients

目的:研究曲安奈德对老年性白内障患者房水肿瘤坏死因子(TNF-α)、白介素1β(IL-1β)、白介素-6(IL-6)等炎性因子水平的影响。方法:94例老年性白内障按随机分为对照组、观察组各47例均行白内障超声乳化吸除联合人工晶状体植入术,观察组术后于前房注射曲安奈德,对照组注射复方平衡盐液,对比两组术后前房细胞数、前房闪辉及TNF-α、、IL-1β、IL-6炎性因子水平。结果:对照组、观察组术后第1d前房细胞数构成比无统计学差异,术后第3d、第5d前房细胞数构成比经卡方检验分析,均有统计学差异,观察组前房细胞数第3d、第5d前房细胞数(-)、(+)、(++)比例逐渐增多;对照组、观察组术后第1d、第3d房水闪辉构成比无统计学差异,术后第5d房水闪辉构成比经卡方检验分析,均有统计学差异,观察组第5d房水闪辉(-)、(+)、(++)比例逐渐增多;观察组房水TNF-α、IL-1β、IL-6浓度均低于对照组,差异具有统计学意义。结论:曲安奈德对老年性白内障超声乳化联合人工晶状体植入术后康复有较好的抗炎效果,值得临床推广应用。

Objective To study the effects of triamcinolone acetonide on tumor necrosis factor-alpha(TNF-alpha)and interleukin-1 beta in aqueous humor of senile cataract patients.Influences of inflammatory factors such as interleukin-1 beta and interleukin-6(IL-6).Methods 94 cases of senile cataract were randomly divided into control group and observation group,47 cases in each group were treated with phacoemulsification combined with intraocular lens implantation.Triamcinolone acetonide was injected into anterior chamber in observation group and compound balanced salt solution was injected into control group.The number of anterior chamber cells,anterior chamber glitter and TNF-a,IL-1beta and IL-6 inflammatory factors were compared between two groups.Results There was no significant difference in the proportion of anterior chamber cells between the control group and the observation group on the 1st day after operation.The proportion of anterior chamber cells on the 3rd and 5th day after operation was statistically different.The proportion of anterior chamber cells(-),(+),(+++)in the observation group increased gradually on the 3rd and 5th day after operation.There was no statistical difference in the composition ratio of glitter.On the fifth day after operation,there were statistical differences in the composition ratio of aqueous glitter.On the fifth day,the proportion of aqueous glitter(-),(+),(++)in the observation group increased gradually.The concentrations of TNF-a,IL-1beta and IL-6 in the observation group were lower than those in the control group,and the difference was statistically significant.Conclusion Triamcinolone acetonide has a good anti-inflammatory effect on the rehabilitation of senile cataract after phacoemulsification combined with intraocular lens implantation,which is worthy of clinical application.