HLA-B27阳性急性前葡萄膜炎患者前房水细胞因子水平的研究

Levels of cytokines in anterior aqueous humor of patients with positive HLA-B27 acute anterior uveitis

目的通过分析HLA-B27阳性急性前葡萄膜炎患者前房水中细胞因子的浓度,探讨急性前葡萄膜炎的发病机制。方法采用非随机对照临床观察型病例研究,选取2008年10月至2009年3月在我院眼科就诊的HLA-B27阳性前葡萄膜炎患者21例(21眼)为患病组,并选取同期住院行白内障手术的患者19例(19眼)为正常对照组。将所有入选病例通过酶联免疫技术测量前房水中肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、干扰素-γ(interferon-γ,IFN-γ)、白细胞介素-10的浓度,并进行组间比较。结果TNF-α在患病组患者前房水中的浓度平均为(29.1±13.9)pg.L-1,而在正常对照组患者则为(19.8±7.2)pg.L-1,2组相比差异有统计学意义(P=0.011)。IFN-γ在患病组患者前房水中的浓度平均为(36.6±27.5)pg.L-1,而在正常对照组患者则为(14.6±12.9)pg.L-1,2组相比差异有统计学意义(P=0.003)。白细胞介素-10在患病组患者前房水中的浓度平均为(2.4±2.7)pg.L-1,而在正常对照组患者则为(3.3±3.9)pg.L-1,2组相比差异无统计学意义(P=0.400)。结论急性前葡萄膜炎患者前房水内TNF-α和IFN-γ的浓度明显升高,炎症病理过程是与Thl型细胞免疫应答所释放的炎症性细胞因子TNF-α、IFN-γ等密切相关。

Objective To investigate the pathogenesis of acute anterior uveitis by analyzing the concentration of cytokines in anterior aqueous humor of patients with positive HLA-B27 acute anterior uveitis.Methods Nonrandomize control clinical case analysis was taken.A total of 21 cases（21 eyes） with positive HLA-B27 acute anterior uveitis in our hospital from October 2008 to March 2009 were enrolled,and 19 cataract patients（19 eyes） at the same time in our hospital were treated as normal control group.The concentrations of tumor necrosis factor-α（TNF-α）,interferon-γ（IFN-γ） and interleukin-10（IL^-10） were measured with enzyme-linked immunosorbentassay,and compared between the two groups.Results The concentrations of TNF-α were （29.1±13.9）pg·L^-1 in anterior aqueous humor of patients with acute anterior uveitis and （19.8±7.2）pg·L^-1 in normal control group,there was significant difference between the two groups（P=0.011）.The concentrations of IFN-γ were （36.6±27.5）pg·L^-1 in anterior aqueous humor of patients with acute anterior uveitis and （14.6±2.9）pg·L^-1 in normal control group,there was significant difference between the two groups（P=0.003）.The concentrations of IL^-10 were （2.4±2.7）pg·L^-1 in anterior aqueous humor of patients with acute anterior uveitis and （3.3±3.9）pg·L^-1 in normal control group,there was significant difference between the two groups（P=0.400）.Conclusions The concentrations of TNF-α and IFN-γ significantly increase in anterior aqueous humor of patients with acute anterior uveitis.Pathological process of inflammation has close relationship with inflammatory factors TNF-α and IFN-γ released by Thl cellular immune responses.