小梁切除术后房水和晶状体中转化生长因子-β_2含量的变化

Changes in transforming growth factor-β2 level in aqueous humor and crystalline lens after trabeculectomy

目的测定兔眼小梁切除术后房水及晶状体中转化生长因子β2(transforming growth factor-β2,TGF-β2)的含量,探讨其变化在小梁切除术后白内障形成中的作用。方法新西兰白兔16只,随机分为2组,每组8只,其中一组左眼行小梁切除术设为A组,右眼未手术眼设为C组(对照组);另一组左眼行丝裂霉素C辅助治疗的小梁切除术设为B组。术后定期观察晶状体混浊情况,术后6个月空气栓塞法处死各组兔,观察晶状体纤维细胞形态学变化,并使用兔TGF-β2ELISA试剂盒检测房水及晶状体水溶性蛋白质中总的TGF-β2(tTGF-β2)和活化的TGF-β2(aTGF-β2)的含量。结果术后6个月,各组晶状体均未出现明显的混浊,晶状体纤维细胞无明显异常。A组和B组房水中tTGF-β2和aTGF-β2含量与C组相比均有明显的增加,A组分别增加了31.50%(P<0.05)和37.21%(P<0.01),B组分别增加了32.92%(P<0.05)和40.95%(P<0.01),A组与B组比较差异均无统计学意义(均为P>0.05)。A组和B组晶状体中tTGF-β2和aTGF-β2含量与C组比较均有明显增加,A组分别增加了31.54%(P<0.05)和32.11%(P<0.05),B组分别增加了37.10%(P<0.01)和37.56%(P<0.01);A组与B组比较差异均无统计学意义(均为P>0.05)。房水和晶状体中TGF-β2活性比率A组、B组、C组间差异均无统计学意义(均为P>0.05)。结论小梁切除术可引起房水和晶状体中tTGF-β2和aTGF-β2含量的增加,TGF-β2含量的增加可能与小梁切除术后白内障的发生和进展有关;术中辅助应用低剂量丝裂霉素C并未进一步增加术后白内障的风险。

Objective To determine the transforming growth factor-β2 （TGF-β2） level in aqueous humor and crystalline lens after trabeculectomy of rabbits,and to investi- gate its function in the cataract formation changes after the trabeculectomy. Methods Sixteen New Zealand white rabbits were randomly and evenly divided into 2 groups. The rabbits in one group were conducted trabeculectomy on the left eye and the left eye was group A, the right eye was group C （ control group）. In the other group, the rabbits trea- ted with Mitomycin C on the left eye after the trabeculectomy was group B. Opacifica- tion on crystalline lens was observed regularly after surgery. All the rabbits were killed through air embolism after post-operative 6 months, then all the aqueous humor and crystalline lens were collected, and morphologic changes in lens fiber cells were ob- served. The levels of whole TGF-β2 （ tTGF-β2 ） and activated TGF-β2 （ aTGF-β2 ） in wa- ter-soluble protein of aqueous humor and crystalline lens were tested by TGF-β2 ELISA kit for rabbits. Results There was no significant opacification on crystalline lens of each group, and no significant abnormalities in lens fiber cells after post-operative 5 months. The levels of tTGF-β2 and aTGF-β2 in aqueous humor of group A and group B markedly increased, compared with group C, and group A increased 3 I. 50% （P 〈 0.05 ） and 37.2195 （P 〈 0.01 ）, respectively; group B increased 32.92% （P 〈 0.05 ） and 40.95 % （P〈0. 01）,respectively. There was no significant difference in group A and group B （P 〉0.05 ）. Compared with group C, the levels of tTGF-β2 and aTGF-β2 in crystalline lens of group A and group B markedly increased, and group A increased 31.54% （ P 〈 0. 05 ） and 32. I 1% （ P 〈 0.05 ）, respectively; group B increased 37.10% （ P 〈 0.01 ） and 37.56% （P 〈 0. 01 ）,respectively. No statistical significance was found in group A and group B （P〉0.05）. The activity ratios of TGF-β2 in aqueous humor and lens were no statistical difference among group A, group B and group C. Conclusion The level of tTGF-β2 and aTGF-β2 in aqueous humor and crystalline lens may increase through trabe- culectomy. The increase of TGF-β2 may be correlated with the occurrence and progressof cataract after trabeculectomy. Mitomycin C at low dose used in the operation may not f^ther increase the cataract risk in post- operation.