曲安奈德对年龄相关性白内障术后前葡萄膜炎的疗效及其对炎症因子的影响

Efficacy of triamcinolone acetonide for anterior uveitis after age-related cataract surgery and its impact on inflammatory cytokines

目的观察曲安奈德对年龄相关性白内障术后前葡萄膜炎的临床疗效及其对相关炎症因子的影响。方法选择2010年2月至2012年6月间我科收治的年龄相关性白内障患者168例(168眼)为研究对象,按照治疗方式的不同分为对照组和曲安奈德组,每组各84例(84眼)。对照组予以术后结膜下注射地塞米松,而曲安奈德组给予前房注射2 mg曲安奈德,对比两组患者术后第1天、第3天和第5天的最佳矫正视力、眼压、前房细胞数、房水闪辉情况,并于术后第5天测肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、干扰素-γ(interferon-γ,IFN-γ)和白细胞介素-10(interleukin-10,IL-10)的含量变化。结果曲安奈德组患者的最佳矫正视力在术后第3天已有明显改善,显著优于对照组(P<0.05)。且两组间前房细胞数及房水闪辉比较发现,术后第3天和第5天,两组差异均具有统计学意义(均为P<0.05)。术后第5天曲安奈德组的TNF-α和IFN-γ的表达水平分别为(19.6±8.9)pg·L-1、(14.4±7.8)pg·L-1,显著低于对照组(29.5±14.2)pg·L-1、(39.8±10.3)pg·L-1,差异均有统计学意义(均为P<0.05),而IL-10含量两组间比较差异却无统计学意义(P>0.05)。结论年龄相关性白内障手术中前房注射曲安奈德可有效抑制术后前葡萄膜炎,减少前房反应,且抗炎效果良好。

Objective To observe the clinical efficacy of triamcinolone acetonide for anterior uveitis after age-related cataract surgery and its impact on associated inflammatory cytokines. Methods A total of 168 age-related cataract patients（ 168 eyes） from February 2010 to June 2012 in our hospital were divided into conventional treatment control group and triamcinolone acetonide group according to the different treatment, 84 cases（ 84 eyes） in each group. Control group received postoperative subconjunctival injection of dexamethasone,and anterior chamber injection of triamcinolone acetonide group was given 2 mg triamcinolone acetonide. Best corrected visual acuity, intraocular pressure, anterior chamber cells and aqueous flare at pre-operation and postoperative 1 day,3 days and 5 days, and TNF-α, IFN-γ and IL-10 were detected at postoperative 5 days. Results Best corrected visual acuity in triamcinolone acetonide group at postoperative 3 days obviously improved, significantly better than that of control group（ P ＆lt; 0.05）. There were statistical differences in number of anterior chamber cells and aqueous flare at postoperative 3 days and 5 days between two groups（ all P ＆lt; 0. 05）. TNF-α and IFN-γ levels in triamcinolone acetonide group at postoperative 5 days were（ 19. 6 ± 8. 9） pg·L- 1 and（ 14. 4 ± 7. 8） pg·L- 1, respectively,which in conventional treatment control group were（ 29. 5 ± 14. 2） pg·L- 1 and（ 39. 8 ±10. 3） pg·L- 1, respectively,there were statistical difference（ all P ＆lt; 0. 05）,but there was no statistical difference in IL-10 between two groups（ P ＆gt; 0. 05）. Conclusion During age-related cataract surgery, injection of triamcinolone acetonide into anterior chamber can effectively inhibit postoperative anterior uveitis and anterior chamber reaction with better anti-inflammatory effects.