原发性青光眼合并2型糖尿病患者血液及房水中MMP-2及TIMP-2的表达研究

Expression of MMP-2 and TIMP-2 in blood and aqueous humor in patients with primary glaucoma complicated with type 2 diabetes mellitus

目的观察和分析原发性青光眼合并2型糖尿病(T2DM)患者血液及房水中基质金属蛋白酶2(MMP-2)及金属蛋白酶2组织抑制因子(TIMP-2)的表达变化。方法选取60例原发性青光眼患者,根据将合并T2DM情况将其分为A组(单纯POAG病例,15例23只眼)、B组(单纯PACG病例,15例26只眼)、C组(POAG合并T2DM病例,15例25只眼)、D组(PACG合并T2DM病例,15例23只眼),选取糖尿病性白内障病例(20例33只眼)作为E组,选取年龄相关性白内障病例(20例32只眼)作为F组。对6组患者房水及血清MMP-2、TIMP-2水平及比值进行观察和比较。结果 B组和D组患者的房水MMP-2、TIMP-2水平均高于其它各组,A组和C组患者的房水TIMP-2水平高于E组或F组,A组、B组、C组、D组患者的房水TIMP-2/MMP-2比值均显著高于E组或F组,差异均有统计学意义(P<0.05);A组患者的血清MMP-2、TIMP-2水平均高于其它各组,差异均有统计学意义(P<0.05),而6组患者血清TIMP-2/MMP-2比值的差异无统计学意义(F=1.634,P>0.05)。结论原发性青光眼患者血液和房水中存在着显著的MMP-2/TIMP-2系统失衡,但合并T2DM并不能加剧这一失衡状态,不具有促进青光眼进展的作用。

Objective To observe and analyze the expression of matrix metalloproteinase-2 （MMP-2 ） and tissue inhibitor of metalloproteinase-2 （ TIMP-2 ） in blood and aqueous humor of patients with primary glaucoma comphcated with type 2 diabetes mellitus （ T2DM ）. Methods 60 primary glaucoma patients were selected and divided into Group A （ simple POAG cases, n =23 eyes） , Group B （simple PACG cases, n =26 eye） , Group C （POAG complicated with T2DM, n = 25 eyes）, Group D （PACG complicated with T2DM, n = 23 eyes）. Patients with diabetic cataract （ n = 33 eyes） were selected as Group E and the patients with age-related cataract （ n = 32 eyes ） were selected as Group F. Serum and aqueous MMP-2, TIMP-2 levels and their ratios in 6 groups were compared. Results Both aqueous MMP-2 and TIMP-2 levels were high in Group B and Group D （ i. e. , PACG patients with or without T2DM ） than in other patients. Aqueous TIMP-2 level was high in Group A and Group C （ i. e. , POAG patients with or without T2DM ） than in Group E or F. The TIMP-2/MMP-2 ratio was high in all glaucoma patients （ Group A through D） than in non-glancoma patients （ Group E and F ）. Serum MMP-2 and TIMP levels were high in Group A than in all other groups （ P 〈 0. 05）. There was no significant difference in serum TIMP-2/MMP-2 ratio between the 6 groups （ F = 1. 634, P 〉 0. 05 ）. Condusions There was significant imbalance in serum and aqueous MMP-2/TIMP-2 system in patients with primary glaucoma. Complication of T2DM did not exacerbate this imbalance.