曲安奈德对年龄相关性白内障患者房水TNF-α、IL-1β、IL-6的影响

Effect of Triamcinolone Acetonide on TNF-α, IL-1β and IL-6 Levels in the Aqueous Fluid of Patients with Age-related Cataract

目的:探讨曲安奈德对年龄相关性白内障术后患者房水肿瘤坏死因子(TNF)-α、白介素(IL)-1β、IL-6水平的影响。方法:选择2014年6月至2016年6月我院接诊的92例年龄相关性白内障患者,通过随机数表法分为观察组(n=46)和对照组(n=46),均择期行白内障超声乳化吸除联合人工晶状体植入术。观察组在人工晶状体植入后,在前房内注射曲安奈德,对照组注射复方平衡盐液,术后24 h,使用普拉洛芬滴眼液,连续用药1个月。比较两组手术前、手术后7d后眼压、角膜内皮细胞计数、裸眼视力、最佳矫正视力、眼部体征积分、炎症因子的变化,手术后1d、手术后7d时前房反应及不良反应的发生情况。结果:两组手术前后眼压、角膜内皮细胞计数均未发生明显变化(P>0.05);手术后,两组裸眼视力、最佳矫正视力、眼部体征积分均较治疗前明显改善(P<0.05),观察组裸眼视力、最佳矫正视力、眼部体征积分明显优于对照组(P<0.05);与手术前相比,两组房水中TNF-α、IL-1β、IL-6水平均显著降低(P<0.05),观察组房水TNF-α、IL-1β、IL-6水平均明显低于对照组(P<0.05);观察组在手术后1d、7d时前房反应1级比例均高于对照组,前房反应3级、4级比例均比对照组低(P<0.05);观察组不良反应总发生率明显低于对照组(P<0.05)。结论:曲安奈德用于年龄相关性白内障患者术后患者的效果显著,其可有效缓解术后前葡萄膜炎,减少并发症,促进术后视力恢复,其机制可能与抑制房水中TNF-α、IL-1β、IL-6的表达相关。

Objective： To study the effect of triamcinolone acetonide on the tumor necrosis factor（TNF）-α, interleukin（IL）-1βand IL-6 levels in the aqueous fluid of patients after age-related cataract surgery. Methods： 92 patients with age-related cataract who were treated from June 2014 to June 2016 in our hospital were selected and divided into the observation group（n=46） and the control group（n=46） according to the random number table. All the patients underwent phacoemulsification combined with intraocular lens implantation. The observation group was injected with triamcinolone acetonide in the anterior chamber after IOL implantation, the control group was injected with compound balanced salt solution, at 24 h postoperation, pranoprofen Eye Drops was used, continuous medication was treated for 1 months. The changes of intraocular pressure, corneal endothelial cell count, uncorrected visual acuity, best corrected visual acuity, ocular signs and inflammatory factors were compared between the two groups before and at 7 days after operation, the anterior chamber reaction at 1 day and 7 days postoperation and the incidence of adverse reactions were compared between two groups. Results： There was no significant change in the intraocular pressure and corneal endothelial cell count before and after operation between the two groups（P〈0.05）; after operation, the uncorrected visual acuity, best corrected visual acuity and ocular signs score of both groups were significantly improved（P〈0.05）, the uncorrected visual acuity, the best corrected visual acuity and the integral of ocular signs of observation group were significantly better than those of the control group（P〈0.05）; compared with preoperation, the TNF-α, IL-1β and IL-6 levels in the aqueous fluid were significantly decreased（P〈0.05）, the levels of TNF-α, IL-1β and IL-6 in the aqueous fluid of observation group were significantly lower than those of the control group（P〈0.05）; the anterior chamber reaction of observation group at 1 day and 7 days after the operation were higher than those of the control group at 1 grade the 3 and the 4 grade of the anterior chamber reaction were lower than those of the control group（P〈0.05）; the incidence of adverse reactions in the observation group was significantly lower than that of the control group（P〈0.05）. Conclusion： Triamcinolone acetonide anterior chamber injection is effective for age-related cataract patients after surgery, which can effectively alleviate the postoperative anterior uveitis, reduce the complications and promote the postoperative visual recovery, which may be related to the inhibition of the expressions of TNF-α,IL-1βand IL-6 in the aqueous fluid.