视网膜静脉阻塞继发黄斑水肿患者房水中不同细胞因子含量与视网膜中央厚度的相关性分析

Correlation of cytokine content in aqueous humor with central retinal thickness in patients with macular edema secondary to retinal vein occlusion

目的探讨视网膜静脉阻塞(RVO)继发的黄斑水肿(RVO-ME)患者房水中不同细胞因子含量与视网膜中央厚度(CRT)的关系。方法选取2020年1月至2020年12月在南京医科大学附属眼科医院经影像学检查确诊为RVO-ME的患者56例56眼。根据视网膜静脉阻塞部位不同,将患者分为2组。视网膜中央静脉阻塞(CRVO)-ME组20例(20眼),视网膜分支静脉阻塞(BRVO)-ME组36例(36眼)。使用OCT测量两组患者CRT。收集房水,采用流式微珠阵列法测定房水中6种细胞因子VEGF、碱性成纤维细胞生长因子(bFGF)、白细胞介素(IL)-6、IL-8、血管细胞黏附分子(VCAM)、肿瘤坏死因子α(TNF-α)含量。比较两组患者房水中各细胞因子含量和CRT;分析各细胞因子含量与CRT的相关性以及VEGF与其他细胞因子含量的相关性。结果CRVO-ME组患者的CRT高于BRVO-ME组,差异有统计学意义(P<0.05)。CRVO-ME组患者房水中IL-6、IL-8、VCAM的含量均明显高于BRVO-ME组,差异均有统计学意义(均为P<0.05)。Spearman相关分析结果显示RVO-ME患者房水中IL-8、IL-6、VCAM和VEGF含量与CRT均呈正相关(r=0.66、0.66、0.74、0.36,均为P<0.05),其中IL-8、IL-6、VCAM含量与CRT的相关性明显高于VEGF含量与CRT的相关性。RVO-ME患者房水中bFGF、TNF-α含量与CRT均无明显的相关性(均为P>0.05)。RVO-ME患者房水中VEGF与IL-6(r=0.28,P<0.05)、VCAM(r=0.22,P<0.05)含量均呈正相关,与bFGF、IL-8、TNF-α含量均无明显相关性(均为P>0.05)。结论在RVO-ME的发生发展过程中炎症因子可能较VEGF具有更为重要的作用,抗炎治疗的同时也可以降低VEGF的含量,采用抗炎手段治疗RVO-ME或许更为关键。

Objective To investigate the relationship between the cytokine content in aqueous humor and the central retinal thickness(CRT)in patients with macular edema secondary to retinal vein occlusion(RVO-ME).Methods Totally 56 RVO-ME patients(56 eyes)confirmed by imaging examination in the Affiliated Eye Hospital of Nanjing Medical University from January to December 2020 were recruited into the study.They were divided into the central retinal vein occlusion(CRVO)-ME group(20 patients with 20 eyes)and the branch retinal vein occlusion(BRVO)-ME group(36 patients with 36 eyes)according to the RVO site.Optical coherence tomography was used to measure the CRT of all patients.Aqueous humor was extracted to measure the content of 6 cytokines vascular endothelial growth factor(VEGF),basic fibroblast growth factor(bFGF),interleukin(IL)-6,IL-8,vascular cell adhesion molecule(VCAM),tumor necrosis factorα(TNF-α)with cytometric bead array.The content of cytokines and CRT between the two groups were compared,and their correlation as well as the correlation between VEGF and other cytokines were analyzed.Results The CRT in the CRVO-ME group was higher than that in the BRVO-ME group(P<0.05).The content of IL-6,IL-8 and VCAM in the CRVO-ME group were higher than those in the BRVO-ME group(all P<0.05).Spearman correlation analysis results showed that the content of IL-8,IL-6,VCAM,and VEGF in the RVO-ME patients were positively correlated with CRT(r=0.66,0.66,0.74,0.36,all P<0.05),among which the correlation between IL-8,IL-6,VCAM and CRT was significantly higher than that between VEGF and CRT.But there was no significant correlation between the content of bFGF and TNF-αand CRT(both P>0.05).The expression of VEGF was positively correlated with the content of IL-6(r=0.28,P<0.05)and VCAM(r=0.22,P<0.05)in RVO-ME patients,while had no significant correlation with the content of bFGF,IL-8,and TNF-α(all P>0.05).Conclusion Inflammatory factors may play a more important role than VEGF in the occurrence and development of RVO-ME.Anti-inflammatory treatment can also reduce the content of VEGF.It may be more critical to use anti-inflammatory means to treat RVO-ME.