双眼慢性原发性闭角型青光眼术前房水中炎症因子的表达及其对预后的影响

Expressions of inflammatory factors of aqueous humor before the surgery of chronic primary angle-closure glaucoma and its influence on prognosis

目的:探讨慢性原发性闭角型青光眼(CPACG)双眼先后行小梁切除术前房水中炎症因子的表达水平及其与术后滤过泡和眼压的相关性。方法:选取2021-09/12在南京医科大学附属眼科医院就诊并行小梁切除术的双眼CPACG患者15例30眼,双眼手术间隔7d,利用酶联免疫吸附试验(ELISA)分别检测双眼术前房水中单核细胞趋化蛋白-1(MCP-1)、白细胞介素-17(IL-17)、转化生长因子-β(TGF-β)和干扰素-γ(IFN-γ)的表达水平,并于术后1mo评估眼压及滤过泡形态。结果:纳入患者第一眼术前房水中MCP-1、IL-17、TGF-β和IFN-γ的含量分别为330.4±46.2、357.3±46.9、2347.5±363.8、527.7±101.6pg/mL,第二眼术前房水中MCP-1、IL-17、TGF-β和IFN-γ的含量分别为298.2±40.7、309.1±53.5、1938.3±426.0、628.2±104.9pg/mL,双眼术前房水中炎症因子表达水平均有差异(P≤0.05)。纳入患者双眼术前房水中IL-17、TGF-β表达水平与术后1mo眼压、滤过泡高度均具有相关性(P<0.05)。结论:CPACG患者第一眼术后第二眼房水中炎症因子的表达水平可能发生一定变化,其中双眼术前房水中IL-17、TGF-β的表达水平与术后眼压和滤过泡高度具有一定的相关性。

AIM:To investigate the expression level of inflammatory factors of aqueous humor before trabeculectomy in binocular chronic primary angle-closure glaucoma(CPACG)and its correlation with postoperative filtration bleb and intraocular pressure.METHODS:A total of 15 cases(30 eyes)with binocular CPACG who admitted to the Affiliated Eye Hospital of Nanjing Medical University from September to December 2021 and received trabeculectomy were selected.The surgery interval between two eyes was 7d,and the preoperative expression levels of monocyte chemoattractant protein-1(MCP-1),interleukin-17(IL-17),transforming growth factor-β(TGF-β),and interferon-γ(IFN-γ)of the aqueous humor in both eyes were respectively detected by enzyme-linked immunosorbent assay(ELISA).Furthermore,the intraocular pressure(IOP)and the morphology of filtering blebs at 1mo after surgery were measured.RESULTS:The concentrations of MCP-1,IL-17,TGF-β,and IFN-γin aqueous humor from the first eye before surgery were 330.4±46.2,357.3±46.9,2347.5±363.8 and 527.7±101.6pg/mL respectively,and those concentrations in aqueous humor from the fellow eye were 298.2±40.7,309.1±53.5,1938.3±426.0 and 628.2±104.9pg/mL respectively.The preoperative expression levels of inflammatory factors of aqueous humor in both eyes were statistically significant(P≤0.05).Furthermore,the expression levels of IL-17 and TGF-βin the aqueous humor of patients with CPACG correlated with IOP and the height of filtering blebs at 1mo after surgery(P<0.05).CONCLUSION:There may be changes in the expression levels of inflammatory factors of aqueous humor in the fellow eye after surgery of the first eye.Moreover,the preoperative expression level of IL-17 and TGF-βin aqueous humor possibly related to postoperative IOP and the height of filtering bleb.