小梁切除术、视网膜光凝联合治疗对NVG患者IP-10、TNF-α、VEGF的影响

Effect of trabeculectomy combined with retinal photocoagulation on IP⁃10,TNF⁃α,VEGF in patients with NVG

目的分析小梁切除术、视网膜光凝联合治疗对新生血管性青光眼(NVG)患者干扰素诱导蛋白-10(IP-10)、肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)的影响。方法选取2019年3月至2022年8月期间保定市第一中心医院接收的103例(103眼)NVG患者,根据不同治疗方法分为观察组(小梁切除术联合视网膜光凝治疗,n=53)和对照组(睫状体冷凝术联合视网膜光凝治疗,n=50)。比较两组临床疗效及IP-10、TNF-α、VEGF水平,记录眼压、神经纤维层厚度及视野缺损值及术后并发症情况。结果观察组临床总有效率(98.11%)高于对照组(88.00%),差异有统计学意义(χ^(2)=4.154,P<0.05)。术后15 d、1个月观察组眼压低于对照组(t=5.208,P<0.05;t=4.532,P<0.05),视野缺损值低于对照组(t=2.525,P<0.05;t=5.881,P<0.05),神经纤维层厚度大于对照组(t=4.577,P<0.05;t=5.372,P<0.05),差异均有统计学意义(P<0.05)。术后1个月观察组IP-10水平高于对照组(t=3.469,P<0.05),TNF-α、VEGF水平低于对照组(t=3.938,P<0.05;t=4.024,P<0.05),差异均有统计学意义(P<0.05)。观察组视力提高率(84.91%)高于对照组(68.00%),差异有统计学意义(χ^(2)=4.114,P<0.05)。观察组并发症发生率(9.43%)低于对照组(26.00%),差异有统计学意义(χ^(2)=4.896,P<0.05)。结论小梁切除术、视网膜光凝联合治疗NVG患者的临床显著,能有效改善眼痛、畏光等症状,减少并发症的发生。

Objective To analyze the effects of combined trabeculectomy and retinal photocoagula⁃tion on interferon⁃inducible protein⁃10(IP⁃10),tumor necrosis factor⁃α(TNF⁃α),vascular endothelial growth factor(VEGF)in patients with neovascular glaucoma(NVG).Methods 103 cases(103 eyes)of NVG patients received in Baoding First Central Hospital from March 2019 to August 2022 were selected,and accord⁃ing to different treatment methods,they were divided into the observation group(trabeculectomy combined with retinal photocoagulation treatment,n=53)and the control group(cyclocondensation combined with retinal photocoagulation treatment,n=50).The clinical efficacy and the levels of IP⁃10,TNF⁃αand VEGF were com⁃pared between the two groups,and the intraocular pressure and visual field defect values and postoperative com⁃plications were recorded in the two groups after treatment.Results The clinical total effective rate in the obser⁃vation group(98.11%)was higher than that in the control group(88.00%),and the difference was statistically significant(χ^(2)=4.154,P<0.05).15 days and 1 month after operation,the intraocular pressure in the observation group was lower than that in the control group(t=5.208,P<0.05;t=4.532,P<0.05),the visual field defect value of the observation group was lower than that of the control group(t=2.525,P<0.05;t=5.881,P<0.05).The thickness of the nerve fiber layer in the observation group was greater than that in the control group,and the difference was statistically significant(t=4.577,P<0.05;t=5.372,P<0.05).One month after operation,the levels of serum IP⁃10 in the observation group was higher than that in the control group(t=3.469,P<0.05),while the levels of TNF⁃αand VEGF in the observation group was lower than that in the control group,and the difference was statistically significant(t=3.938,P<0.05;t=4.024,P<0.05).The improvement rate of visual acuity in the observation group(84.91%)was higher than that in the control group(68.00%),and the differ⁃ence was statistically significant(χ^(2)=4.114,P<0.05).The incidence of complications in the observation group(9.43%)was lower than that in the control group(26.00%),and the difference was statistically significant(χ^(2)=4.896,P<0.05).Conclusion Trabeculectomy combined with retinal photocoagulation has a significant clini⁃cal effect in the treatment of NVG patients,which can effectively improve the symptoms such as eye pain and photophobia,reduce the incidence of complications.