原发性急性闭角型青光眼患者房水中CXCR2和bFGF表达与小梁切除术后预后的关系

Relationship between expression of chemokine receptor 2 and basic fibroblast growth factor in aqueous humor and prognosis of trabeculectomy in patients with acute primary angle-closure glaucoma

目的:探讨原发性急性闭角型青光眼(APACG)患者的房水中趋化因子受体2(CXCR2)、碱性成纤维细胞生长因子(bFGF)水平与小梁切除术后预后的关系。方法:收集2020-06/2022-01期间本院收治的80例80眼行小梁切除术的APACG患者纳入病例组,依据术后疗效分为成功组60例60眼和失败组20例20眼;收集同期本院行白内障超声乳化术且眼压正常的白内障患者86例86眼纳入对照组。采用酶联免疫吸附法检测房水中CXCR2、bFGF水平;采用ROC曲线分析房水中CXCR2、bFGF水平预测APACG患者小梁切除术失败的价值;APACG患者小梁切除术失败的影响因素采用多因素Logistic回归分析。结果:病例组房水中CXCR2、bFGF水平显著高于对照组(P<0.05)。失败组房水中CXCR2、bFGF水平及术后浅前房发生患者比例显著高于成功组(P<0.05)。房水中CXCR2、bFGF水平单独及联合预测APACG患者小梁切除术后失败的AUC分别为0.885、0.883、0.953。CXCR2、bFGF是APACG患者小梁切除术后失败的危险因素(P<0.05)。结论:APACG患者房水中CXCR2、bFGF水平显著升高,且二者均是小梁切除术后失败的危险因素。

AIM:To investigate the relationship between the levels of chemokine receptor 2(CXCR2)and basic fibroblast growth factor(bFGF)in aqueous humor and the prognosis of trabeculectomy in patients with acute primary angle-closure glaucoma(APACG).METHODS:A total of 80 cases(80 eyes)APACG patients who underwent trabeculectomy in our hospital from June 2020 to January 2022 were collected in the case group.According to the postoperative efficacy,they were grouped into a success group of 60 cases(60 eyes)and a failure group of 20 cases(20 eyes).Another 86 cataract patients(86 eyes)who underwent phacoemulsification with normal intraocular pressure in our hospital during the same period were included in the control group.Enzyme linked immunosorbent assay was applied to detect the levels of CXCR2 and bFGF in aqueous humor.ROC curve was applied to analyze the value of predicting trabeculectomy failure in APACG patients by the levels of CXCR2 and bFGF in aqueous humor.Furthermore,multivariate Logistic regression was applied to analyze the influencing factors of trabeculectomy failure in APACG patients.RESULTS:The levels of CXCR2 and bFGF in the aqueous humor of the case group were significantly higher than those of the control group(P<0.05).The levels of CXCR2 and bFGF in the aqueous humor of the failed group and the proportion of patients with postoperative shallow anterior chamber were significantly higher than those of the successful group(P<0.05).The AUC for predicting trabeculectomy failure in APACG patients using CXCR2 and bFGF levels alone and in combination was 0.885,0.883 and 0.953,respectively.CXCR2 and bFGF were independent risk factors for trabeculectomy failure in APACG patients(P<0.05).CONCLUSION:The levels of CXCR2 and bFGF in the aqueous humor of APACG patients are obviously elevated,and both are risk factors for trabeculectomy failure.