血清人巨细胞病毒免疫球蛋白G与原发性闭角型青光眼的相关性研究

Correlation between serum human cytomegalovirus immunoglobulin G level and primary angle-closure glaucoma

目的 探讨血清人巨细胞病毒(HCMV)免疫球蛋白G(IgG)水平与原发性闭角型青光眼(PACG)的相关性。方法 采用回顾性病例对照研究。收集2019年6月—2020年6月于复旦大学附属眼耳鼻喉科医院确诊为PACG的患者66例作为病例组,同时收集与病例组年龄、性别匹配的正常体检者88例作为对照组。根据视野平均缺损(MD)大小,将PACG患者分为轻度组(MD≤6 dB)、中度组(612 dB)。采用全自动电化学发光法免疫分析仪对血清HCMV IgG抗体含量进行检测分析。结果 PACG组HCMV IgG水平(M=508.00,四分位数:313.40,780.75)显著高于对照组(M=318.80,四分位数:164.33,498.40),差异有统计学意义(P<0.001)。Spearman相关分析显示,PACG组HCMV IgG水平与眼压(r=0.28,P=0.025 3)呈正相关,与平均光敏感度(r=-0.25, P=0.049 3)及MD(r=-0.24, P=0.034 2)呈负相关。轻度PACG组HCMV IgG水平显著低于中度和重度PACG组(P值均<0.05)。Logistic回归分析发现,HCMV IgG水平升高是PACG发病的独立危险因素(P<0.001, OR=1.003, 95%CI为1.002~1.005)。结论 PACG患者血清HCMV IgG水平显著升高,并与眼压及MD呈正相关,提示HCMV IgG水平与PACG疾病进展相关。

Objective To study the correlation between serum human cytomegalovirus(HCMV)immunoglobulin G(IgG)level and primary angle-closure glaucoma(PACG).Methods Retrospective case-control study was conducted.A total of 66 PACG patients in Eye&ENT Hospital of Fudan University from June 2019 to June 2020 were selected as the case group and 88 age-and gender-matched healthy people who received physical examination in the hospital during the same period were collected as the control group.Patients in the PACG group were divided into three subgroups according to the mean defect(MD)of visual field:mild PACG group(MD≤6 dB),moderate PACG group(6 dB<MD≤12 dB)and severe PACG group(MD>12 dB).The detailed ophthalmological and physical examinations information of two groups were collected from the medical data platform.Serum HCMV IgG level was detected by automatic electrochemi-luminescene immuno-analyzer.Results Based on the laboratory results,the HCMV IgG level was significantly higher in the PACG group(M=508.00;313.40,780.75)than that in the control group(M=318.80;164.33,498.40)(P<0.001).Moreover,the HCMV IgG level was significantly lower in the mild PACG subgroup than that in both moderate and severe subgroups(P<0.05).Spearman correlation analysis showed that HCMV IgG level had a positive correlation with the IOP(r=0.28,P=0.0253),while a negative correlation with either the mean sensitivity(MS)(r=-0.25,P=0.0493)or MD(r=-0.24,P=0.0342)level in patients with PACG.Logistic regression analysis found that the increased HCMV IgG level was an independent risk factor for the development of PACG(P<0.001,OR=1.003,95%CI=1.002-1.005).Conclusions Compared with normal people,the HCMV IgG level of PACG patients is increased significantly and positively correlated with IOP and MD.The HCMV IgG level may be related to the progression of PACG.