血清MLT、Klotho蛋白与原发性闭角型青光眼患者促炎症因子和疗效的关系

Relationship between serum MLT and Klotho protein and pro-inflammatory factors and efficacy in patients with primary angle-closure glaucoma

目的探讨血清褪黑素(MLT)、Klotho蛋白与原发性闭角型青光眼(PACG)患者促炎症因子和手术治疗效果的关系。方法选取2018年6月至2021年6月自贡市第四人民医院收治的PACG患者149例为病例组,另选取同期在该院体检的健康者149例为对照组,比较两组血清MLT、Klotho蛋白及促炎症因子白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平,采用Pearson相关分析血清MLT、Klotho蛋白与促炎症因子水平的相关性,采用单因素和多因素Logistic回归模型分析手术治疗效果的影响因素。结果与对照组比较,病例组血清MLT、Klotho蛋白水平降低(P<0.05),IL-1β、IL-6、TNF-α水平升高(P<0.05)。Pearson相关分析结果显示,血清MLT、Klotho蛋白均与促炎症因子IL-1β、IL-6、TNF-α水平呈负相关(P<0.05)。149例患者手术治疗12个月后,手术治疗效果无效患者30例(无效组),占20.13%;手术治疗效果有效患者119例(有效组),占79.87%。单因素分析结果显示,与有效组比较,无效组术前眼压(IOP)、慢性PACG比例、术前最佳矫正视力、术前房角粘连>160°比例升高(P<0.05),术前前房深度、MLT、Klotho蛋白水平降低(P<0.05)。多因素Logistic回归模型结果显示,术前IOP升高、慢性PACG、MLT水平降低、Klotho水平降低是手术治疗效果无效的独立危险因素(P<0.05)。结论血清MLT、Klotho蛋白在PACG患者中水平降低,与促炎症因子关系密切,是影响手术治疗效果的相关因素。

Objective To investigate the relationship of serum melatonin(MLT)and Klotho protein with pro-inflammatory factors and the effect of surgical treatment in patients with primary angle-closure glaucoma(PACG).Methods A total of 149 PACG patients admitted to the Zigong Fourth People′s Hospital from June 2018 to June 2021 were selected as the case group,and 149 healthy people who underwent physical examination in the hospital during the same period were selected as the control group.The levels of MLT,Klotho protein,interleukin-6(IL-6),interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)were compared between the two groups.Pearson correlation analysis was used to analyze the correlation between MLT,Klotho protein and pro-inflammatory factors.Univariate and multivariate Logistic regression models were used to analyze the influencing factors of surgical treatment.Results Compared with the control group,the levels of MLT and Klotho protein in the case group were decreased(P<0.05),and the levels of IL-1β,IL-6 and TNF-αwere increased(P<0.05).Pearson correlation analysis showed that serum MLT and Klotho protein were negatively correlated with the levels of pro-inflammatory factors IL-1β,IL-6,and TNF-α(P<0.05).After 12 months of surgical treatment,30 patients(20.13%)had no effect of surgical treatment(ineffective group).119 patients(79.87%)had effective surgical treatment(effective group).The univariate analysis showed that compared with the effective group,the preoperative intraocular pressure(IOP),proportion of chronic PACG,preoperative best corrected visual acuity,proportion of preoperative Angle adhesion>160°were significantly increased(P<0.05),and the preoperative anterior chamber depth,MLT,and Klotho protein levels were decreased in the ineffective group(P<0.05).Multivariate Logistic regression analysis showed that elevated preoperative IOP,chronic PACG,decreased MLT and Klotho levels were independent risk factors for ineffective surgical treatment(P<0.05).Conclusion serum MLT,Klotho protein levels in patients with PACG,closely associated with proinflammatory factor,is the related factors influencing the effect of surgical treatment.