高眼压症和原发性开角型青光眼患者血管内皮功能与循环内皮祖细胞的关联研究

Association between vascular endothelial function and circulating endothelial progenitor cells in patients with ocular hypertension and primary open-angle glaucoma

目的评估高眼压症和原发性开角型青光眼患者血管内皮功能并探讨循环内皮祖细胞在其间的作用。方法纳入高眼压症患者(OHT组)、原发性开角型青光眼患者(POAG组)以及年龄、性别相匹配的健康受试者(对照组)各30例。所有受试者年龄<65岁,无心血管疾病史或心血管危险因素。行常规体格检查、眼科检查和生化检测,利用超声诊断系统测定肱动脉血流介导的血管舒张(FMD),采用流式细胞术测定循环内皮祖细胞数量。结果与对照组比较,OHT组和POAG组FMD、内皮祖细胞计数、血浆一氧化氮(NO)含量下降(P<0.05),上述各指标在OHT组和POAG组组间比较,无统计学意义(P>0.05)。心血管危险因素在三组间比较,均无统计学差异(P>0.05)。偏相关分析显示,OHT组和POAG组内皮祖细胞数量与FMD(r=0.436,P=0.013)及NO(r=0.385,P=0.036)显著正相关,与基线眼压(r=0.347,P=0.041)呈负相关。结论OHT和POAG患者存在系统性内皮功能障碍,其机制可能与循环内皮祖细胞数量减少有关。促进内皮祖细胞动员以改善内皮功能可能是OHT和POAG患者临床治疗的崭新方向。

Objective To evaluate the vascular endothelial function in patients with ocular hypertension and primary open-angle glaucoma,and explore the role of circulating endothelial progenitor cells in this process.Methods Ocular hypertension(OHT group),primary open-angle glaucoma patients(POAG group),and age-and gender-matched healthy subjects(control group)were included with 30 sample size in each group.All subjects were<65 years old and had no history of cardiovascular disease or cardiovascular risk factors.Routine physical examination,ophthalmic examination and biochemical detection were performed.Brachial artery flow mediated dilation(FMD)was measured using ultrasonic diagnostic system,and the number of circulating endothelial progenitor cells was measured by flow cytometry.Results Compared with control group,FMD,endothelial progenitor cell count,plasma nitric oxide(NO)content decreased(P<0.05)in OHT group and POAG group,while there was no statistical significance in the comparison of indicators above between OHT group and POAG group(P>0.05).There were no statistical differences in cardiovascular risk factors among the three groups(P>0.05).Partial correlation analysis showed that the number of endothelial progenitor cells in the OHT group and POAG group was significantly positively correlated with FMD(r=0.436,P=0.013)and NO(r=0.385,P=0.036),and negatively correlated with baseline intraocular pressure(r=0.347,P=0.041).Conclusion Patients with OHT or POAG have systemic endothelial dysfunction,and the mechanism may be related to reduced number of circulating endothelial progenitor cells.Promoting the mobilization of endothelial progenitor cells to improve endothelial function may be a new direction for clinical treatment of patients with OHT or POAG.