兔晶状体摘除和人工晶状体植入术后房水细胞因子水平和一氧化氮含量与眼内炎性反应的关系

A study on cytokine levels and nitric oxide content in rabbit aqueous humor after lens extraction and intraocular lens implantation

目的 探讨晶状体摘除和人工晶状体植入术后房水中白细胞介素 (interleukin ,IL) 2、肿瘤坏死因子 (tumournecrosisfactor,TNF) α水平及一氧化氮 (nitricoxide,NO)含量与眼内炎性反应严重程度之间的关系。方法 将 18只新西兰白兔随机分成 3组 ,每组 6只兔。Ⅰ组为正常对照组 ,Ⅱ组行囊外晶状体摘除术 ,Ⅲ组行囊外晶状体摘除及人工晶状体囊袋内植入术。分别于术后 0、1、3、7、14及 30d检查各组动物角膜水肿及前房渗出情况 ,抽取房水做房水细胞计数及分类 ,同时测定房水中细胞因子IL 2和TNF α水平及NO-2 /NO-3含量 ,并观察其变化。结果 Ⅲ组术后 7～ 14d ,前房渗出程度最严重 ,房水中单核 /巨噬细胞数目最多。术后 1～ 14dⅢ组房水中IL 2、TNF α和NO-2 /NO-3含量均明显高于Ⅰ、Ⅱ组 ,并于术后 3～ 7d达高峰 ,2周后逐渐降低。各组房水IL 2、TNF α、NO-2 /NO-3 含量和眼内炎性反应的严重程度变化规律基本一致 ,即炎性反应重时含量高。结论 人工晶状体植入术后眼内炎性反应的严重程度与房水细胞因子IL 2和TNF α水平及NO含量变化有密切关系。

Objective To investigate the relationship among inflammatory reaction and cytokine levels, nitric oxide (NO) content in aqueous humor after intraocular lens implantation. Methods Eighteen New Zealand rabbits were divided randomly into 3 groups (each 6 rabbits): (1) control group, (2) extracapsular cataract extraction group (ECCE) and (3) ECCE and posterior chamber intraocular lens implantation group (ECCE+IOL). The inflammation of all experimental rabbit eyes were observed by a zoom-photo slit-lamp microscope 0, 1, 3, 7, 14, 30 days postoperatively, including corneal edema and anterior chamber exudation. Meanwhile, aqueous humor was drawn for white blood cell (WBC) count and classification, as well as for NO -2/NO -3 and cytokine assays, including interleukin-2 (IL-2), tumor necrosis factor-α (TNF-α). Statistics were taken by SPSS software. Results (1) The anterior chamber exudation was the most serious and monocyte/macrophage in aqueous humor were the highest in ECCE+IOL group in postoperative 7-14 days. (2) The levels of IL-2, TNF-α and the content of NO -2/NO -3 in aqueous humor of ECCE+IOL group were higher than that in ECCE group and control group in the postoperative 1-14 days respectively, and they increased to their peak values at the postoperative 3-7 days and decreased gradually after postoperative two weeks. (3) The change regularity of IL-2, TNF-α, NO -2/NO -3 and inflammatory reaction in each group were basically similar, i.e. the more serious the reaction, the higher the levels of the contents. Conclusion The intraocular inflammation after intraocular lens implantation is closely related to the changes of cytokine levels and NO content in aqueous humor.