先天性晶状体半脱位患者手术前后眼房水细胞因子的定量分析  

Quantitative analysis of cytokines in aqueous humor of patients with congenital dislocated lens before and after surgery

作　　者：魏英丽 宋旭东[2] 张玲[2] 杨爽[2] 

机构地区：[1]河北三河燕郊二三医院眼科,065201 [2]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科学与视觉科学重点实验室

出　　处：《中华眼科医学杂志（电子版）》2014年第1期32-36,共5页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

摘　　要：目的 探讨先天性晶状体半脱位患者手术前后房水中白细胞介素(IL)及肿瘤坏死因子(TNF)等细胞因子的变化情况及其与术后炎症反应的关系。方法 回顾性分析2011年6月至2012年6月首都医科大学附属北京同仁医院眼科26例(52只眼)行晶状体摘除术+人工晶状体植入+晶状体囊袋张力环(CTR)植入术患者的临床资料。根据CTR的移位情况,将患者分为两组,第1组(术后2~5 d组)12例(24只眼)患者CTR轻度移位,术后2~5 d行巩膜缝合固定术;第2组(术后30 d组)14例(28只眼)患者CTR重度移位,术后约1个月行巩膜缝合固定术。术前取术眼房水标本,置于-80℃深低温冰箱冻存,采用流式细胞术微球阵列法测定出房水中各细胞因子的含量。术眼房水中各细胞因子的浓度等计量数据,采用均数±标准差(x珋±s)表示,手术前后两样本均数的比较采用配对t检验。结果 在术后2~5 d患者组中,术前房水标本中的IL-6含量为(4 347.11±5 506.90)pg/L,明显低于术后的(101 420.60±43 120.69)pg/L,手术前后比较差异有统计学意义(t=20.27,P=0.001);术前房水标本中的IL-1β、IL-2、IL-4、IL-5、IL-10、IFN-γ及TNF-α含量分别为(148.36±114.96)pg/L、(106.80±53.19)pg/L、(32.67±17.97)pg/L、(72.93±40.65)pg/L、(105.43±53.36)pg/L、(126.21±80.52)pg/L及(80.36±53.29)pg/L,术后分别为(152.36±88.58)pg/L、(124.31±78.55)pg/L、(66.66±35.61)pg/L、(50.81±18.30)pg/L、(201.37±133.11)pg/L、(60.66±40.03)pg/L及(49.94±35.59)pg/L,手术前后上述各种细胞因子含量比较,差异无统计学意义(t=0.561,1.087,2.412,6.929,5.396,6.327,5.886;P=0.468,0.318,0.146,0.062,0.059,0.057,0.055)。在术后1个月患者组中,术前房水标本中的IL-6含量为(3 605.28±4 255.05)pg/L,明显低于术后的(77 401.52±16 120.2)pg/L,手术前后比较差异有统计学意义(t=11.56,P=0.003);术前房水标本中IL-1β、IL-2、IL-4、IL-5、IL-10、IFN-γ及TNF-α的含量分别为(150.25±118.65)pg/L、(135.31±73.16)pg/L、Objective To discuss the relationship between the change of cytokines including terleukin( IL) , tumor necrosis factor ( TNF ) , interferon ( IFN ) ect.in aqueous humor of patients with congenital dislocated lens before and after surgery and the postoperative inflammation.Methods Twenty-six cases (52 eyes) with congenital dislocated lens undertaken Phaco+IOL+capsulartensionring ( CTR) surgery from June 2011 to June 2012 in Department of Ophthalmology, TongRen Hospital were retrospectively analyzed.Patients were divided into Group A 12 cases (24 eyes) and group B 14 cases (28 eyes).In group A,CTR shift modestly after surgery,the dislocated CTR was sutured to sclera 2-5 days postoperatively.In group B,CTR shift seriously after surgery,the dislocated CTR was sutured to sclera 30 days postoperatively. Aqueous humor samples were taken by anterior chamber puncture before and after surgery ( 2-5 days postoperatively in group A and 30 days postoperatively in group B) .Specimens of aqueous humor were frozen at -80℃.The densities of IL-1β,IL-2,IL-4,IL-5,IL-6,IL-10,TNF-αand IFN-γwere determined by flow cytometry bead array method.Paired-samples ttest was used in this study.Results In group A, IL-6 was (4 347±5 506)pg/L before surgery and (101 420.60±43 120.69)pg/L after surgery.The difference was statistically significant (t=20.27,P=0.001); before operation IL-1β,IL-2,IL-4,IL-5,IL-10,IFN-γ,TNF-α′s content were (148.36 ±114.96) pg/L,(106.80 ±53.19) pg/L, (32.67 ±17.97) pg/L, (72.93 ± 40.65)pg/L,(105.43±53.36)pg/L, (126.21±80.52)pg/L, (80.36±53.29)pg/L vs postoperation (152.36±88.58)pg/L, (124.31±78.55)pg/L, (66.66 ±35.61)pg/L, (50.81±18.30)pg/L, (201.37±133.11)pg/L,(60.66±40.03)pg/L,(49.94±35.59)pg/L,the difference was not statistically significant(t=0.561,1.087,2.412,6.929,5.396,6.327,5.886;P=0.468,0.318,0.146,0.062,0.059, 0.057,0.055).In group B,IL-6 was (3 605.28 ±4 255.05) pg/L before surgery and (7 7401.52 ± 16 120.2)pg/L after surgery.The difference was also statistically significant (t=11.5

关 键 词：先天性晶状体半脱位 晶状体摘除术 人工晶状体植入术 晶状体囊袋张力环 房水细胞因子 

分 类 号：R779.66[医药卫生—眼科]