原发性开角型青光眼视网膜纤维层厚度、视野缺损与房水中sCD44浓度的相关性研究  

Correlation between aqueous humor s CD44 concentration, visual field defect and retinal nerve fiber layer thickness in primary open-angle glaucoma

作　　者：刘思彤 吴志鸿[1] LIU Sitong;WU Zhihong(Department of Ophthalmology, General Hospital of Chinese People's Armed Police Force, Beijing 100039, China)

机构地区：[1]武警总医院眼科,北京100039

出　　处：《中华灾害救援医学》2018年第1期19-23,共5页Chinese Journal of Disaster Medicine

摘　　要：目的探讨原发性开角型青光眼(primary open angle glaucoma,POAG)患者房水中可溶性CD44(soluble CD44,sCD4)浓度与视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度及视野平均缺损(mean defect,MD)的相关性。方法选取2015-07至2017-05在武警总医院就诊的POAG患者40例(40眼)为研究对象(观察组),按照视野MD程度将患者分为A、B、C三个亚组;选取同期手术的年龄相匹配的白内障患者20例(22眼)为对照组。使用光学相干断层扫描技术(optical coherence tomography,OCT)测量受试者RNFL厚度,采用双抗体夹心免疫酶联吸附法(enzyme linked immunosorhent assay,ELISA)测定各组房水中sCD44浓度。分别比较各组sCD44浓度、RNFL厚度,并分析sCD44浓度与视盘RNFL厚度及视野MD的相关性。结果 (1)与对照组相比,观察组房水中sCD44浓度显著升高(t=-13.17,P<0.001),视盘RNFL厚度显著变薄(t=9.65,P<0.001)。(2)单因素方差分析结果显示,各组sCD44浓度及RNFL厚度不全相同(F=197.38,P<0.001;F=135.96,P<0.001),进一步两两比较显示,A、B、C三组sCD44浓度依次增高,RNFL厚度依次变薄,差异均有统计学意义(P<0.05)。(3)Spearman秩相关分析结果显示,房水中sCD44的浓度与视野MD值(r_s=-0.916,P<0.05)及视盘RNFL厚度值(r_s=-0.915,P<0.05)均呈显著负相关。结论 POAG患者房水中sCD44浓度较非POAG患者增高,且随着其浓度的增高,视盘RNFL变薄,视野损伤加重。Objective The objective of this study was to explore the correlation between aqueous humor sCD44concentration,visual field mean defect(MD),and the retinal nerve fiber layer(RNFL)thickness in primary open angle glaucoma(POAG)patients.Methods A sample of40patients(40eyes)diagnosed with POAG,treated in General Hospital of PAP from July2015to May2017were selected as study object(observation group),and were divided into groups A,B,C according to the degree of visual field MD.20cases(22eyes)of cataract patients matched in age in the same period were selected as control group.The thickness of RNFL was measured by optical coherence tomography(OCT),and the concentration of sCD44in aqueous humor was measured by double antibody sandwich enzyme linked immunosorbent assay(ELISA).The concentration of sCD44and RNFL thickness in each group were compared respectively,and the correlation between sCD44concentration and RNFL thickness,visual field MD were analyzed.Results(1)Compared with the control group,the sCD44concentration in the observation group was significantly increased(t=-13.17,P<0.001),and the RNFL thickness in the observation group became significantly thinner(t=9.65,P<0.001).(2)One-way ANOVA analysis showed that the sCD44concentration and RNFL thickness in each group were not all the same(F=197.38,P<0.001;F=135.96,P<0.001),further comparison showed that the sCD44concentration in groups A,B and C increased in turn,and the RNFL thickness in groups A,B and C became thinner in turn,and the differences were statistically significant(P<0.05).(3)Spearman rank correlation analysis showed that the sCD44concentration was negatively correlated with visual field MD(rs=-0.916,P<0.05)and RNFL thickness(rs=-0.915,P<0.05).Conclusions The concentration of sCD44in aqueous humor in patients with POAG are significantly increased compared to that in the non-POAG patients.Along with the increase of sCD44concentration,the thickness of RNFL becomes thinner and the visual field defect becomes aggravated.

关 键 词：原发性开角型青光眼 可溶性CD44 视野缺损 视网膜神经纤维层 

分 类 号：R775.2[医药卫生—眼科]