玻璃体腔注射雷珠单抗治疗对视网膜分支静脉阻塞继发黄斑水肿患者房水中细胞因子表达水平的影响  

The effect of intravitreal ranibizumab on the expression of cytokines in aqueous humor of patients with macular edema due to branch retinal vein occlusion

作　　者：朱成义[1] 潘兰兰[1] 伊琼[1] 韦企平[2] Zhu Chengyi;Pan Lanlan;Yi Qiong;Wei Qiping(Department of Ophthalmology,Beijing Hepingli Hospital,Beijing 100013,China)

机构地区：[1]北京市和平里医院眼科,北京100013 [2]北京中医药大学东方医院眼科,北京100078

出　　处：《中华眼底病杂志》2022年第9期739-743,共5页Chinese Journal of Ocular Fundus Diseases

基　　金：2021年度北京市东城区卫生科技计划项目(东卫健研[2021]-7);2018年度北京中医药科技发展资金项目(JJ2018-20);2018年度首都特色应用研究项目(Z181100001718085)。

摘　　要：目的观察视网膜分支静脉阻塞继发黄斑水肿(BRVO-ME)患眼玻璃体腔注射雷珠单抗(IVR)治疗后房水中细胞因子表达水平的变化。方法前瞻性临床研究。2018年6月至2021年6月于北京市和平里医院眼科检查确诊的非缺血型BRVO-ME患者31例31只眼纳入研究。其中,男性15例15只眼,女性16例16只眼;年龄70(65,72)岁;病程10(9,15)d。均为初次发病者。患眼均行IVR治疗,每一个月1次,连续3个月。每次IVR治疗结束时即刻抽取房水0.1 ml,流式细胞仪检测房水中血管内皮生长因子(VEGF)、白细胞介素-6(IL-6)、单核细胞趋化蛋白-1(MCP-1)、细胞间黏附分子-1(ICAM-1)、血管细胞黏附分子-1(VCAM-1)的浓度。治疗前后患眼房水中细胞因子浓度比较行Kruskal-Wallis或Wilcoxon Signed-Rank秩和检验;治疗前患眼房水中VEGF与MCP-1表达水平的相关性行Spearman相关性分析。结果治疗后1个月与治疗前、治疗后2个月与治疗后1个月比较,患眼房水中VEGF、ICAM-1浓度均显著降低,差异有统计学意义(Z=4.03、3.25、2.50、3.48,P<0.05);IL-6、VCAM-1浓度升高,MCP-1浓度降低,但差异均无统计学意义(Z=-0.21、1.42、0.86、-0.53、0.92、-1.57,P>0.05)。Spearman相关性分析结果显示,治疗前患眼房水中VEGF与MCP-1呈强正相关(r=0.78,P<0.001)。结论BRVO-ME患眼IVR治疗后房水中VEGF、ICAM-1浓度明显下降;IL-6、MCP-1、VCAM-1浓度无明显变化。Objective To study the changes the changes of cytokine expression the aqueous humor of patients with macular edema secondary to branch retinal vein occlusion(BRVO-ME)before and after intravitreal ranibizumab(IVR).Methods A prospective clinical study.From June 2018 to June 2021,31 eyes of 31 patients with non-ischemic BRVO-ME diagnosed by ophthalmic examination in Department of Ophthalmology,Beijing Hepingli Hospital were included in the study.Among them,15 males had 15 eyes,and 16 females had 16 eyes.Age was 70(65,72)years;the course of disease was 10(9,15)days.All of them were first-time patients.All eyes were treated with IVR once a month for 3 consecutive months.At the end of each IVR treatment,0.1 ml aqueous humor was extracted immediately.The concentrations of vascular endothelial growth factor(VEGF),interleukin-6(IL-6),monocyte chemoattractant protein-1(MCP-1),intercellular adhesion molecule-1(ICAM-1)and vascular cell adhesion molecule-1(VCAM-1)in aqueous humor were detected by flow cytometry.The concentrations of cytokines in aqueous humor before and after treatment were compared by Kruskal-Wallis or Wilcoxon signed-rank test.Spearman correlation analysis was performed on the correlation between VEGF and MCP-1 expression level in aqueous humor before treatment.Results The concentrations of VEGF and ICAM-1 in aqueous humor were significantly lower at 1 month after treatment compared with that before treatment,and at 2 months after treatment compared with that at 1 month after treatment(Z=4.03,3.25,2.50,3.48;P<0.05);the concentrations of IL-6 and VCAM-1 increased and the concentration of MCP-1 decreased,but there was no significant difference(Z=-0.21,1.42,0.86,-0.53,0.92,-1.57;P>0.05).Spearman correlation analysis showed that there was a strong positive correlation between VEGF and MCP-1 in aqueous humor before treatment(r=0.78,P<0.001).Conclusion The concentrations of VEGF and ICAM-1 in aqueous humor significantly decrease after IVR treatment in BRVO-ME;the concentrations of IL-6,MCP-1 and VCAM-1 do not obv

关 键 词：视网膜静脉闭塞 黄斑水肿 血管生成抑制剂 眼房水 细胞因子类 

分 类 号：R774[医药卫生—眼科]