白内障伴青光眼患者术后胰岛素抵抗及炎症因子水平与视觉质量的关系  

Relationship between postoperative insulin resistance and inflammatory factor levels and visual quality in patients with cataract and glaucoma

作　　者：蔡业海 刘伟仙[2] 卓业辉 黄丽珍 CAI Yehai;LIU Weixian;ZHUO Yehui;HUANG Lizhen(Department of Ophthalmology,People􀆳s Hospital of Wanning,Wanning 571500,Hainan,China;Department of Ophthalmology,the First Affiliated Hospital of Hainan Medical College,Haikou 570000,Hainan,China)

机构地区：[1]万宁市人民医院眼科,海南万宁571500 [2]海南医学院第一附属医院眼科,海南海口570000

出　　处：《中南医学科学杂志》2023年第2期242-245,共4页Medical Science Journal of Central South China

基　　金：海南省卫生健康行业科研项目(20A200200)。

摘　　要：目的 分析白内障伴青光眼患者术后胰岛素抵抗及炎症因子水平变化与视觉质量的关系。方法 选取47例(47眼)白内障伴青光眼患者为研究对象,均接受超声乳化+小梁切除术治疗。术前、术后7天、术后3个月检测患者客观散射指数(OSI)、点扩散函数(PSF)、调制传递函数截止频率(MTF cutoff)、胰岛素敏感指数及白细胞介素(IL)-1β、IL-10、IL-2水平。采用Pearson法分析视觉质量参数与胰岛素抵抗情况及炎症因子的相关性。结果与术前比较,术后7天和术后3个月最佳校正视力、MTF cutoff及胰岛素敏感指数升高,且术后3个月更高(P<0.05);与术前比较,术后7天和术后3个月眼压、角膜内皮细胞计数、PSF、OSI及血清IL-1β、IL-2、IL-10水平降低,且术后3个月更低(P<0.05)。Pearson分析显示,术前、术后7天和术后3个月,白内障伴青光眼患者OSI与胰岛素敏感指数呈负相关(P<0.05),与血清IL-1β、IL-2、IL-10水平呈正相关(P<0.05);MTF cutoff与胰岛素敏感指数呈正相关(P<0.05),与血清IL-1β、IL-2、IL-10水平呈负相关(P<0.05);PSF与血清IL-1β水平呈负相关(P<0.05)。术后7天和3个月,PSF与胰岛素敏感指数呈正相关(P<0.05),与血清IL-2、IL-10水平呈负相关(P<0.05)。结论 超声乳化联合小梁切除术对视觉质量的改善可能与胰岛素抵抗及炎症因子变化密切相关。Aim To analyze the relationship between postoperative insulin resistance and inflammatory factor levels and visual quality in patients with cataract and glaucoma.Methods Forty seven patients(47 eyes)with cataract and glaucoma were selected as the research objects,and all received phacoemulsification+trabeculectomy.Objective scattering index(OSI),point spread function(PSF),modulation transfer function cutoff(MTF cutoff)〛,insulin sensitivity index and interleukin(IL)-1β,IL-10,IL-2 were detected before surgery,7 days after surgery,and 3 months after surgery.Pearson method was used to analyze the correlation between visual quality parameters and insulin resistance and inflammatory factors.Results Compared with baseline,the best corrected visual acuity,MTF cutoff and insulin sensitivity index increased at 7 days and 3 months after operation,and 3 months after operation was more higher(P<0.05).Compared with baseline,intraocular pressure,corneal endothelial cell density,PSF,OSI,and serum IL-1β,IL-2,and IL-10 levels decreased at 7 days and 3 months after surgery,and 3 months after surgery days was more lower(P<0.05).Pearson analysis showed that at baseline,7 days after surgery and 3 months after surgery,OSI was negatively correlated with insulin sensitivity index in patients with cataract and glaucoma(P<0.05),and was positively correlated with serum IL-1β,IL-2,IL-10 levels(P<0.05);MTF cutoff was positively correlated with insulin sensitivity index(P<0.05),and was negatively correlated with serum IL-1β,IL-2 and IL-10 levels(P<0.05);PSF was negatively correlated with serum IL-1βlevel(P<0.05).At 7 days and 3 months after operation,PSF was positively correlated with insulin sensitivity in-dex(P<0.05),and was negatively correlated with serum IL-2 and IL-10 levels(P<0.05).Conclusion Improve-ment in visual quality by ultrasound emulsification combined with trabeculectomy may be closely related to insulin resistance and changes in inflammatory factors.

关 键 词：白内障 青光眼 视觉质量 胰岛素抵抗 炎症因子 

分 类 号：R776.1[医药卫生—眼科]