双眼超声乳化联合人工晶状体植入手术间隔时间对第2眼房水细胞因子及炎症的影响  

Effect of surgical interval on aqueous cytokines and inflammation in the second eye after bilateral phacoemulsification combined with intraocular lens implantation

作　　者：甘宇 李悦 李英琦 夏媛玲 GAN Yu;LI Yue;LI Yingqi;XIA Yuanling(Ophthalmology Teaching Division,School of Clinical Medicine,Guizhou Medical University,Guiyang 550004,Guizhou,China;Department of Ophthalmology,Qingdao Municipal Hospital,Qingdao 266000,Shandong,China;Department of Ophthalmology,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学临床医学院眼科学教研室,贵州贵阳550004 [2]青岛市市立医院(集团)眼科,山东青岛266000 [3]贵州医科大学附属医院眼科,贵州贵阳550004

出　　处：《贵州医科大学学报》2023年第4期478-483,共6页Journal of Guizhou Medical University

基　　金：贵州省卫生计生委科学技术基金(gzwjkj2017-1-043)。

摘　　要：目的 探讨双眼超声乳化联合人工晶状体(IOL)植入术手术间隔时间对第2眼房水细胞因子及炎症的影响。方法 36例老年性白内障患者根据双眼手术间隔时间分为3~7 d(A)组(n=12)、8~28 d(B)组(n=12)及>28 d(C)组(n=12),第1手术眼标记为1,第2手术眼为2,收集3组患者一般临床资料;患者双眼均在手术开始时于透明角膜缘切口处取房水样本,采用电化学发光(ECL)法检测3组患者2次手术时双眼房水内肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、白细胞介素-2(IL-2)及白细胞介素-6(IL-6)的水平,均于术后第1、3、14天用裂隙灯观察并记录术眼房水闪辉、房水细胞分级情况及后囊膜混浊(PCO)情况,比较3组患者2次手术中有效超声时间及超声能量。结果 与同组第1眼比较,A组和B组患者房水中TNF-α降低(P<0.05),A组IL-2增高(P<0.05);术后同时点3组患者房水闪辉分级及房水细胞分级比较,差异无统计学意义(P>0.05);3组患者术中有效超声时间及超声能量比较,差异无统计学意义(P>0.05);术后14 d观察周期内3组患者均未见PCO发生。结论 超声乳化联合IOL植入术患者术后28 d内第2眼房水内部分细胞因子有变化,但炎症反应无明显改变。Objective To investigate the effect of bilateral phacoemulsification combined with intraocular lens(IOL)implantation interval on preoperative aqueous cytokines and inflammation in the second eye.Methods A total o f 36 patients with senile cataract were divided into three groups evenly according to the interval between bilateral surgeries:group A(3-7 days),group B(8-28 days),and group C(>28 days).The general clinical data of the three groups were collected.The first surgical eye was marked as 1,and the second eye was marked as 2.Aqueous humor samples were taken from the clear limbal incision of both eyes at the beginning of the surgery.The levels of tumor necrosis factor-α(TNF-α),interleukin-1(IL-1),interleukin-2(IL-2),and interleukin-6(IL-6)in the aqueous humor of two times surgeries in three groups were detected by electrochemiluminescence(ECL).The aqueous flare,aqueous humor cell grading and posterior capsular opacification(PCO)were observed and recorded by slit lamp on the 1 st,3 rd and 14 th day after surgery;comparing effective ultrasound time and energy of all groups in two times surgeries.Results Compared with the first eye of the same group,the level of TNF-αin group A and group B was decreased(P<0.05),and the level of IL-2 in group A was increased(P<0.05).There were no significant differences in the aqueous flare grading and aqueous humor cell grading among three groups at the same time point after operation(P>0.05).There were no significant differences in effective ultrasound time and ultrasound energy among three groups(P>0.05).No PCO occurred in all three groups within 14 days after operation.Conclusions Some cytokines in the second eye aqueous humor of patients with phacoemulsification combined with IOL implantation change within 28 days after surgery,but there is no significant change in inflammatory response.

关 键 词：白内障 细胞因子类 炎症 后囊膜混浊 超声乳化晶体吸除术 房水 

分 类 号：R776.1[医药卫生—眼科]