糖尿病新生血管性青光眼虹膜组织中VEGF和IL-17A表达及其意义  

Expression and significance of VEGF and IL⁃17A in iris tissue of diabetes neovascular glaucoma

作　　者：屈晶 汪军红 杨安怀[2] 杨北方[3] Qu Jing;Wang Junhong;Yang Anhuai;Yang Beifang(Department of Eye,Ear,Nose and Throat,Macheng Traditional Chinese Medicine Hospital,Huanggang 438300,China;Department of Ophthalmology,Hubei Provincial People's Hospital,Wuhan 430060,China;Infection Department of Hubei Provincial Center for Disease Control and Prevention,Wuhan 430000,China)

机构地区：[1]麻城市中医医院眼耳鼻喉科,黄冈438300 [2]湖北省人民医院眼科,武汉430060 [3]湖北省疾病预防控制中心感染科,4300003

出　　处：《临床眼科杂志》2024年第3期215-220,共6页Journal of Clinical Ophthalmology

基　　金：湖北省自然科学基金(2019CFB682)。

摘　　要：目的分析糖尿病(DM)新生血管性青光眼(NVG)患者虹膜组织中血管内皮生长因子(VEGF)和白细胞介素⁃17A(IL⁃17A)的表达水平及意义。方法前瞻性病例研究。选取2019年1月至2022年1月本院接收的244例DM并发NVG患者为DM⁃NVG组,同时期本院收治的244例无新生血管的慢性闭角型青光眼患者为参照组,术中收集患者虹膜组织并采用免疫组化(SP)法检测虹膜组织VEGF和IL⁃17A表达;对DM⁃NVG患者随访1年统计其预后情况,分为预后不良组、预后良好组;Logistic回归分析DM并发NVG患者预后不良的影响因素。结果DM⁃NVG组VEGF、IL⁃17A阳性率均高于参照组(均P<0.05);DM并发NVG患者虹膜组织VEGF、IL⁃17A表达与眼压、DM类型、NVG分期相关(均P<0.05);预后不良发生率为90.57%(221/244);预后不良组中眼压>21 mmHg、DM类型为2型、NVG分期为Ⅲ期、虹膜组织VEGF、IL⁃17A阳性表达患者占比高于预后良好组(均P<0.05),且多因素Logistic回归分析表明均是DM并发NVG患者预后不良的危险因素(均P<0.05)。结论DM并发NVG患者虹膜组织VEGF、IL⁃17A表达均升高,二者均与DM并发NVG患者临床病理特征相关,是DM并NVG患者预后不良的危险因素。Objective To analyze the expression levels and significance of vascular endothelial growth factor(VEGF)and interleukin⁃17A(IL⁃17A)in iris tissue of diabetes patients with neovascular glaucoma(NVG).Methods Prospective cases study.A total of 244 patients with DM and NVG admitted to our hospital from January 2019 to January 2022 were collected as the DM⁃NVG group.During the same period,244 patients with chronic angle closure glaucoma without neovascularization admitted to our hospital were collected as the reference group.The iris tissues of patients were collected during surgery and the expression of VEGF and IL⁃17A in iris tissue was detected using immunohistochemistry(SP)method.The prognosis of DM⁃NVG patients was statistically analyzed after one⁃year follow up,and they were divided into poor prognosis group and good prognosis group.Logistic regression was applied to analyze the influencing factors of poor prognosis in patients with DM and NVG.Results The positive rates of VEGF and IL⁃17A in the DM⁃NVG group were higher than those in the reference group(P<0.05).The expression of VEGF and IL⁃17A in iris tissue of patients with DM and NVG was correlated with intraocular pressure,DM type,and NVG stage(P<0.05).The incidence of poor prognosis was 90.57%(221/244).The proportions of patients with intraocular pressure>21 mmHg,DM type 2,NVG stageⅢ,positive expression of VEGF and IL-17A in iris tissue in the poor prognosis group were higher than those in the good prognosis group(P<0.05).The multivariate logistic regression analysis showed that both were risk factors for poor prognosis in patients with DM and NVG(P<0.05).Conclusions The expression of VEGF and IL-17A in the iris tissue of patients with DM and NVG is elevated,and both are related to the clinicopathological characteristics of patients with DM and NVG.They are risk factors for poor prognosis in DM and NVG patients.

关 键 词：糖尿病 新生血管性青光眼 血管内皮生长因子 白细胞介素⁃17A 

分 类 号：R587.2[医药卫生—内分泌] R775[医药卫生—内科学]