房水细胞因子与飞秒激光辅助白内障手术后角膜内皮细胞密度变化的关系  

Relationship Between Aqueous Humor Cytokines and Corneal Endothelial Cell Density After Femtosecond Laser-Assisted Cataract Surgery

作　　者：陈祎祎 李晶晶 彭建军 丰婷[1] Chen Yiyi;Li Jingjing;Peng Jianjun;Feng Ting(Department of Ophthalmology,Puren Hospital affiliated to Wuhan University of Science and Technology,Wuhan 430081,Hubei,China;Department of Ophthalmology,Xiangyang Central Hospital/Affiliated Hospital of Hubei University of Arts and Sciences,Xiangyang Central Hospital,Xiangyang441021,Hubei,China)

机构地区：[1]武汉市普仁医院(武汉科技大学附属普仁医院)眼科,湖北武汉430081 [2]湖北文理学院附属医院(襄阳市中心医院)眼科,湖北襄阳441021

出　　处：《应用激光》2024年第8期140-148,共9页Applied Laser

基　　金：湖北省卫生和计划生育委员会科研项目(WJ2016F013)。

摘　　要：目的探讨房水细胞因子与飞秒激光辅助白内障手术(FLACS)后角膜内皮细胞密度(ECD)变化的关系。方法选取2017年2月到2020年7月期间在武汉市普仁医院眼科门诊完成FLACS的30例白内障患者作为研究对象。使用基于磁珠的多重免疫检测系统分析术前房水细胞因子的浓度。在术前及术后1、6、12个月,使用日本Tomey EM-4000角膜内皮细胞显微镜测定ECD。结果白内障术后BCVA逐渐改善,术前视力与术后1、6和12个月的视力之间存在显著差异(均P<0.05)。患者术后ECD逐渐降低(P<0.05),在1至6个月(1M-6M)、1至12个月(1M-12M)和6至12个月(6M-12M)中平均减少。糖尿病组和无糖尿病组患者基线房水细胞因子水平、术前ECD、术后1、6、12个月ECD及ECD变化均无显著差异(P>0.05)。经Pearson和Spearman相关系数分析,房水中白细胞介素(IL)-7、干扰素诱导蛋白-10(IP-10)、巨噬细胞炎性蛋白(MIP)-1a、MIP-1b与1M-6M的ECD损失量(EDC1M-6M绝对值)呈正相关(P<0.05),房水中IL-1b、IL-7、IP-10、受激活调节正常T细胞表达和分泌因子(RANTES)与1M-12M的ECD损失量(EDC1M-12M绝对值)呈正相关(P<0.05),房水中IP-10、RANTES与6M-12M的ECD损失量(EDC6M-12M绝对值)呈正相关(P<0.05)。经多变量逐步回归分析,结果显示房水中IL-7是1M-6M时ECD损失的强影响因子,而IP-10是1M-12M时ECD损失的强影响因子(P<0.05)。结论房水中IL-7和炎症细胞因子与FLACS后的ECD损失量呈显著正相关,提示这些细胞因子可能促进ECD损伤进展。Objective To investigate the relationship between aqueous humor cytokines and the changes of corneal endothelial cell density(ECD)after femtosecond laser-assisted cataract surgery(FLACS).Methods Thirty cataract patients who underwent FLACS at our ophthalmic clinic between February 2017and July 2020were enrolled.Preoperative aqueous humor cytokine concentrations were analyzed using a magnetic bead-based multiplex immunoassay system.ECD was measured using a corneal endothelial cell microscope before surgery and at 1,6,and 12months postoperatively.Results BCVA improved gradually after cataract surgery,and there were significant differences between preoperative visual acuity and postoperative visual acuity at 1,6and 12months(all P<0.05).ECD decreased gradually after operation(P<0.05),with an average decrease at 1to 6 months(1M-6M),1to 12months(1M-12M)and 6to 12months(6M-12M).There were no significant differences in baseline aqueous humor cytokine levels,preoperative ECD,and changes of ECD at 1,6,and 12months after surgery between diabetic group and non-diabetic group(P>0.05).Pearson and Spearman correlation coefficient analysis showed that interleukin(IL)-7,interferon-induced protein-10(IP-10),macrophage inflammatory protein(MIP)-1a,MIP-1Bin aqueous humor were positively correlated with ECD loss from 1Mto 6M(EDC1M-6Mabsolute value)(P<0.05).IL-1b,IL-7,IP-10,and regulated upon activation normal T cell expressed and secreted(RANTES)in aqueous humor were positively correlated with ECD loss at 1M-12M(EDC1M-12Mabsolute value)(P<0.05),and IP-10,RANTES in aqueous humor were positively correlated with ECD loss at 6M-12M(EDC1M-12Mabsolute value)(P<0.05).Multivariable stepwise regression analysis showed that IL-7in aqueous humor was a strong influencing factor of ECD loss at 1M-6M,while IP-10was a strong influencing factor of ECD loss at 1M-12M(P<0.05).Conclusion IL-7and inflammatory cytokines in aqueous humor were positively correlated with ECD loss after FLACS,suggesting that these cytokines may promote the progression of ECD

关 键 词：房水细胞因子 飞秒激光辅助 白内障手术 角膜内皮细胞密度 

分 类 号：R779.6[医药卫生—眼科]