房水中MCP-1水平与视网膜静脉阻塞继发黄斑水肿复发及黄斑区微循环的关系  

Relationship between the expression of monocyte chemoattractant protein-1 in aqueous humor and the recurrence and microcirculation of macular edema secondary to retinal vein occlusion

作　　者：冷炫[1] 李杰[1] 区健滨 Leng Xuan;Li Jie;Ou Jianbin(Department of Ophthalmology,Zhongshan City People's Hospital,Zhongshan 528400,Guangdong Province,China;Zhongshan Aier Eye Hospital,Zhongshan 528400,Guangdong Province,China)

机构地区：[1]广东省中山市人民医院眼科,528400 [2]中山爱尔眼科医院,广东省中山市528400

出　　处：《国际眼科杂志》2025年第5期725-733,共9页International Eye Science

基　　金：2023年度广东省医学科研基金立项项目(No.B2023217)。

摘　　要：目的:探讨视网膜静脉阻塞继发黄斑水肿(RVO-ME)患者房水中单核细胞趋化蛋白-1(MCP-1)水平与黄斑区微循环的关系。方法:选择2022-07/2024-07在本院就诊的RVO-ME患者327例327眼为研究对象,根据是否复发分为未复发组291例291眼,复发组36例36眼。收集临床资料、黄斑区微循环指标、房水MCP-1水平。采用无序多分类Logistic回归分析在排除其他因素的影响后,分析MCP-1对RVO-ME复发的影响。利用立方样条分析黄斑区微循环指标及MCP-1表达水平与RVO-ME复发的剂量-反应关系。采用多元线性回归分析黄斑区微循环指标与MCP-1表达水平的关系,分析不同MCP-1表达水平在不同黄斑区微循环指标下复发的差异。Bootstrap法检验黄斑区微循环指标在MCP-1表达水平和RVO-ME复发中的中介效应。结果:复发组患者的ME病程、玻璃体黄斑牵拉(VMT)发生率、纤维膜黄斑前膜(ERM)发生率、最佳矫正视力(BCVA)、视网膜内外层点状强反射(HRF)数量、注射抗VEGF次数及剂量显著高于未复发组(均P<0.05),视网膜外界膜(ELM)完整性、视网膜椭圆体带(EZ)完整性显著低于未复发组(均P<0.05)。复发组患者的黄斑中心厚度(CFT)、黄斑中心凹厚度(CMT)、视网膜浅层毛细血管丛(SCP)血管密度、深层毛细血管丛(DCP)血管密度和MCP-1均高于未复发组(均P<0.05),黄斑中心凹无血管区面积(FAZ)低于未复发组(P<0.05)。Logistic分析结果显示,调整混杂因素前后,MCP-1是RVO-ME复发的危险因素。黄斑区微循环指标及MCP-1表达水平与RVO-ME复发风险均呈明显的非线性剂量-反应关系(非线性检验,均P<0.001)。CFT、CMT、SCP和DCP血管密度与MCP-1表达水平均呈正相关(均P<0.05),FAZ与MCP-1表达水平呈负相关(P<0.05)。随着CFT、CMT、SCP和DCP血管密度的增加以及FAZ的减小,MCP-1表达水平随之上升,并且RVO-ME复发风险呈现上升趋势,Q3(>28.47 pg/mL)组MCP-1的比例最高(P<0.05)。黄斑区微循环�AIM:To investigate the relationship between the level of monocyte chemoattractant protein-1(MCP-1)in the aqueous humor and macular microcirculation in patients with macular edema secondary to retinal vein occlusion(RVO-ME).METHODS:A total of 327 patients(327 eyes)with RVO-ME treated in our hospital from July 2022 to July 2024 were selected as the research objects.According to the recurrence or not,they were divided into non-recurrence group(291 cases,291 eyes)and recurrence group(36 cases,36 eyes).The clinical data,macular microcirculation index and MCP-1 level were collected.Unordered multinomial Logistic regression was used to analyze the effect of MCP-1 on RVO-ME recurrence after excluding the influence of other factors.Cubic spline was used to analyze the dose-response relationship between macular microcirculation indexes and MCP-1 expression level and RVO-ME recurrence.Multiple linear regression was used to analyze the relationship between macular microcirculation parameters and MCP-1 expression level,and the difference of MCP-1 expression level in recurrence under different macular microcirculation parameters was analyzed.Bootstrap method was used to test the mediating effect of macular microcirculation indexes on MCP-1 expression level and RVO-ME recurrence.RESULTS:The course of ME,the incidence of vitreomacular traction(VMT),the incidence of fibrous membrane epiretinal membrane(ERM),best corrected visual acuity(BCVA),hyperreflective foci in the inner and outer retinal layers(HRF),the frequency and dose of anti-vascular endothelial growth factor(VEGF)injection in the recurrence group were significantly higher than those in the non-recurrence group(all P<0.05).The external limiting membrane(ELM)integrity and ellipsoid zone(EZ)integrity in the recurrence group were significantly worse than those in the non-recurrence group(all P<0.05).The central foveal thickness(CFT),central macular thickness(CMT),superficial capillary plexus(SCP)vascular density,deep capillary plexus(DCP)vascular density and MCP-1 in the r

关 键 词：单核细胞趋化蛋白-1(MCP-1) 视网膜静脉阻塞 继发黄斑水肿 黄斑区微循环 

分 类 号：R774.1[医药卫生—眼科]