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既往急性原发性闭角型青光眼患者房水中炎性细胞因子水平与小梁切除术的手术效果

Inflammatory cytokines levels in aqueous humour and surgical outcomes of trabeculectomy in patients with prior acute primary angle closure.

作者信息

Yu Ping, Qian Tianwei, Gong Qiaoyun, Fu Mingshui, Bian Xiaolan, Sun Tao, Zhang Zhihua, Xu Xun

机构信息

Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.

National Clinical Research Center for Eye Diseases, Shanghai, China.

出版信息

Acta Ophthalmol. 2021 Nov;99(7):e1106-e1111. doi: 10.1111/aos.14763. Epub 2021 Jan 13.

Abstract

PURPOSE

To quantify the levels of three inflammatory cytokines in the aqueous humour of patients with prior acute primary angle closure (APAC) and investigate their correlation with surgical outcomes of trabeculectomy.

METHODS

In this prospective cohort study, aqueous humour samples were collected from 44 prior APAC eyes. Analyte concentrations of monocyte chemoattractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) were measured using multiplexed immunoassay kits. Intraocular pressure was measured using Goldmann application tonometry.

RESULTS

Forty-four prior APAC eyes were followed up for 24 months after trabeculectomy and divided into success and failure groups according to surgical outcomes. Monocyte chemoattractant protein-1 (MCP-1) levels in the aqueous humour were significantly higher in the failure group (p = 0.0118). Univariate and multivariate analyses showed that MCP-1 level was a significant risk factor for trabeculectomy outcomes (univariate analysis: p = 0.016, odds ratio = 14.538; multivariate analysis: p = 0.023, odds ratio = 13.718). When prior APAC eyes were divided according to MCP-1 levels, the overall success rate was significantly higher in eyes with low MCP-1 levels than eyes with high MCP-1 levels (p = 0.0249).

CONCLUSION

In prior APAC patients, the MCP-1 level in the aqueous humour predicts trabeculectomy results. Therefore, modulation of MCP-1 expression may have potential clinical applications after filtration surgery.

摘要

目的

量化既往急性原发性闭角型青光眼(APAC)患者房水中三种炎性细胞因子的水平,并研究它们与小梁切除术手术效果的相关性。

方法

在这项前瞻性队列研究中,从44只既往患APAC的眼睛中采集房水样本。使用多重免疫分析试剂盒测量单核细胞趋化蛋白-1(MCP-1)、血管内皮生长因子(VEGF)和白细胞介素-6(IL-6)的分析物浓度。使用Goldmann压平眼压计测量眼压。

结果

44只既往患APAC的眼睛在小梁切除术后随访24个月,并根据手术效果分为成功组和失败组。失败组房水中单核细胞趋化蛋白-1(MCP-1)水平显著更高(p = 0.0118)。单因素和多因素分析表明,MCP-1水平是小梁切除术结果的显著危险因素(单因素分析:p = 0.016,比值比 = 14.538;多因素分析:p = 0.023,比值比 = 13.718)。当根据MCP-1水平对既往患APAC的眼睛进行分组时,MCP-1水平低的眼睛总体成功率显著高于MCP-1水平高的眼睛(p = 0.0249)。

结论

在既往患APAC的患者中,房水中的MCP-1水平可预测小梁切除术结果。因此,调节MCP-1表达在滤过性手术后可能具有潜在的临床应用价值。

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