
浏览全部资源
扫码关注微信
1.张家港市中医医院眼科,江苏 张家港 215600
2.中国中医科学院眼科医院眼表科,北京 100040
张新月,E-mail:183262012@qq.com
纸质出版日期:2024-03-25,
收稿日期:2023-03-23,
扫 描 看 全 文
张宇,赵庆一,吴宁玲等.青光眼患者小梁切除术后泪液炎症因子与术后并发症的相关性分析[J].局解手术学杂志,2024,33(03):247-250.
.Correlation between tear inflammatory factors and postoperative complications in glaucoma patients after trabeculectomy[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(03):247-250.
张宇,赵庆一,吴宁玲等.青光眼患者小梁切除术后泪液炎症因子与术后并发症的相关性分析[J].局解手术学杂志,2024,33(03):247-250. DOI: 10.11659/jjssx.03E023150.
.Correlation between tear inflammatory factors and postoperative complications in glaucoma patients after trabeculectomy[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2024,33(03):247-250. DOI: 10.11659/jjssx.03E023150.
目的
2
探讨泪液炎症因子在早期评估青光眼患者小梁切除术后并发症发生的应用价值。
方法
2
纳入在张家港市中医医院眼科接受小梁切除术的闭角型青光眼患者150例(共150眼)。收集所有患者临床资料,术前采集患者泪液,检测泪液中的炎症因子(G-CSF、GM-CSF、IFN-γ、MCP-1、TNF-α、IL-12、IL-13、IL-15、IL-1β、IL-4、IL-7、IL-10、IL-17、IL-5)水平。根据术后并发症发生情况将患者分为并发症组和对照组,对比2组患者临床资料,采用
Logistic
回归分析青光眼患者小梁切除术后发生并发症的相关因素;通过
Logistic
回归建立泪液炎症因子预测模型,绘制受试者工作特征(
ROC
)曲线分析该模型在早期评估青光眼患者小梁切除术后并发症发生的价值。
结果
2
150例青光眼患者小梁切除术后有35例(23.33%)发生并发症,其中浅前房24例,睫状体或脉络膜脱离5例,虹膜睫状体炎3例,前房积血2例,视网膜脱离1例。并发症组患者IFN-γ、GM-CSF和IL-5水平低于对照组(
P<
0.05);2组患者其余炎症因子比较,差异无统计学意义(
P
>
0.05)。多因素
Logistic
回归分析显示,IFN-γ升高(
OR
=0.999)、GM-CSF升高(
OR
=0.988)和IL-5升高(
OR
=0.996)是青光眼患者小梁切除术后并发症发生的独立保护因素(
P<
0.05);
ROC
曲线分析显示,该模型在早期评估青光眼患者小梁切除术后并发症发生的敏感度为94.29%,特异度为83.84%,
AUC
为0.906,高于IFN-γ(
AUC
=0.642)、GM-CSF(
AUC
=0.721)和IL-5(
AUC
=0.666)单独预测。
结论
2
术前分析青光眼患者的泪液炎症因子能够早期评估术后并发症的发生情况,特别是IFN-γ、GM-CSF和IL-5水平联合检测对于预测术后并发症的发生具有重要意义。
Objective
2
To investigate the application value of tear inflammatory factors in early evaluation of the occurrence of complications after trabeculectomy in glaucoma patients.
Methods
2
A total of 150 eyes of 150 patients with angle-closure glaucoma who underwent trabeculectomy in Department of Ophthalmology of Zhangjiagang Hospital of Traditional Chinese Medicine were included.The clinical data of all patients were collected,and the levels of inflammatory factors (including G-CSF,GM-CSF,IFN-γ,MCP-1,TNF-α,IL-12,IL-13,IL-15,IL-1β,IL-4,IL-7,IL-10,IL-17,IL-5) in tears were detected before surgery.According to the occurrence of postoperative complications,the patients were divided into the complication group and the control group,and the clinical data of the two groups were compared.
Logistic
regression was used to analyze the related factors of the occurrence of complications after trabeculectomy in glaucoma patients.The predictive model of tear inflammatory factors was established by
Logistic
regression,and the
receiver operating characteristic
(
ROC
) curve was drawn to analyze the value of this model in early evaluation of the occurrence of complications after trabeculectomy in glaucoma patients.
Results
2
Complications occurred in 35 (23.33%) of 150 glaucoma patients after trabeculectomy,including 24 cases of shallow anterior chamber,5 cases of ciliary body or choroid detachment,3 cases of iridocyclitis,2 cases of hyphema,and 1 case of retinal detachment. IFN-γ,GM-CSF and IL-5 levels of the patients in the complication group were lower than those in the control group (
P
<
0.05).There was no significant difference in the levels of other inflammatory factors of patients between the two groups (
P
>
0.05).Multivariate
Logistic
regression analysis showed that increased levels of IFN-γ (
OR
=0.999),GM-CSF (
OR
=0.988) and IL-5 (
OR
=0.996) were independent protective factors for complications after trabeculectomy in glaucoma patients (
P
<
0.05).
ROC
curve analysis showed that the sensitivity and specificity of the model were 94.29% and 83.84% in early evaluation of the occurrence of complications after trabeculectomy in glaucoma patients,and the
AUC
was 0.906,which was higher than that predicted by IFN-γ (
AUC
=0.642),GM-CSF (
AUC
=0.721) and IL-5 (
AUC
=0.666) alone.
Conclusion
2
Preoperative analysis of tear inflammatory factors in glaucoma patients can early evaluate the occurrence of postoperative complications,especially the combined detection of IFN-γ,GM-CSF and IL-5 levels is of great significance for predicting the occurrence of complications.
青光眼泪液小梁切除术并发症炎症因子
glaucomatear fluidtrabeculectomycomplicationsinflammatory factors
夏沁韵,陈震,邢怡桥.新生血管性青光眼治疗进展[J].国际眼科杂志,2020,20(6):987-989.doi:10.3980/j.issn.1672-5123. 2020.6.13http://dx.doi.org/10.3980/j.issn.1672-5123.2020.6.13.
孟京亚,王鑫,温良,等.青光眼小梁切除术后远期动态泪膜稳定性及其与滤过泡形态的相关研究[J].中华眼科杂志,2019,55(3):214-219.doi:10.3760/cma.j.issn.0412-4081.2019.03.011http://dx.doi.org/10.3760/cma.j.issn.0412-4081.2019.03.011.
Blanco-Vázquez M,Vázquez A,Fernández I,et al.Inflammation-related molecules in tears of patients with chronic ocular pain and dry eye disease[J].Exp Eye Res,2022,69(219):109057.doi:10.1016/j.exer.2022.109057http://dx.doi.org/10.1016/j.exer.2022.109057.
李亚文,焦可心,赵敏,等.房水细胞因子对小梁切除术预后的影响研究[J].临床眼科杂志,2022,30(6):568-571.doi:10.3969/j.issn.1006-8422.2022.06.026http://dx.doi.org/10.3969/j.issn.1006-8422.2022.06.026.
King AJ,Hudson J,Fernie G,et al.Primary trabeculectomy for advanced glaucoma:pragmatic multicentre randomised controlled trial (TAGS)[J].BMJ,2021,373:n1014.doi:10.1136/bmj.n1014http://dx.doi.org/10.1136/bmj.n1014.
龚一波,岳建中.小梁切除术联合康柏西普或雷珠单抗治疗对NVG患者视力、眼压及血清IP-10、TNF-α、VEGF水平的影响[J].临床误诊误治,2019,32(4):43-47.doi:10.3969/j.issn.1002-3429.2019.04.011http://dx.doi.org/10.3969/j.issn.1002-3429.2019.04.011.
中华医学会眼科学分会青光眼学组,中国医师协会眼科医师分会青光眼学组.中国青光眼指南(2020年)[J].中华眼科杂志,2020,56(8):573-586.doi:10.3760/cma.j.cn112142-20200313-00182http://dx.doi.org/10.3760/cma.j.cn112142-20200313-00182.
中华医学会眼科学分会青光眼学组.我国复合式小梁切除术操作专家共识(2017年)[J].中华眼科杂志,2017,53(4):249-251.doi:10.3760/cma.j.issn.0412-4081.2017.04.004http://dx.doi.org/10.3760/cma.j.issn.0412-4081.2017.04.004.
刘兴岚,李鸿.多重细胞因子在青光眼中的研究进展[J].重庆医科大学学报,2020,45(11):1624-1628.doi:10.13406/j.cnki.cyxb.002499http://dx.doi.org/10.13406/j.cnki.cyxb.002499.
谢瞻,张娇,杜牧龙,等.原发性闭角型青光眼行小梁切除术中应用可调整缝线的对照研究[J].临床眼科杂志,2020,28(2):108-112.doi:10.3969/j.issn.1006-8422.2020.02.003http://dx.doi.org/10.3969/j.issn.1006-8422.2020.02.003.
Khanna RK,Catanese S,Emond P,et al.Metabolomics and lipidomics approaches in human tears:a systematic review[J].Surv Ophthalmol,2022,67(4):1229-1243.doi:10.1016/j.survophthal.2022.01.010http://dx.doi.org/10.1016/j.survophthal.2022.01.010.
Liu X,Liu X,Wang Y,et al.Proteome characterization of glaucoma aqueous humor[J].Mol Cell Proteomics,2021,20:100117.doi:10.1016/j.mcpro.2021.100117http://dx.doi.org/10.1016/j.mcpro.2021.100117.
Neil J,Kessal K,Merabet L,et al.IgE ratio in tears:a predictive tool of ocular allergic inflammation[J].Ocul Immunol Inflamm,2020,28(5):775-785.doi:10.1080/09273948.2019.1629462http://dx.doi.org/10.1080/09273948.2019.1629462.
Kim DW,Seo JH,Lim SH.Evaluation of ocular surface disease in elderly patients with glaucoma:expression of matrix metalloproteinase-9 in tears[J].Eye (Lond),2021,35(3):892-900.doi:10.1038/s41433-020-0993-yhttp://dx.doi.org/10.1038/s41433-020-0993-y.
King AJ,Fernie G,Hudson J,et al.Primary trabeculectomy versus primary glaucoma eye drops for newly diagnosed advanced glaucoma:TAGS RCT[J].Health Technol Assess,2021,25(72):1-158.doi:10.3310/hta25720http://dx.doi.org/10.3310/hta25720.
Tokumo K,Komatsu K,Yuasa Y,et al.Treatment outcomes in the neovascular glaucoma tube versus trabeculectomy study[J].Graefes Arch Clin Exp Ophthalmol,2021,259(10):3067-3076.doi:10.1007/s00417-021-05257-2http://dx.doi.org/10.1007/s00417-021-05257-2.
Kalarn S,Le T,Rhee DJ.The role of trabeculectomy in the era of minimally invasive glaucoma surgery[J].Curr Opin Ophthalmol,2022,33(2):112-118.doi:10.1097/ICU.0000000000000811http://dx.doi.org/10.1097/ICU.0000000000000811.
郭宣妮,姜春辉,朱安泰,等.青光眼术后干眼患者泪液中MAPK、Sirt1水平与泪膜功能的相关性分析[J].眼科新进展,2020,40(7):663-666.doi:10.13389/j.cnki.rao.2020.0152http://dx.doi.org/10.13389/j.cnki.rao.2020.0152.
张韫洁,李新章,赵莉,等.复合式与传统小梁切除术对青光眼患者眼压、生活质量及血清细胞因子的影响[J].现代生物医学进展,2021,21(2):393-396.doi:10.13241/j.cnki.pmb.2021. 02.042http://dx.doi.org/10.13241/j.cnki.pmb.2021.02.042.
Csősz É,Deák E,Tóth N,et al.Comparative analysis of cytokine profiles of glaucomatous tears and aqueous humour reveals potential biomarkers for trabeculectomy complications[J].FEBS Open Bio,2019,9(5):1020-1028. doi:10.1002/2211-5463.12637http://dx.doi.org/10.1002/2211-5463.12637.
0
浏览量
0
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010802024621