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中华眼科医学杂志(电子版) ›› 2019, Vol. 09 ›› Issue (05) : 312 -319. doi: 10.3877/cma.j.issn.2095-2007.2019.05.008

论著

糖尿病合并白内障及单纯老年性白内障与房水中细胞因子相关性的临床研究
汪晓娟1, 虹霏1, 杨大勇1, 朱丹1,†(), 陶勇2   
  1. 1. 010050　呼和浩特，内蒙古医科大学附属医院眼科
    2. 100020　首都医科大学附属北京朝阳医院眼科
  • 收稿日期:2019-01-14 出版日期:2019-10-28
  • 通信作者: 朱丹
  • 基金资助:
    国家自然科学基金项目(81860178，81560165); 国家高技术研究发展计划(2015AA020949); 北京朝阳医院"1351人才培养计划"(CYXX-2017-21)

The relationship between cytokine level in aqueous humor and diabetes mellitus with cataract and age-related cataract

Xiaojuan Wang1, Fei Hong1, Dayong Yang1, Dan Zhu1,†(), Yong Tao2   

  1. 1. Department of Ophthalmology, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China
    2. Department of Ophthalmology, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China
  • Received:2019-01-14 Published:2019-10-28
  • Corresponding author: Dan Zhu
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引用本文：

汪晓娟, 虹霏, 杨大勇, 朱丹, 陶勇. 糖尿病合并白内障及单纯老年性白内障与房水中细胞因子相关性的临床研究[J]. 中华眼科医学杂志(电子版), 2019, 09(05): 312-319.

Xiaojuan Wang, Fei Hong, Dayong Yang, Dan Zhu, Yong Tao. The relationship between cytokine level in aqueous humor and diabetes mellitus with cataract and age-related cataract[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2019, 09(05): 312-319.

目的

探讨糖尿病合并白内障及单纯老年性白内障与房水中细胞因子的相关性。

方法

收集2017年10月至2018年2月在内蒙古医科大学附属医院接受白内障手术治疗49例患者(49只眼)的临床资料。其中，男性22例(22只眼)，女性27例(27只眼)，平均年龄(64.4±9.7)岁。依据患者是否患有糖尿病，分为实验1组和实验2组。其中，糖尿病合并白内障患者14例(14只眼)为实验1组；单纯老年性白内障患者35例(35只眼)为实验2组。所有患者白内障术中收集房水。采用细胞因子微球技术检测患者血清及房水中白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、血管内皮生长因子(VEGF)、血管细胞粘附分子-1(VCAM-1)及成纤维细胞生长因子(bFGF)的浓度，酶联免疫吸附试验检测人血管内皮细胞生长因子B(VEGF-B)和胎盘生长因子(PLGF)的浓度。采用Spearman相关分析评价两组房水中各细胞因子浓度与晶状体皮质混浊、核性混浊及后囊下混浊的相关性。

结果

实验1组和2组患者房水中IL-8、IL-10、VEGF、BFGF、VCAM-1、PLGF、VEGF-B浓度分别为(31.69±27)pg/ml、(5.2±0.41)pg/ml、(47.27±20.58)pg/ml、(17.28±4.11)pg/ml、(416.5±310.66)pg/ml、(17.85±6.70)pg/ml、(65.54±26.89)pg/ml、(12.38±6.52)pg/ml、(3.7±2.13)pg/ml、(36.54±14.97)pg/ml、(17.43±4.33)pg/ml、(331.39±205.80)pg/ml、(22.21±17.47)pg/ml及(74.36±26.75)pg/ml。实验1组房水中VCAM-1浓度与晶状体核性混浊呈负相关(r＝-0.61，P<0.05)。实验1组和2组患者血清中各细胞因子与晶状体核性混浊无相关性(r＝-0.03，-0.10，0.26，0.04，-0.32，-0.19；P均>0.05)、(r＝-0.15，0.13，-0.15，-0.11，0.11，-0.18；P均>0.05)、(r＝0.21，0.53，0.20，0.13，-0.12，0.16；P均>0.05)、(r＝-0.06，0.03，-0.01，-0.20，0.09，0.20；P均>0.05)、(r＝0.39，0.02，-0.11，-0.20，-0.13，0.03；P均>0.05)及(r＝0.13，0.09，0.32，0.25，0.11，-0.10；P均>0.05)。

结论

两组房水中细胞因子与白内障之间规律不同。糖尿病患者房水中VCAM-1的浓度与晶状体的核性混浊呈负相关，VCAM-1可能是核性白内障的保护性因素。

关键词: 血管细胞粘附分子-1, 白内障, 糖尿病合并白内障
Objective

This study was aim to investigate the changes of factors in aqueous humor of diabetes mellitus with cataract, and to analyze their relationship with cataract of diabetic patients.

Methods

Clinical data of 49 patients (49 eyes) receiving cataract surgery in the affiliated hospital of Inner Mongolia Medical University from October 2017 to February 2018 were collected, including 14 patients (14 eyes) with diabetes mellitus with cataract as the experimental group and 35 patients (35 eyes) with simple senile cataract as the cataract group. Among of the experimental group, the age was 54 to 75, the average age was (64.8±10.7). Among of the cataract group, the age was 55 to 72, the average age was (64.0±8.8). All the patients conduct preoperative collection of fasting venous blood and intraoperative collection of aqueous humor. Using cytometric bead array to detect vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), interleukin-8 (IL-8), interleukin-10 (IL-10) and vascular cell adhesion molecule-1 (VCAM-1) and using enzyme-linked immuno-sorbent assay to detect vascular endothelial growth factor B (VEGF-B) and placental growth factor (PLGF). Spearman′s rank correlation coefficient was used to detect the correlation aqueous humour levels of IL-8, IL-10, VEGF, bFGF, PLGF, VCAM-1 and VEGF-B with cortical opacity, nuclear opacity and posterior subcapsular opacity in both groups. Spearman′s rank correlation coefficient was also used to detect the correlation serum levels of IL-8, IL-10, VEGF, bFGF, VCAM-1 and VEGF-B with cortical opacity, nuclear opacity and posterior subcapsular opacity between two groups.

Results

The aqueous humor concentrations of IL-8, IL-10, VEGF, BFGF, VCAM-1, PLGF and VEGF-B in the experimental 1 and 2 group were (31.69±27)pg/ml, (5.2±0.41) pg/ml, (47.27±20.58) pg/ml, (17.28±4.11) pg/ml, (416.5±310.66) pg/ml, (17.85±6.70) pg/ml, (65.54±26.89) pg/ml, (12.38±6.52) pg/ml, (3.7±2.13) pg/ml, (36.54±14.97) pg/ml, (17.43±4.33) pg/ml, (331.39±205.80) pg/ml, (22.21±17.47) pg/ml, (74.36±26.75) pg/ml, respectively. The concentration of VCAM-1 in aqueous humor was negatively correlated with nuclear opacity in the experimental 1 group (r=-0.61, P<0.05). The concentration of all factors in serum was not correlated with nuclear opacity in the experimental 2 group (r=-0.03, -0.10, 0.26, 0.04, -0.32, -0.19; P>0.05), (r=-0.15, 0.13, -0.15, -0.11, 0.11, -0.18; P>0.05), (r=0.21, 0.53, 0.20, 0.13, -0.12, 0.16; P>0.05), (r=-0.06, 0.03, -0.01, -0.20, 0.09, 0.20; P>0.05), (r=0.39, 0.02, -0.11, -0.20, -0.13, 0.03; P>0.05) and (r=0.13, 0.09, 0.32, 0.25, 0.11, -0.10; P>0.05).

Conclusion

The concentration of VCAM-1 in aqueous humor of diabetic patients was negatively correlated with the nuclear opacity, and VCAM-1 may act as a protective factor for nuclear cataract.

Key words: Vascular cell adhesion molecules-1, Cataract, Diabetes mellitus with cataract
图1 实验1组中房水血管细胞粘附分子-1的浓度与晶状体核性混浊的箱式图　1~3依次代表晶状体的混浊程度，数值越大代表加重越明显
表1 两组房水中各细胞因子浓度与白内障分期的相关性结果
组别 眼数 相关性 白细胞介素-8 白细胞介素-10 血管内皮生长因子 重组人碱性成纤维细胞生长因子 血管细胞粘附分子-1 人血管内皮细胞生长因子B 胎盘生长因子
皮质混浊                  
  实验1组 14 r 0.393 0.14 0.41 0.35 0.47 0.22 0.19
      P >0.05 >0.05 >0.05 >0.05 >0.05 >0.05 >0.05
  实验2组 35 r 0.15 -0.2 -0.03 0.24 -0.22 -0.02 0.14
      P >0.05 >0.05 >0.05 >0.05 >0.05 >0.05 >0.05
核性混浊                  
  实验1组 14 r -0.24 0.06 -0.33 -0.61 0.00 -0.38 0.02
      P >0.05 >0.05 >0.05 <0.05 >0.05 >0.05 >0.05
  实验2组 35 r -0.16 -0.02 -0.16 -0.28 -0.28 -0.04 0.15
      P >0.05 >0.05 >0.05 >0.05 >0.05 >0.05 >0.05
后囊下混浊                  
  实验1组 14 r -0.38 -0.07 -0.02 -0.43 -0.28 -0.13 -0.06
      P >0.05 >0.05 >0.05 <0.05 >0.05 >0.05 >0.05
  实验2组 35 r -0.09 0.00 0.25 -0.29 -0.19 -0.05 0.11
      P >0.05 >0.05 >0.05 >0.05 >0.05 >0.05 >0.05
表2 两组房水中各细胞因子浓度的比较( ±s，pg/ml)
组别 眼数 白细胞介素-8 白细胞介素-10 血管内皮生长因子 重组人碱性成纤维细胞生长因子 血管细胞粘附分子-1 胎盘生长因子 人血管内皮细胞生长因子B
实验1组 14 31.69±0.41 5.2±0.41 47.27±20.58 17.28±4.11 416.50±310.66 17.85±6.70 65.54±26.89
实验2组 35 12.38±6.52 3.7±2.13 36.54±14.97 17.43±4.33 331.39±205.80 22.21±17.47 74.36±26.75
t/z   -3.75b -1.63b -2.03a -0.20b -0.95a -0.40b -1.11b
P值   <0.05 >0.05 <0.05 >0.05 >0.05 >0.05 >0.05
表3 两组血清中各细胞因子浓度与白内障分期的相关性结果
组别 眼数 相关性 白细胞介素-8 白细胞介素-10 血管内皮生长因子 重组人碱性成纤维细胞生长因子 血管细胞粘附分子-1 人血管内皮细胞生长因子B
皮质混浊                
  实验1组 14 r -0.03 -0.10 0.26 0.04 -0.32 -0.19
      P >0.05 >0.05 >0.05 >0.05 >0.05 >0.05
  实验2组 35 r 0.15 0.13 -0.15 -0.11 0.11 -0.18
      P >0.05 >0.05 >0.05 >0.05 >0.05 >0.05
核性混浊                
  实验1组 14 r 0.21 0.53 0.20 0.13 -0.12 0.16
      P >0.05 >0.05 >0.05 >0.05 >0.05 >0.05
  实验2组 35 r -0.06 0.03 -0.01 -0.20 0.09 0.20
      P >0.05 >0.05 >0.05 >0.05 >0.05 >0.05
后囊下混浊                
  实验1组 14 r 0.39 0.02 -0.11 -0.20 -0.13 0.03
      P >0.05 >0.05 >0.05 <0.05 >0.05 >0.05
  实验2组 35 r 0.13 0.09 0.32 0.25 0.11 -0.10
      P >0.05 >0.05 >0.05 >0.05 >0.05 >0.05
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